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1.
Am J Orthod Dentofacial Orthop ; 156(2): 248-256.e2, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375235

RESUMEN

INTRODUCTION: The treatment options for adults with increased overbite are limited to dentoalveolar changes that camouflage the condition. Because of high relapse tendency, defining the problem area is important when creating a treatment plan. This study aimed to evaluate dentoskeletal morphology in skeletal Class I and II anomalies associated with Angle Class I, Class II Division 1 (Class II/1), and Class II Division 2 (Class II/2) malocclusions with increased overbite compared with normal occlusion. METHODS: Pretreatment cephalograms of 306 patients (131 men, 175 women; overall ages 18-45 years) were evaluated. Four groups were constructed. Three groups had increased overbite (>4.5 mm): group 1 (n = 96) skeletal Class I (ANB = 0.5°-4°), group 2 (n = 85) skeletal Class II (ANB >4.5°) with Class II/1; and group 3 (n = 79) skeletal Class II with Class II/2 malocclusion. Group 4 as a control (n = 46) skeletal Class I normal overbite. Dental and skeletal characteristics of the groups were compared by sex. For statistical evaluations, analysis of variance followed by Tukey post hoc, Mann-Whitney U, and Kruskall-Wallis tests were used. Additionally correlation coefficients between overbite and skeletal/dental parameters were calculated. RESULTS: Between sexes, with regard to skeletal parameters, the men had greater values in millimetric measurements, and the women had higher SN/GoGn values. Maxillary/mandibular molar heights and the mandibular incisor heights were higher in men. In group 1, decreased lower anterior facial height (LAFH), retrusive mandibular incisors, and increased interincisal degree were determined. The maxillary molars were intrusive, whereas the vertical position of the mandibular molars and incisors in both jaws were normal. In group 2, retrognathic mandible, increased LAFH and mandibular plane angle, extrusive maxillary/mandibular incisors, protrusive mandibular incisors, and decreased interincisal degree were found. In group 3, decreased LAFH, increased interincisal degree, and retrusive incisors in both jaws were determined. There were significant negative correlations between SN/GoGN, palatal plane, and overbite in group 2 and between ANS-SN and overbite in group 3, and positive correlation between interinsical angle and overbite in all increased overbite groups. CONCLUSIONS: Dental morphology seems to be the main factor of increased overbite. Differences between groups were related primarily to inclinations and vertical positions of the incisors, rather than molar positions.


Asunto(s)
Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase I/patología , Sobremordida/epidemiología , Sobremordida/patología , Adolescente , Adulto , Análisis de Varianza , Puntos Anatómicos de Referencia , Cefalometría , Femenino , Humanos , Incisivo/patología , Masculino , Maloclusión de Angle Clase III/patología , Mandíbula/patología , Maxilar/patología , Persona de Mediana Edad , Diente Molar/patología , Retrognatismo/patología , Factores Sexuales , Turquia , Adulto Joven
2.
Int. j. morphol ; 37(2): 744-751, June 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1002288

RESUMEN

During development, bony changes in the palate are reflected in the palatal rugae. Therefore, we hypothesized that the palatal dimensions (PD) influence the shape and number of palatal rugae (PR). The objectives were to record the palatal rugae characteristics (PRC) and palatal dimensions (intercanine distance (ICD), intermolar distance (IMD), palatal height (PH) and palatal area (PA) in Classes I, II and III malocclusion patients and investigate their interrelationship, and statistically examine the possibility of predicting PRC with the PD. Four hundred eighty-one pre-orthodontic study casts of healthy patients with normal palate anatomy were grouped as Classes I, II and III and scanned using 3D cast scanner. The PRC, ICD, IMD, PH, and PA were recorded digitally using 3D enabled software. The data was statistically analyzed. A strong statistically significant difference was observed between PA and number of straight and wavy rugae. ICD and the number of straight rugae were also related. A weak correlation exists between malocclusion classes and PA. The remaining rugae characteristics did not exhibit any relation with palatal dimensions. PA is positively related to the number of straight rugae and negatively related to the number of wavy rugae. Bigger palates have more straight rugae and less number of wavy rugae. A weak correlation between PA and Angle's class I malocclusion exists. We also propose that PA has a developmental association with the number and shape of PR.


Durante el desarrollo, los cambios óseos en el paladar se reflejan en las rugas palatinas. Por lo tanto, planteamos la hipótesis de que las dimensiones palatinas influyen en la forma y el número de las rugas palatinas. Los objetivos fueron registrar las características de las rugas palatinas y las dimensiones palatales (distancia intercanina, distancia intermolar, altura palatina y área palatina) en pacientes con maloclusión de clases I, II y III e investigar su interrelación, y examinar estadísticamente la posibilidad de predecir las características de las rugas palatinas con las dimensiones palatinas. Cuatrocientos ochenta y un estudios pre-ortodónticos de pacientes sanos con anatomía normal del paladar se agruparon como Clases I, II y III y se escanearon con un escáner de emisión 3D. La distancia intercanina, distancia inter molar, altura palatina y área palatina se registraron digitalmente utilizando el software 3D. Los datos se analizaron estadísticamente. Se observó una diferencia estadísticamente significativa entre la altura palatina y el número de rugas rectas y onduladas. Se registró también la distancia intercanina y el número de rugas rectas. Existe una correlación débil entre las clases de maloclusión y la altura palatina. Las características restantes de las rugas palatinas no mostraron ninguna relación con las dimensiones palatinas. El área palatina está relacionada positivamente con el número de rugas rectas y negativamente relacionada con el número de rugas onduladas. Los paladares más grandes tienen más rugas rectas y menor cantidad de rugas onduladas. Existe una correlación débil entre el área palatina y la clase I de maloclusión de Angle. También proponemos que el área palatina tiene una asociación de desarrollo con el número y la forma de rugas palatinas.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Adulto Joven , Paladar Duro/patología , Maloclusión/patología , Estudios Transversales , Estudio Observacional , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase III/patología
3.
Am J Orthod Dentofacial Orthop ; 155(4): 473-481, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30935602

RESUMEN

INTRODUCTION: The objective was to study the growth spurt of Class I subjects, focusing on the ability to predict the peak of the growth spurt of the maxillary (Co-A) and mandibular (Co-Pog) lengths from the maturational changes of the cervical vertebrae. METHODS: The longitudinal lateral cephalographs of 14 males (ages, 10-15 years) and 12 females (ages, 9-14 years) were selected from the Craniofacial Growth Studies Legacy Collection of the American Association of Orthodontists Foundation. The cephalographs were taken at regular 1-year intervals. A cervical vertebral maturation (CVM) method that divided skeletal maturation into 6 stages was used for growth prediction. Growth increments calculated for the annual age intervals were used to examine the diagnostic performance of the CVM method. RESULTS: In males, the most peaks for Co-Pog were detected in the CVM3-CVM4 interval in 7 males (50%); for Co-A, the most peaks were found in the CVM2-CVM3 interval in 7 males (50%). In females, the most peaks for both Co-Pog and Co-A were seen in the CVM2-CVM3 interval in 7 females (58%) and in 6 females (50%), respectively. The fewest peaks were detected in CVM4-CVM5 for both males and females. CONCLUSIONS: In Class I subjects with balanced anteroposterior jaw relationships, presence of CVM3 would indicate the peak of the growth spurt, and CVM2 would mean that the peak has not yet arrived. During CVM2, the shapes of cervical vertebrae 3 and 4, whether trapezoid or horizontal rectangular, would indicate whether the subject is in the early CVM2 or is about to be in CVM3.


Asunto(s)
Huesos Faciales/crecimiento & desarrollo , Maloclusión de Angle Clase I/patología , Cráneo/crecimiento & desarrollo , Adolescente , Cefalometría , Vértebras Cervicales/crecimiento & desarrollo , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Mandíbula/crecimiento & desarrollo , Maxilar/crecimiento & desarrollo
4.
Orthod Craniofac Res ; 22(1): 9-15, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30421852

RESUMEN

OBJECTIVES: To clarify the associations among tongue volume, hyoid position, airway volume and maxillofacial form using cone beam computed tomography (CBCT) data for children with Class-I, Class-II and Class-III malocclusion. SETTING AND SAMPLE POPULATION: Sixty children (mean age, 9.2 years) divided into Class-I, Class-II and Class-III malocclusion groups according to the A-nasion-B angle. MATERIAL AND METHODS: Cone beam computed tomography was used for three-dimensional reconstruction of the maxillofacial region and airway. The hyoid position and the tongue, airway and oral cavity volumes were evaluated. Upper airway ventilation status was calculated using computational fluid dynamics. The groups were compared using analysis of variance and Kruskal-Wallis tests; relationships among the parameters were assessed using Pearson's and Spearman's rank correlation tests. RESULTS: The tongue volume was larger in Class-III patients (50.63 cm3 ) than in Class-I patients (44.24 cm3 ; P < 0.05). The hyoid position was lower (49.44 cm), and anatomical balance (AB; tongue volume/oral cavity volume; 85.06%) was greater in Class-II patients than in Class-I patients (46.06 cm, 80.57%, respectively; P < 0.05 for both). The hyoid height showed a positive correlation with AB (r = 0.614; P < 0.001). CONCLUSIONS: Children with Class-III malocclusion have large tongue volumes and small AB; the reverse is true for children with Class-II malocclusion. The hyoid position is closely associated with AB in children with malocclusion.


Asunto(s)
Hueso Hioides/patología , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase I/patología , Nasofaringe/patología , Lengua/patología , Niño , Tomografía Computarizada de Haz Cónico , Cara/diagnóstico por imagen , Cara/patología , Femenino , Humanos , Hueso Hioides/diagnóstico por imagen , Imagenología Tridimensional , Masculino , Maloclusión de Angle Clase I/diagnóstico por imagen , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase III/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Maxilar/patología , Nasofaringe/diagnóstico por imagen , Estudios Retrospectivos , Lengua/diagnóstico por imagen
5.
Cranio ; 37(4): 214-222, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29327661

RESUMEN

OBJECTIVE: To assess changes in the tongue and hyoid bone positions and airway dimensions after maxillary protraction using lateral cephalograms. METHODS: Lateral cephalograms were obtained before (C0) and after (C1) an observation period for untreated children with skeletal Class I malocclusion and before (T0), immediately after (T1), and one year after (T2) maxillary protraction in children with skeletal Class III malocclusion. Cephalometric measurements were compared between the time points in both patient groups. RESULTS: Immediately after maxillary protraction, the tongue moved superiorly and the nasopharyngeal and superior oropharyngeal airway dimensions increased. No significant changes in the middle or inferior oropharyngeal airway dimensions or in the hyoid bone position were noted after treatment. CONCLUSIONS: Maxillary protraction improved tongue posture and modified the nasopharyngeal and superior oropharyngeal airway dimensions in patients with skeletal Class III malocclusion. Consequently, maxillary protraction may restore the intra- and extraoral balance and improve respiratory function.


Asunto(s)
Cefalometría/métodos , Hueso Hioides/patología , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/rehabilitación , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase I/rehabilitación , Maxilar , Faringe/patología , Lengua/patología , Tracción/métodos , Niño , Aparatos de Tracción Extraoral , Femenino , Humanos , Masculino , Maloclusión de Angle Clase I/diagnóstico , Maloclusión de Angle Clase III/diagnóstico , Factores de Tiempo , Tracción/instrumentación
6.
J Contemp Dent Pract ; 19(6): 712-718, 2018 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-29959301

RESUMEN

AIM: The study was conducted to assess facial asymmetry in various dental malocclusions and to determine asymmetry in lower, mid, and upper face and jaws using posteroanterior cephalometric analysis. MATERIALS AND METHODS: Overall, 120 posteroanterior cepha-lograms were taken of individuals between 12 and 25 years of both sexes, and were divided into four groups: Angle's class I excellent occlusion, Angle's class I malocclusion, Angle's class II malocclusion, and Angle's class III malocclusion. These cepha-lograms were traced and Grummon's analysis was performed. RESULTS: In Angle's class I occlusion and Angle's class II malocclusion, the results obtained showed asymmetry present in the upper face. Correlation was found between occlusion, maloc-clusion, and facial asymmetry. CONCLUSION: Facial asymmetry was found in all dental occlusions whether excellent or malocclusion group, with maximum asymmetry having upward trend toward upper face starting from lower. CLINICAL SIGNIFICANCE: For the success of the orthodontic treatments in various types of malocclusion and to determine the facial asymmetry, posteroanterior view can be very helpful, as it gives additional information which can be utilized to augment treatment planning and improve prognosis in terms of relapse prevention.


Asunto(s)
Asimetría Facial/diagnóstico , Maloclusión/patología , Adolescente , Adulto , Cefalometría , Niño , Cara/patología , Asimetría Facial/patología , Femenino , Humanos , Maxilares/patología , Masculino , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase III/patología , Adulto Joven
7.
BMC Oral Health ; 18(1): 109, 2018 06 19.
Artículo en Inglés | MEDLINE | ID: mdl-29921259

RESUMEN

BACKGROUNDS: The occlusal registration of virtual models taken by intraoral scanners sometimes shows patterns which seem much different from the patients' occlusion. Therefore, this study aims to evaluate the accuracy of virtual occlusion by comparing virtual occlusal contact area with actual occlusal contact area using a plaster model in vitro. METHODS: Plaster dental models, 24 sets of Class I models and 20 sets of Class II models, were divided into a Molar, Premolar, and Anterior group. The occlusal contact areas calculated by the Prescale method and the virtual occlusion by scanning method were compared, and the ratio of the molar and incisor area were compared in order to find any particular tendencies. RESULTS: There was no significant difference between the Prescale results and the scanner results in both the molar and premolar groups (p = 0.083 and 0.053, respectively). On the other hand, there was a significant difference between the Prescale and the scanner results in the anterior group with the scanner results presenting overestimation of the occlusal contact points (p < 0.05). In Molars group, the regression analysis shows that the two variables express linear correlation and has a linear equation with a slope of 0.917. R2 is 0.930. Groups of Premolars and Anteriors had a week linear relationship and greater dispersion. CONCLUSIONS: Difference between the actual and virtual occlusion revealed in the anterior portion, where overestimation was observed in the virtual model obtained from the scanning method. Nevertheless, molar and premolar areas showed relatively accurate occlusal contact area in the virtual model.


Asunto(s)
Modelos Dentales , Oclusión Dental , Imagenología Tridimensional , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase I/patología , Adulto , Humanos , Técnicas In Vitro , Maloclusión de Angle Clase I/diagnóstico por imagen , Maloclusión de Angle Clase II/diagnóstico por imagen , Interfaz Usuario-Computador
8.
J Contemp Dent Pract ; 19(5): 515-520, 2018 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-29807960

RESUMEN

AIM: The purpose of this study was to assess the arch width, transverse discrepancy, and transverse interarch ratio for class I malocclusion sample, with and without crossbite, in permanent dentition stage. MATERIALS AND METHODS: Records of class I malocclusion patients with minimal crowding and spacing with and without posterior crossbite were selected. Each group consisted of 40 pairs of dental casts (20 males and 20 females). Arch widths were measured for the canine, first, and second premolars, and first permanent molars using the buccal approach. Means and standard deviations (SDs) of dental arch widths were measured for the maxillary and mandibular arches, and the interarch width ratio was calculated. RESULTS: There was a highly significant difference between the noncrossbite and crossbite groups regarding the maxillary width, p < 0.001. However, no differences were found between groups for the mandibular widths, p > 0.01. There were also significant differences between both groups for the intercanine, first and second premolars, and first molar ratios, p < 0.001. CONCLUSION: This new simple method showed that a transverse maxillary-mandibular ratio of 1:1.1 is ideal. A ratio less than 1:0.9 will indicate the presence of crossbite. CLINICAL SIGNIFICANCE: The interarch ratio significantly aids in orthodontic treatment planning in patients requiring maxillary expansion and/or surgical cases.


Asunto(s)
Cefalometría/métodos , Arco Dental/patología , Maloclusión de Angle Clase I/patología , Diente Premolar , Diente Canino , Dentición Permanente , Femenino , Humanos , Masculino , Mandíbula/patología , Maxilar/patología , Diente Molar
9.
Angle Orthod ; 88(5): 552-559, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29809053

RESUMEN

OBJECTIVES: The aim of this study was to assess three-dimensionally the upper airway changes following functional appliance treatment in growing Class II patients. MATERIALS AND METHODS: Pre-and post-treatment Cone beam computed tomography scans of 20 patients (age range: 9 to 12; mean: 11.4 ± 1.0 years) were retrieved from the list of patients previously treated with functional appliances in the Postgraduate Clinic at the Section of Orthodontics, Aarhus University, Denmark. Total and partial volumes of the upper airway (ie, lower nasopharynx, velopharynx, and oropharynx) were calculated. To rule out the effect of growth, the changes in the functional appliance group were compared to an age-matched Class I group of 18 patients (age range: 8 to 14; mean: 11.8 ± 1.4 years). RESULTS: In the functional appliance group, all the partial and total volumes were significantly larger at the end of treatment when compared to the start of treatment ( P < .003). On the other hand, when comparing the changes for the total and partial volumes of the upper airway in the functional appliance group with the Class I group, a statistical difference was seen only for the oropharynx ( P = .022) and total volume ( P = .025), with the functional appliance group showing a larger volume increment. CONCLUSIONS: An increase in the upper airway volume was found after treatment with functional appliances. This difference was mainly related to the changes at the oropharynx level, which differed significantly from what was observed in the Class I group.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Avance Mandibular , Aparatos Ortodóncicos Funcionales , Faringe/patología , Adolescente , Niño , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Hipofaringe/diagnóstico por imagen , Hipofaringe/patología , Imagenología Tridimensional , Masculino , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Avance Mandibular/métodos , Orofaringe/diagnóstico por imagen , Orofaringe/patología , Faringe/diagnóstico por imagen , Estudios Retrospectivos
10.
Indian J Dent Res ; 29(2): 137-143, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29652003

RESUMEN

Introduction:: Soft-tissue analysis has become an important component of orthodontic diagnosis and treatment planning. Photographic evaluation of an orthodontic patient is a very close representation of the appearance of the person. The previously established norms for soft-tissue analysis will vary for different ethnic groups. Thus, there is a need to develop soft-tissue facial profile norms pertaining to Indian ethnic groups. Aim and Objectives:: The aim of this study is to establish the angular photogrammetric standards of soft-tissue facial profile for Indian males and females and also to compare sexual dimorphism present between them. Materials and Methods: The lateral profile photographs of 300 random participants (150 males and 150 females) between ages 18 and 25 years were taken and analyzed using FACAD tracing software. Inclusion criteria were angles Class I molar occlusion with acceptable crowding and proclination, normal growth and development with well-aligned dental arches, and full complements of permanent teeth irrespective of third molar status. This study was conducted in Indian population, and samples were taken from various cities across India. Descriptive statistical analysis was carried out, and sexual dimorphism was evaluated by Student's t-test between males and females. Results: The results of the present study showed statistically significant (P < 0.05) gender difference in 5 parameters out of 12 parameters in Indian population. Conclusion: In the present study, soft-tissue facial measurements were established by means of photogrammetric analysis to facilitate orthodontists to carry out more quantitative evaluation and make disciplined decisions. The mean values obtained can be used for comparison with records of participants with the same characteristics by following this photogrammetric technique.


Asunto(s)
Cara/anatomía & histología , Adolescente , Adulto , Cefalometría , Femenino , Humanos , India , Masculino , Maloclusión de Angle Clase I/patología , Fotogrametría , Fotografía Dental , Factores Sexuales , Adulto Joven
11.
BMC Oral Health ; 18(1): 45, 2018 03 16.
Artículo en Inglés | MEDLINE | ID: mdl-29548316

RESUMEN

BACKGROUND: The purpose of this study was to determine and compare the shapes, sizes, and bridging of the sella turcica in patients with different skeletal patterns and genders. METHODS: It was a cross-sectional comparative study. The samples were divided into three groups according to the skeletal pattern viz. Class I, Class II and Class III, and each group consisted of 40 samples (20 males and 20 females). The lateral cephalograms were traced and the sella turcica was assessed for its size, shape, and bridging. RESULTS: The mean length, anteroposterior diameter and depth of sella turcica were 8.13 ± 2.03 mm, 9.60 ± 1.43 mm and 6.40 ± 1.21 mm respectively. The mean length of sella turcica was 7.91 ± 1.52 mm in Class I, 7.32 ± 1.62 mm in Class II and 9.16 ± .2.42 in Class III skeletal pattern; anteroposterior diameter was 9.30 ± 1.02 mm in Class I, 9.15 ± 1.28 mm in Class II and 10.35 ± 1.64 mm in Class III skeletal pattern; and the depth was 6.40 ± 0.92 mm in Class I, 6.07 ± 1.01 mm in Class II and 6.74 ± .1.54 mm in Class III skeletal pattern. There were significant differences in length and anteroposterior diameter and sella turcica between Class I, Class II and Class III skeletal patterns (p = 0.01), (p = 0.01) respectively. There was no significant difference in size of sella turcica between different genders and age groups. Sixty percent of the patients studied had normal Sella morphology. Partial Sella turcica bridging and Sella turcica bridging was seen in this study in 23.33% and 11.67% of patients respectively. CONCLUSION: Sixty percent of the patients had normal sella turcica. There were significant differences in lengths and anteroposterior diameters among Class I, Class II and Class III patients. The larger size was present in skeletal Class III patients.


Asunto(s)
Maloclusión/patología , Silla Turca/patología , Adolescente , Adulto , Factores de Edad , Estudios Transversales , Femenino , Humanos , Masculino , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase III/patología , Radiografía , Silla Turca/diagnóstico por imagen , Factores Sexuales , Adulto Joven
12.
Am J Orthod Dentofacial Orthop ; 153(1): 36-45, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29287646

RESUMEN

INTRODUCTION: Our objective was to investigate craniofacial morphology in women with Class I occlusion and maxillary anterior crowding (MxAC) with bilateral palatal displacement of the lateral incisors and facial displacement of the canines. METHODS: Thirty-three women with normal occlusion (mean age, 20.7 ± 2.3 years) were selected as the control group, and 33 women with severe MxAC (mean age, 23.3 ± 3.8 years) with bilateral palatal and facial displacement of the lateral incisors and canines, respectively, were selected as the MxAC group. Mesiodistal tooth crown diameter, arch length discrepancy, facial-palatal displacement of lateral incisors and canines, and dental arch dimensions were measured. Fourteen skeletal and 10 dental cephalometric measurements were made. Medians, interquartile ranges, means, and standard deviations were calculated for each parameter, and the nonparametric Mann-Whitney U test (P <0.05) was used to compare the 2 groups. RESULTS: Compared with the control group, the MxAC group showed a significantly wider angle (P <0.05) and shorter length (P <0.01) in the cranial base, a smaller sagittal maxillary base (P <0.01), and a hyperdivergent skeletal pattern (P <0.01 and P <0.05). CONCLUSIONS: Women with Class I occlusion and severe MxAC exhibited a significantly wider angle and shorter length in the cranial base, a smaller sagittal maxillary base, and a hyperdivergent skeletal pattern. These skeletal and dental characteristics and cranial base dysmorphology may be helpful as potential indicators for orthodontic treatment with extractions.


Asunto(s)
Cefalometría , Cara/anatomía & histología , Maloclusión de Angle Clase I/patología , Cráneo/anatomía & histología , Estudios Transversales , Diente Canino , Femenino , Humanos , Incisivo , Maxilar , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Adulto Joven
13.
Angle Orthod ; 88(2): 195-201, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29215300

RESUMEN

OBJECTIVES: To evaluate prevalence, distribution, and sexual dimorphism of dental anomalies (DA) among different skeletal malocclusions (SM) and growth patterns (GP) under the hypothesis that specific clinical patterns exist and may indicate common etiological roots. MATERIALS AND METHODS: A total of 1047 orthodontic records of patients older than 8 years were evaluated. The SN-GoGn angle was used to classify GP (hypodivergent, normal, and hyperdivergent), and the ANB angle was used to verify SM (Angle Classes I, II, and III). These assessments were done from lateral cephalometric radiographs. DA were diagnosed using panoramic radiographs by one calibrated investigator. Odds ratios, chi-square, and Student's t-tests were used. RESULTS: Of the subjects, 56.7% were female, with mean age of 16.41 (±10.61) years. The prevalence of DA was 15.7%. Impaction and tooth agenesis were the most prevalent DA, with relative frequencies of 14.4% and 9.7%, respectively. DA were most prevalent in Class III SM (80.8%) and in hypodivergent GP (82.5%), although this was not statistically significant. Tooth agenesis ( P < .01) and microdontia ( P = .025) were significantly more common among hypodivergent GP and Class III SM, respectively. CONCLUSIONS: The results of this study support the idea that DA are preferentially associated with certain patterns of malocclusion.


Asunto(s)
Maloclusión/etiología , Anomalías Dentarias/complicaciones , Adolescente , Adulto , Cefalometría , Niño , Femenino , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Maloclusión/patología , Maloclusión de Angle Clase I/etiología , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/etiología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase III/etiología , Maloclusión de Angle Clase III/patología , Radiografía Dental , Radiografía Panorámica , Anomalías Dentarias/diagnóstico por imagen , Anomalías Dentarias/patología , Diente Impactado/complicaciones , Diente Impactado/patología , Adulto Joven
14.
Eur J Orthod ; 40(2): 206-213, 2018 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-29016736

RESUMEN

Aim: To investigate the long-term (≥15 years) post-treatment (Tx) occlusal changes and outcome quality after Class II:1 Tx. Subjects and Methods: Herbst-MBA Tx had been performed at age 12.8 ± 2.7 years in 119 patients. A recall was conducted and study models from before and after active Tx, after retention as well as after recall were evaluated using standard occlusal variables and the PAR index. These data were compared to 31 untreated Class I controls. Results: 52 out of 119 patients could be located and participated at 33.6 ± 3.1 years. Compared to the 67 patients who did not participate in the recall, the pre- and post-Tx occlusal data of the participants did not differ systematically; however, the PAR scores were higher by 3.0-4.7 points at all times. Pre-Tx, the mean values of the 52 participants were: PAR = 27.2 ± 7.6, Class II molar relationship (MR) = 0.7 cusp widths (cw), overjet = 8.2 mm, overbite = 4.1 mm. After Tx, the PAR score was 3.4 ± 2.2. A Class I MR (0.0 ± 0.1 cw) with normal overjet (2.3 ± 0.7 mm) and overbite (1.3 ± 0.7 mm) existed. At recall, a mild PAR score increase to 8.2 ± 5.5 points had occurred; this was mainly due to increased overjet and overbite values (3.6 ± 1.1 and 2.8 ± 1.6 mm) while the MR was stable (0.0 ± 0.2 cw). For all these variables, similar findings were made in the untreated controls. Conclusion: The occlusal outcome of Class II:1 Tx showed very good long-term stability. While mild changes occur post-Tx, the long-term result is similar to untreated Class I controls.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Adolescente , Cefalometría/métodos , Niño , Oclusión Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Aparatos Ortodóncicos Funcionales , Ortodoncia Correctiva/instrumentación , Ortodoncia Correctiva/métodos , Sobremordida/terapia , Resultado del Tratamiento
15.
Prog Orthod ; 18(1): 44, 2017 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-29250718

RESUMEN

BACKGROUND: In the long-lasting debate of extraction versus non-extraction treatment, the impact of extractions on the skeletal vertical dimension remains rather unclear. The aim of this retrospective research study was to obtain a bias-free sample of morphologically similar borderline patients treated with or without extraction of the four first premolars and to retrospectively evaluate the vertical changes that occurred. METHODS: A borderline sample of 83 patients, 41 treated with four first premolar extractions and 42 treated without, was obtained by means of discriminant analysis applied to a previously investigated parent sample of 542 class I patients. The pretreatment and posttreatment cephalometric radiographs were analyzed digitally, and seven measurements were assessed for vertical skeletal changes. Also, average tracings between the two treatment groups were evaluated using the Procrustes superimposition method. RESULTS: The variables of SN to Go-Gn and Y-axis showed adjusted intergroup differences of - 0.91° and - 1.11° (P = 0.04). Comparing the mean intra-group differences of all the variables simultaneously, a significant difference was found between the two treatment groups (overall P value = 0.04). In the extraction group, only the gonial angle showed a significant decrease (P = 0.01) while the overall P value evaluating the intra-group differences between pre- and posttreatment was significant (overall P value < 0.01). In the non-extraction group, the variable of N-ANS/N-Me showed a significant decrease (P = 0.02) and the overall P value evaluating the intra-group differences between pre- and posttreatment was also significant (overall P value < 0.01). Differences in treatment duration were assessed using a log-normal model and showed that extraction treatment lasted significantly longer than non-extraction treatment (P < 0.01). CONCLUSIONS: The borderline group of patients identified by the discriminant analysis exhibited similar morphological characteristics at treatment's onset; therefore, the posttreatment changes could safely be attributed to the choice of extraction or non-extraction treatment and not to pre-existing differences. Treatment choice had an impact on the patients' vertical skeletal dimensions. Patients treated with four first premolar extractions showed a slight decrease in the vertical skeletal measurements, whereas non-extraction patient treatment showed a slight increase. The treatment time was also significantly higher in the extraction group.


Asunto(s)
Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase I/terapia , Extracción Dental , Dimensión Vertical , Adolescente , Diente Premolar , Cefalometría , Niño , Análisis Discriminante , Femenino , Humanos , Masculino , Maloclusión de Angle Clase I/diagnóstico por imagen , Radiografía Panorámica , Factores de Tiempo
16.
Int. j. morphol ; 35(4): 1422-1428, Dec. 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-893152

RESUMEN

SUMMARY: The objectives of the study were to, 1. Compare the accuracy of four methods of acquisition of palatal rugae (PR) characteristics (PRC). 2. Study the predominant PRC in Angles Class 1, 2, and 3 malocclusions. 3. To statistically correlate the predominant PRC with Class 1, 2 & 3 malocclusions and thus explore the possibility of utilizing it in predicting malocclusions. Study casts and intraoral 3D scan images (3Shape® Intra-Oral Scanner) of the palate of 104 healthy orthodontic patients were included as Group I and Group II respectively. The casts of Group I were scanned using 3Shape® (Group III) and Sirona inEos X5® (Group IV) cast scanners. PRC for all groups were recorded and PRC of Group I was compared with PRC of Groups II, III and IV for possible matching. 3D images of Group IV were further divided according to Angles classification and predominant PRC analyzed. 97.8 % of PRC match was observed in Group I and Group IV. Wavy and complex rugae were predominant in Class 1 and 3 malocclusions and showed statistically significant difference between Class 1, 2 and 3 malocclusions (p=0.00 and 0.014 respectively) with wavy being higher in Class 1 and complex being higher in Class 3 (LSD Post Hoc analysis). Direct intraoral 3D scanning and 3D scanning of the palatal area of casts are equally reliable methods for PR acquisition for examining PRC. All PRC considered together have a minimal impact on prediction of malocclusions, however, influence of wavy characteristic was maximum.


RESUMEN: Los objetivos del estudio fueron los siguientes: 1. Comparar la precisión de cuatro métodos de adquisición de las características de la rugosidad palatina (CRP). 2. Estudiar las CRP predominantes en maloclusiones clases 1, 2 y 3. 3. Correlacionar estadísticamente las CRP predominantes con maloclusiones clase 1, 2 y 3 e investigar la posibilidad de utilizarlas en la predicción de maloclusiones. Se incluyeron en el Grupo I y en el Grupo II, los moldes de estudio y las imágenes de barrido 3D intraoral (3Shape® Intra-Oral Scanner) del paladar de 104 pacientes ortodónticos sanos. Los escaneos del Grupo I se escanearon utilizando escáner fundidos 3Shape® (Grupo III) y Sirona inEos X5® (Grupo IV). CRP para todos los grupos se registraron y CRP del Grupo I se comparó con las CRP de los Grupos II, III y IV para una posible coincidencia. Las imágenes 3D del Grupo IV se dividieron de acuerdo con la clasificación de ángulos y las CRP predominantes analizadas. Se observó un 97,8 % de concordancia en CRP en los grupos I y IV. Las rugas onduladas y complejas predominaron en las maloclusiones de Clases 1 y 3 y mostraron diferencias estadísticamente significativas entre las maloclusiones de Clases 1, 2 y 3 (p = 0,00 y 0,014 respectivamente), siendo el ondulado más alto en la Clase 1 y el complejo en la Clase 3 (LSD Post Hoc). El escaneo 3D intraoral directo y el escaneado 3D del área palatal son métodos igualmente confiables para la adquisición de CRP para el examen de las CRP. Todas las CRP consideradas en conjunto tienen algún grado de impacto en la predicción de las maloclusiones, sin embargo, fue mayor la influencia de la característica ondulada.


Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Maloclusión/patología , Paladar Duro/anatomía & histología , Imagenología Tridimensional , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase I/patología
17.
Am J Orthod Dentofacial Orthop ; 152(3): 371-381, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28863918

RESUMEN

INTRODUCTION: Patients with cleft lip and palate (CLP) suffer from several esthetic and functional challenges. Comprehensive treatment of these patients involves orthognathic surgery that may lead to velopharyngeal insufficiency or reduction in lower airway. Several cases of airway insufficiency, velopharyngeal incompetence, snoring, hypopnea, and obstructive sleep apnea have been reported in subjects with CLP. The aim of this study was to compare the anteroposterior dimensions of the oropharyngeal airway at 5 levels, the height of the oropharyngeal column, and the volume of the oropharyngeal airway in subjects with and without CLP. METHODS: The sample consisted of 62 patients with CLP and 42 subjects with Angle Class I malocclusion. Anteroposterior dimension, height, and volume of the oropharyngeal airway were measured using the midsagittal and axial slices obtained from 3-dimensional digital volume tomographic scans for both groups. RESULTS: The anteroposterior dimensions of the airway were significantly reduced in the study subjects compared with the control group at the level of the postnasal spine, the base of the tongue, and the epiglottis. The airway dimensions measured on the axial sections at the level of the palatal and epiglottic plane were also significantly lower in the study group. The height and volume of the oropharyngeal airway were also significantly smaller in patients with CLP compared with subjects without CLP. CONCLUSIONS: Patients with CLP showed reduced dimensions and volumes of the oropharyngeal airway in all 3 planes compared with the control group.


Asunto(s)
Labio Leporino/patología , Fisura del Paladar/patología , Orofaringe/patología , Adolescente , Estudios de Casos y Controles , Niño , Labio Leporino/diagnóstico por imagen , Fisura del Paladar/diagnóstico por imagen , Femenino , Humanos , Imagenología Tridimensional/métodos , Masculino , Maloclusión de Angle Clase I/diagnóstico por imagen , Maloclusión de Angle Clase I/patología , Orofaringe/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adulto Joven
18.
Int. j. morphol ; 35(3): 1133-1139, Sept. 2017. ilus
Artículo en Inglés | LILACS | ID: biblio-893105

RESUMEN

The aim of this study was to quantify the presence of cortical and cancellous bone in the mandibular symphysis. A descriptive study was conducted using cone beam computed tomography where skeletal class I and class III subjects were included, defined according to characteristics detected on dental, clinical and dental occlusion x-rays. From the 3D reconstruction, sections were used in relation to the axial axis of the teeth of the anterior sector; the amount of buccal cortical, cortical, lingual, inferior cortical and cancellous bone as well as symphysis height were determined. The measurements were taken using routine methods and analyzed with ANOVA and Tukey's HSD test with p <0.05 for statistical significance. 20 skeletal class I subjects aged 23 years (± 4.5) and 20 class III subjects aged 22 years (± 5.2) were included. Symphysis height was significantly greater in skeletal class III subjects, exceeding by 0.8 mm the height of class I subjects; the buccal cortical bone presented on average 2 mm less at different dental levels, whereas the lingual cortical and inferior basal bones were significantly larger than the buccal cortical bone. The cancellous and cortical bones did not present any significant differences between the two groups (p=0.093). The buccal and basilar cortical bone is smaller than lingual cortical bone.


El objetivo fue determinar la presencia de hueso cortical y esponjoso en sínfisis mandibular. Se realizó un estudio descriptivo en tomografías computadorizadas cone beam donde se analizaron sujetos clase I y clase III esqueletal definidos según características dentales, clínicas y radiográficas de oclusión dental y características radiográficas. Desde la reconstrucción 3D se utilizaron cortes en relación al eje axial de los dientes del sector anterior; en ellos se determinó la cantidad de hueso cortical bucal, cortical, lingual, cortical inferior, hueso esponjoso y altura de sínfisis. Las mediciones fueron realizadas con métodos de rutina y fueron analizados con la prueba ANOVA y HDS Turkey considerando un valor de p <0.05 para considerar significancia estadística. 20 sujetos clase I esqueletal con 23 años (+ 4.5) y 20 sujetos clase III esqueletal con edad de 23 años (+ 4.5) fueron incluidos. La altura de sínfisis fue significativamente mayor en sujetos de clase III esqueletal, superando por 0.8 mm la altura de sujetos clase I; el hueso cortical bucal presento en promedio menor de 2 mm en diferentes niveles dentarios, mientras que la cortical lingual y basal inferior fueron significativamente mayor que la cortical bucal. El hueso esponjoso y hueso cortical no presentó diferencias significativas entre ambos grupos (p=0.093). La cortical bucal y basilar son menores que el hueso cortical lingual.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Mentón/patología , Hueso Esponjoso , Hueso Cortical , Mandíbula/patología , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase III/patología
19.
Am J Orthod Dentofacial Orthop ; 152(2): 242-249, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28760286

RESUMEN

INTRODUCTION: The Frankfort horizontal (FH) is a plane that intersects both porions and the left orbitale. However, other combinations of points have also been used to define this plane in 3-dimensional cephalometry. These variations are based on the hypothesis that they do not affect the cephalometric analysis. We investigated the validity of this hypothesis. METHODS: The material included cone-beam computed tomography data sets of 82 adult subjects with Class I molar relationship. A third-party method of cone-beam computed tomography-based 3-dimensional cephalometry was performed using 7 setups of the FH plane. Six lateral cephalometric hard tissue measurements relative to the FH plane were carried out for each setup. Measurement differences were calculated for each pair of setups of the FH plane. The number of occurrences of differences greater than the limits of agreement was counted for each of the 6 measurements. RESULTS: Only 3 of 21 pairs of setups had no occurrences for the 6 measurements. No measurement had no occurrences for the 21 pairs of setups. Setups based on left or right porion and both orbitales had the greatest number of occurrences for the 6 measurements. CONCLUSIONS: This investigation showed that significant and undesirable measurement differences can be produced by varying the definition of the FH plane.


Asunto(s)
Cefalometría/métodos , Tomografía Computarizada de Haz Cónico/métodos , Imagenología Tridimensional/métodos , Adolescente , Adulto , Puntos Anatómicos de Referencia/diagnóstico por imagen , Puntos Anatómicos de Referencia/patología , Huesos Faciales/diagnóstico por imagen , Huesos Faciales/patología , Femenino , Humanos , Masculino , Maloclusión de Angle Clase I/diagnóstico por imagen , Maloclusión de Angle Clase I/patología , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Radiografía Dental/métodos , Cráneo/diagnóstico por imagen , Cráneo/patología , Adulto Joven
20.
Am J Orthod Dentofacial Orthop ; 151(5): 914-920, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28457269

RESUMEN

INTRODUCTION: Our objective was to evaluate the craniofacial growth of subjects with untreated Class II Division 2 malocclusion. METHODS: A mixed longitudinal sample of 39 white Class II Division 2 subjects was analyzed at 5 time points: T1 (6 or 7 years), T2 (9 or 10 years), T3 (12 or 13 years), T4 (15 or 16 years), and T5 (18 or 19 years). They were compared with an age- and sex- matched sample of Class I controls. Seventeen measurements (12 angular, 5 proportional) were computed. Multilevel modeling procedures were used to statistically describe the growth changes and to evaluate group differences. RESULTS: There were no group differences in the relative sizes and anteroposterior positions of the jaws during childhood, adolescence, or early adulthood. Subjects with Class II Division 2 malocclusion demonstrated significantly (P <0.05) smaller mandibular plane angles, smaller palatal-to-mandibular plane angles, larger posterior-to-anterior facial height ratios, smaller gonial angles, smaller cranial base angles, larger interincisal angles, and more retroclined maxillary incisors than did the Class I subjects. The hypodivergent patterns were established early and became more pronounced over time. Group differences in the mandibular plane angle, palatal-to-mandibular plane angle, gonial angle, interincisal angle, and maxillary incisor-to-cranial base angle, as well as the posterior-to-anterior facial height ratio all increased over time; the difference in the cranial base angle remained unchanged over time. Retroclination of the maxillary incisors occurred primarily during the early mixed dentition. CONCLUSIONS: Subjects with Class II Division 2 malocclusion are more hypodivergent and have more upright maxillary incisors than do subjects with Class I occlusion. Hypodivergence establishes itself early and increases progressively through early adulthood; maxillary incisor retroclination occurs early.


Asunto(s)
Maloclusión de Angle Clase II/patología , Adolescente , Estudios de Casos y Controles , Cefalometría , Niño , Huesos Faciales/crecimiento & desarrollo , Huesos Faciales/patología , Femenino , Humanos , Incisivo/patología , Estudios Longitudinales , Masculino , Maloclusión de Angle Clase I/patología , Mandíbula/crecimiento & desarrollo , Mandíbula/patología , Maxilar/crecimiento & desarrollo , Maxilar/patología , Cráneo/crecimiento & desarrollo , Cráneo/patología , Adulto Joven
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