Width of dental arches in patients with maxillary midline diastema

BACKGROUND

The aims of the study were as follows: (1) to examine the width of the dental arches of patients with maxillary midline diastema and compare it with control group; (2) to investigate the impact of the width of upper dental arch on the width of diastema.

MATERIALS AND METHODS

Diagnostic orthodontic plaster models of 102 patients with permanent dentition were studied. Patients were divided into two groups: study group with diastema and control group without diastema. Patients with severe malocclusion, craniofacial diseases, hypodontia and microdontia and pa-tients with periodontal disease were excluded. The transpalatal width of palate, premolar and molar arch widths in Pont's points of upper and lower jaw were measured using digital calliper. The results were statistically analysed.

RESULTS

Analysis showed a significant correlation between presence of diastema and premolar and molar width of the dental arches for both upper and lower jaw. Studied widths were larger in patients with diastema compared to the group without diastema. Analysis of the transpalatal width showed statistically significant differences between the study group and the control group. Analysis of widths of diastema and transpalatal widths showed that there was not statistically sig-nificant correlation.

CONCLUSIONS

Patients with diastema had increased in size in both the premolar and molar width of the dental arches. Increase the width affect to both upper and lower dental arch. Patients with diastema also were characterised by often occurrence of normal or increased of the transpalatal width but the width of the diastema did not correlate with the width of the palate. (Folia Morphol 2018; 77, 2: 340-344).

Craniofacial structure in patients with obstructive sleep apnoea

BACKGROUND

Obstructive sleep apnoea (OSA) is characterised by at least five 10-s episodes of apnoea or markedly shallow breathing per 1 h of sleep, which can lead to severe, sometimes life-threatening complications. It is essential to determine the specific features of the affected patients' craniofacial structure, thus enabling their allocation to risk groups. The aim of the study was to assess the craniofacial structure in OSA patients, comparing the findings with Hasund's and Segner's cephalometric normal values. In addition, the sagittal dimensions of the upper airways, measured at two levels, were compared to McNamara's normal values.

MATERIALS AND METHODS

The study covered 41 patients diagnosed polysomno-graphically with OSA. Lateral cephalograms with cephalometric analysis and the measurements of the upper and lower sagittal dimensions of the upper airways were taken for each patient.

RESULTS

The only feature of the patents' facial skeleton that significantly diverged from the normal range was the SNB angle (p = 0.004). Other angles, i.e. SNA, ANB, NL/NSL, NL/ML and NSL/ML, were not significantly different from normal. The average upper cross-sectional area of the upper airways was 10.4 mm; in 97.6% patients, this measurement was below McNamara's normal values. In the majority of patients (75.6%), the average lower sagittal dimension of the upper airways (10.4 mm) was also below the normal.

CONCLUSIONS

Mandibular retrognathia, manifested by the reduced SNB angle, and the narrowed upper and lower sagittal dimensions of the upper airways can be considered one of OSA prognostic factors.

Nucleotide Variants of the BH4 Biosynthesis Pathway Gene GCH1 and the Risk of Orofacial Clefts

A deficiency of GTP cyclohydrolase, encoded by the GCH1 gene, results in two neurological diseases: hyperphenylalaninaemia type HPABH4B and DOPA-responsive dystonia. Genes involved in neurotransmitter metabolism and motor systems may contribute to palatogenesis. The purpose of the study was to analyse polymorphic variants of the GCH1 gene as risk factors for non-syndromic cleft lip with or without cleft palate (NSCL/P). Genotyping of nine polymorphisms was conducted in a group of 281 NSCL/P patients and 574 controls. The GCH1 variant rs17128077 was associated with a 1.7-fold higher risk for NSCL/P (95 %CI = 1.224-2.325; p = 0.001). We also found a significant correlation between the rs8004018 and rs17128050 variants and an increased risk of oral clefts (p trend = 0.003 and 0.004, respectively). The best evidence of the global haplotype association was observed for rs17128050 and rs8004018 (p corr = 0.0152). This study demonstrates that the risk of NSCL/P is associated with variants of the GCH1 gene related to BH4 metabolism and provides some evidence of the relationships between morphological/functional shifts in the central nervous system and orofacial clefts.

The size of anterior teeth in patients with gaps in the upper dental arch

BACKGROUND

The aim of this study was to assess the size of upper incisors and canines in patients with gaps in the upper dental arch, especially medium gap between upper central incisors.

MATERIALS AND METHODS

Diagnostic orthodontic models of 30 adult patients with full permanent dentition with diastema in the upper arch were studied. Patients with severe malocclusion, missing teeth and periodontal disease were excluded. Width-to-length (W/L) ratio of the clinical crown of the central, lateral incisors and canines for both sides was measured. Together 180 teeth were tested. The results were compared with the values indicated by Sterrett et al.

RESULTS

In all patients, the clinical crowns of central incisors were symmetrical. In most cases, a higher W/L ratio was found, which indicates that the clinical crowns of medial incisors were too broad in relation to the length. Lateral incisors: In most cases, the ratio was the same for the right and the left side; however, a few patients had asymmetry of lateral incisors. Most of the lateral incisors had higher W/L ratios, which means that the teeth were wider than they were long; some had reduced ratios and only in one case the ratio was proper. Canines were also asymmetrical, and none of the canine exhibited perfect proportions. The vast majority showed increased W/L ratio of the clinical crown. In several cases, the W/L ratio was decreased.

CONCLUSIONS

Patients with gaps between the teeth have abnormal W/L ratio of the clinical crowns of the upper front teeth. The values were increased in the majority of cases, which indicates that the front teeth were wider than they were long in patients with gaps. Moreover, despite the disturbed W/L proportions, central incisors remained symmetrical. In contrast, lateral incisors and canines more often exhibited asymmetries.

Evaluation of upper airways depth among patients with skeletal Class I and III

BACKGROUND

The aim of this study was to determine the value of upper and lower pharyngeal depth among patients with skeletal Class III malocclusion on lateral cephalograms, as well as to examine the relationship between SNA, SNB, and ANB angles, along with Wits appraisal and the cross-sectional value of upper airway space at the level of the soft palate and tongue base among patients with skeletal Class I and III.

MATERIALS AND METHODS

The material consisted of lateral cephalograms taken from 80 patients living in the Lubelskie voivodeship. The study group consisted of cephalograms of 50 patients with skeletal Class III malocclusion (17 male and 33 female), whereas the control group consisted of 30 roentgenograms of patients with Class I malocclusion with proper jaw to mandible relation (14 maleand 16 female). The study and the control group shared no statistically significant differences considering basic sociographic data such as gender (chi = 1.267, p = 0.26)and age (U = 727.5, p = 0.82). The upper and lower pharyngeal depths were assessed with the use of McNamara's method. Spearman's rho test, Mann--Whitney's U test, and chi test were used for statistical analysis.

RESULTS

Among both males and females the pharyngeal depths were greater considering patients with skeletal Class III in comparison to patients with Class Imalocclusion (p < 0.001). Furthermore, it was determined that the lower as well as the upper pharyngeal width is statistically significantly dependent on ANB and SNB angles and Wits appraisal (p < 0.001).

CONCLUSIONS

Pharyngeal width at the level of the soft palate and tongue base depends on skeletal class, namely ANB angle and Wits appraisal; it increases with the increase of SNB angle (forward movement of the mandible). The SNA angle (position of the maxilla) does not influence the anterior-posterior nasopharyngeal dimension.

[Reactions of school children to the appearance of teeth]

Using a questionnaire the author collected data from 170 school children aged 9 to 12 years. In 70% the children came from the families of intelligentsia and in 30% from working classes. The responses to the questionnaire made possible establishing the number of children given nicknames, establishing the cause of the nickname and reaction to it. The own opinion of own appearance was presented by the children who were asked to answer the questions about the physical feature of own body with which they were dissatisfied and which they would like to change. Nicknames of various origin had 72.12% of children. The most frequent were distortions of the first name or family name. No nickname referred to the appearance of teeth. In 81.75% of cases the children were not offended by the nicknames, but nicknames referring to physical features were usually disliked. In self-opinions on own appearance the children mentioned teeth as a feature which they would like to change as first.