Esthetic preferences of orthodontists, dentists, and plastic surgeons for balanced facial profiles.

PURPOSE: The aim of this investigation was to determine whether the facial esthetics of subjects rated as "attractive" can be related to specific cephalometric soft tissue parameters. METHODS: The profile silhouettes of 100 subjects (45 males and 55 females) were rated by 60 esthetics specialists (20 orthodontists, 20 dentists, and 20 plastic surgeons) using a Likert scale, and 30 of the subjects were selected as being "attractive". The cephalometric measurements of the attractive group were then compared with norms for the general Caucasian population. RESULTS: The effects of specific measured parameters on profile beauty grades were assessed using the median test, and the following variables were found to show significant correlations between the Caucasian norms and the attractive profile group: the ratio of the upper to lower face height (P = 0.011), the ratio of the subnasale - labrale inferius (Sn-Li) and labrale inferius - menton (Li-Me`) lines (P = 0.011), the distance between the chin and the subnasale perpendicular (P = 0.002), upper lip thickness (P = 0.021), soft tissue chin thickness (P = 0.021), vertical height ratio (P = 0.021), and nasolabial angle (P = 0.021). CONCLUSION: A straight profile with a fuller and more protruded upper lip, a higher nasal tip, and a smaller lower facial third are considered to be the most attractive facial features, and may be useful for improvement of facial esthetics.

Reliability and validity of the Serbian version of Children's Dental Fear Questionnaire.

BACKGROUND/AIM: Dental anxiety leads to avoidance of dental treatment and could lead to impaired oral health. The aim of this study was to determine the reliability of the Serbian version of Children's Fear Survey Schedule Dental Subscale (CFSS-DS) and the relations between dental anxiety and oral health status in a sample of Serbian schoolchildren. METHODS: The CFSS-DS scale was translated into Serbian and administered to 231 (12-year old) patients of the Pediatric Dental Department, Public Health Center Cukarica, Belgrade. The number of healthy, decayed, missing and filled teeth (DMFT score) in children was determined by a clinical exam. RESULTS: The average CFSS-DS score was 26.47 ± 10.33. The girls reported higher anxiety than the boys (p < 0.05). Most common fears were drilling, choking, going to the hospital and anesthesia. Lower CFSS-DS scores were recorded in children with all healthy teeth (p < 0.05). Children with higher CFSS-DS scores mostly visit the dentist due to pain or parental insistence, and those with lower anxiety scores more often visited dentist due to regular check-ups or non-invasive treatments (p < 0.01). A high value of the Cronbach's coefficient of internal consistency (α = 0.88) was found in the entire scale. CONCLUSION: The Serbian version of CFSS-DS questionnaire is reliable and valid psychometric instrument for evaluation of dental fear in Serbian children. Dental anxiety negatively affects dental attendance and oral health of the examined schoolchildren.

Cephalometric assessment of maxillary length in Serbian children with skeletal class III.

BACKGROUND/AIM: Malocclusion of skeletal class III is a complex irregularity of sagittal inter-jaw relationship, which is due to irregularities of sagittal position of one or both of the jaw bones, which is often associated with disproportionate ratio of their length. The aim of this study was to determine whether the length of the jaw of children with skeletal class III in the period of mixed dentition was changed. METHODS: Fifty children with skeletal class III and the same number of those with skeletal class I, of both sexes, have been selected on the basis of cephalometric analysis of profile tele-x-ray of the head. All the children aged 6-12 had mixed dentition, and were divided according to sex and age into three subgroups within each group. The length of maxilla, mandible and cranial base were measured. Proportions among the lengths measured within each group were found and difference significance in the measured lengths and their proportions among groups and subgroups were evaluated. RESULTS: The children with skeletal class III, compared with the findings in the control group, had significantly lower values of maxillary length, total maxillary length, as well as lower values of their lengths in proportion to lengths of the front or the total length of cranial base and in proportion to mandibular lengths (p < 0.05). Among the patients of different sexes, both in the test and the control group, a significant difference in the values of the measured lengths was found. CONCLUSION: The children with skeletal class III have significantly shorter maxilla than those with skeletal class I.

[Analysis of variation of sagittal position of the jaw bones in skeletal Class III malocclusion].

BACKGROUND/AIM: Skeletal Class III malocclusion is a discrepancy in the sagittal jaw relationship, due to imbalances in their development and/or position, resulting in the dominant appearance of the lower jaw in facial profile. The aim of this study was to determine variations in the sagittal position of the jaw bones to the cranial base in subjects with skeletal Class III, for the earliest possible diagnosis of malocclusion. METHODS: Fifty children and as many adults with skeletal Class III, both sexes, were examined and selected, based on the findings of sagittal interjaw relationship (ANB) < or = 0 degrees from the cephalometric analysis of tele-x-ray profile head shots. The subjects were grouped according to age. The first group consisted of children aged 6-12 years, and another group, of adults aged 18-26 years. We measured the angles of maxillary prognathism (SNA), mandibular prognathism (SNB) and ANB. Based on these results, within the respective groups subclassification into the subgroups was done, among which a significant difference measured values was evaluated. In both groups a significant correlation of the determined values was evaluated. RESULTS: An average SNA angle ranged 77.36 +/- 3.58 in children and 77.32 +/- 4.88 in adults, while an average SNB angle was 79.46 +/- 3.91 in the group of children and 81.12 +/- 3.76 in adults. An average ANB angle was -2.10 +/- 2.07 in children, and -4.00 +/- 2.34 in adults. In both groups, a significant correlation between the measured values and a significant difference in the values of all the measured parameters were found between patients from different subgroups (p < 0.01). CONCLUSION: The most common morphological variation of sagittal position of the upper jaw is its retrognatism, which is equally present in both children and adults. Sagittal position of the lower jaw in most of the adults was prognathic, while mandible prognathism in the children was less present.

[Size of lower jaw as an early indicator of skeletal class III development].

BACKGROUND/AIM: Malocclusion of skeletal class III is a complex abnormality, with a characteristic sagital position of the lower jaw in front of the upper one. A higher level of prognatism of the lower jaw in relation to the upper one can be the consequence of its excessive length. The aim of this study was to find the differences in the length of the lower jaw in the children with skeletal class III and the children with normal sagital interjaw relation (skeletal class I) in the period of mixed dentition. METHODS: After clinical and x-ray diagnostics, profile tele-x-rays of the head were analyzed in 60 examinees with mixed dentition, aged from 6 to 12 years. The examinees were divided into two groups: group 1--the children with skeletal class III and group 2--the children with skeletal class I. The length of the lower jaw, upper jaw and cranial base were measured. The proportional relations between the lengths measured within each group were established and the level of difference in the lengths measured and their proportions between the groups were estimated. RESULTS: No significant difference between the groups was found in the body length, ramus and the total length of the lower jaw. Proportional relation between the body length and the length of the lower jaw ramus and proportional relation between the forward cranial base and the lower jaw body were not significantly different. A significant difference was found in proportional relations of the total length of the lower jaw with the total lengths of cranial base and the upper jaw and proportional relation of the length of the lower and upper jaw body. CONCLUSION: Of all the analyzed parameters, the following were selected as the early indicators of the development of skeletal class III on the lower jaw: greater total length of the lower jaw, proportional to the total lengths of cranial base and theupper jaw, as well as greater length of the lower jaw body, proportional to the length of the upper jaw body.

[Radiographic cephalometry assessment of the linear and angular parameters on cranial base in children with skeletal class III].

BACKGROUND/AIM: In malocclusion of skeletal class III, mandible is located in front of maxilla in sagital plain, which is manifested by a lower value of the sagital inter-jaw angle than in skeletal class I, where the jaw sagital relation is normal. Apart from the deformities on mandible and/or maxilla, in skeletal class III deformities are also frequent on the cranial base. The aim of this research was to find the differences in the parameter values on the cranial base among the children with skeletal class III and the children with skeletal class I in the period of mixed dentition. METHODS: After clinical examination and orthopan-tomography, profile radiography of the head was analyzed in 60 examinees, aged from 6-12 years. The examinees were divided into two groups: group 1--the children with skeletal class III; group 2--the children with skeletal class I. Both linear and angular parameters on the cranial base were measured, as well as the angles of maxillary and mandible prognatism and the angle of sagital inter-jaw relation. The level of difference in the parameter values between the groups was estimated and the degree of correlation of the main angle of the cranial base with the angles of sagital position of the jaws in each of the two groups was established. RESULTS: A significant difference between the groups was found only in the average values of the angles of maxillary prognatism and sagital inter-jaw relation. In the group 1, the main angle of the cranial base was in a significant correlation with the angles of sagital positions of the jaws, while in the group 2, such significance was not found. CONCLUSION: There were no significant differences in the parameter values on the cranial base between the groups. There was a significant correlation of the main angle of the cranial base with the angles of sagital position of the jaws in the group 1 only.

[Effects of orthodontic treatment after adenoidectomy on jaw relations in the sagittal plane].

AIM: To evaluate the orthodontic treatment effects, performed immediately after adenoidectomy, on lips relation, overjet and class (Angle). METHODS: Three groups of patients, aged 6-17 years, were observed: group K--patients with oral respiration caused by adenoidal enlargement; group 1--patients with adenoidectomy performed five and more years previously; group 2--patients with one year of orthodontic treatment performed immediately after adenoidectomy. Lips and overjet status and class (Angle) was measured in the examined patients. RESULTS: In all of the three examined groups, there was a statistically highly significant increase (p<0.01) of competent lips. In the patients of group K, the overjet values ranged from 1 mm up to 12 mm where 90% of them had overjet > 4 mm and 6% < 1 mm. The front open bite, low overbite and reversed overjet was found in the patients with low overjet in this group, as well. Overjet values in the patients of group 1 ranged from -2 mm up to 12 mm where 86% had overjet > 4 mm and 10% < 1 mm. Significantly higher increase (p<0.01) of overjet values (1-4 mm in 94% of patients) was observed in the patients of group 2 in comparison to the values found in the patients from groups 0 and 1. Class II (Angle) was recorded in 81% of the patients in group 0, and 79% in group 1, while class I (Angle) was observed 100% only in the patients of group 2. CONCLUSION: Orthodontic treatment immediately after adenoidectomy was necessary for achieving the competition lips relation, normal overjet and class I (Angle).

[Effects of adenoidectomy and immediate orthodonthic treatment on jaw relations and naso-respiratory rehabilitation]. / Efekti adenoidektomije i neposrednog ortodontskog lecenja na uskladenost vilica i rehabilitaciju nazalne respiracije.

AIM: To determine if adenoidectomy itself could provide spontaneous relation of the transverse growth of jaws as well as an adequate mode of breathing or if there is a need for an additional orthodontic treatment to solve the problem. METHODS: The study included one hundred and one patients aged 6-17 yrs., divided into three groups: group K--patients with oral respiration caused by adenoidal enlargement; group 1--patients with adenoidectomy done 5 or more years before; group 2--patients with orthodontic treatment done immediately after adenoidectomy. Transverse occlusion relation, the frequency of crossbite, and the intensity of nasal respiration were measured in all three groups of patients. RESULTS: The obtained results have shown that in the patients with adenoidal enlargement and oral respiration, there was an evidence of maxillary width reduction as opposed to mandibular width. Of the patients, 14% were with unilateral or bilateral crossbite. In the patients with adenoidectomy done 5 or more years before, transverse maxillary growth compared to mandibular one in the region of the front width, showed statistically significant increase (p < 0.05) as opposed to the patients with adenoidal enlargement. The effect of adenoidectomy on transverse maxillary growth was not satisfactory anyway, which was also indicated by the increase of frequency of crossbite in 24% of the patients with adenoidectomy done 5 or more years before. In operated on and in the patients one month after orthodontic treatment, transverse maxillary growth compared to mandibular growth in all the regions of both front and back width, there was statistically highly significant increase (p < 0.01) as opposed to the patients with adenoidal enlargement and adenoidectomy done many years before. Significant maxillary and mandibular transverse relation was obtained without the presence of crossbite. Nasal respiration prevailled. CONCLUSION: Orthodontic therapy one month after adenoidectomy was necessary for solving the orthodontic problems caused by adenoidal enlargement and significantly contributed to the rehabilitation of nasal respiration.