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1.
Am J Med Genet A ; 185(1): 46-49, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33030227

RESUMO

Retrognathia (recessed chin) and prognathism (prominent chin) often present as signs of an underlying condition. Accurate clinical definitions are important. Yet their definitions were according to "clinical impression", or to seldom used X-ray criteria. We propose a statistical and anthropometric definition of retrognathia and prognathism based upon the ratio between the goniomaxillar length (distance between the gonion at the mandible angle and the subnasale and the goniomandibular length (distance between the mandible angle and the most anterior point of the bony chin). We assumed that an increase in the ratio indicates retrognathia and a decrease reflects prognathism. We conducted a prospective, observational, anthropometric study in 204 consecutive healthy term infants. Measurements took place on the second day of life, using sliding calipers. Mean ± SD of goniomandibular length (5.1 ± 0.3 cm), goniomaxillar length (5.4 ± 0.3 cm), were calculated. All measurements correlated significantly with gestational age, and with infant birthweight. The mean ± SD goniomaxillar length/goniomandibular length ratio was 1.06 ± 0.05. We defined a normal ratio as being within 2 SD of the mean, that is, between 0.96 and and 1.16. This ratio correlated with neither gestational age nor with birthweight. We conclude that the goniomaxillar length/goniomandibular length ratio can be calculated whenever retro - or prognathism is suspected. A ratio outside of the 95% confidence interval should help in making this diagnosis. An increase in this ratio beyond 2 SD above the mean (1.16) could be interpreted as retrognathia and a decrease beyond 2 SD below the mean (0.96) as prognathism.


Assuntos
Cefalometria , Prognatismo/diagnóstico , Retrognatismo/diagnóstico , Adulto , Queixo/diagnóstico por imagem , Queixo/patologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Maxila/diagnóstico por imagem , Maxila/patologia , Mães , Prognatismo/diagnóstico por imagem , Prognatismo/patologia , Retrognatismo/diagnóstico por imagem , Retrognatismo/patologia
2.
Ann Anat ; 226: 3-9, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31336151

RESUMO

The purpose of this study was to evaluate the skeletal units of a normal mandible (class I) and a prognathic mandible (class III), to compare the groups, and to investigate the key functional unit responsible for mandibular prognathism. Hemi-mandibles of 101 cases were evaluated by cone-beam computed tomography. Of these, 50 cases had Class I and 51 had Class III mandibles. The length, volume, and volume/length ratio of each skeletal unit were measured. The ratios of the condyle, body unit, and sum of the hemi-mandible between Class I and Class III showed statistically significant results (P<0.05). However, the ratios of angle, coronoid, and symphysis units did not show any statistical significance on comparison. Dependent on gender, in males the ratio of the condyle of the hemi-mandible showed statistically significant results (P<0.05). Meanwhile in females the ratio of the body and sum of the hemi-mandible showed statistically significant results (P<0.05). Accordingly, the mandibular body and condylar units are thinner in mandibular prognathism. On the basis of the functional matrix theory to determine the aetiology of mandibular prognathism, the key skeletal units are the body and condylar units.


Assuntos
Mandíbula/patologia , Prognatismo/patologia , Esqueleto , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Masculino , Mandíbula/diagnóstico por imagem , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Prognatismo/diagnóstico por imagem , Reprodutibilidade dos Testes , Caracteres Sexuais , Adulto Jovem
3.
Am J Orthod Dentofacial Orthop ; 156(1): 104-112.e3, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256822

RESUMO

INTRODUCTION: Mandibular prognathism (MP) is subject to major polygenic influence and segregates within families in autosomal dominance with variable expressivity and incomplete penetrance. We aimed to identify the inheritance pattern and genes and loci involved in the development of MP in Mediterranean families and to evaluate the dentoskeletal characteristics of affected individuals. METHODS: Fifty-one eastern Mediterranean families with individuals affected by MP were identified. Data and biospecimens were collected from 14 of the families, including clinical examination, lateral cephalography (on subjects with Class III malocclusion), and 5 mL blood drawn from consenting affected and nonaffected relatives. Next-generation sequencing (NGS) was performed on 8 families (7 Lebanese, 1 Lebanese/Syrian), including large numbers of affected individuals over many generations and severe conditions, with the use of whole-exome sequencing. RESULTS: Most pedigrees suggested autosomal-dominant inheritance with an equal number of affected male and female individuals. Affected individuals had macrognathic and prognathic mandibles with dentoalveolar compensation. Genetic screening did not correspond with previously reported MP-linked genes, but yielded 3 novel genes (C1orf167, NBPF8, NBPF9) on chromosome 1 potentially responsible for mandibular development and macrognathism. CONCLUSIONS: In this first genetic study with the use of NGS on the largest reported number of families with MP, novel genes (C1orf167, NBPF8, NBPF9) were associated with familial MP in the eastern Mediterranean population.


Assuntos
Estudos de Associação Genética , Predisposição Genética para Doença/genética , Má Oclusão Classe III de Angle/genética , Prognatismo/genética , Adulto , Povo Asiático , Cefalometria , Cromossomos Humanos Par 1/genética , Feminino , Genoma Humano , Humanos , Líbano , Masculino , Má Oclusão Classe III de Angle/sangue , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/patologia , Pessoa de Meia-Idade , Linhagem , Prognatismo/sangue , Prognatismo/diagnóstico por imagem , Prognatismo/patologia , Análise de Sequência de DNA , Síria , Adulto Jovem
4.
J Oral Maxillofac Surg ; 76(5): 1095.e1-1095.e14, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29425750

RESUMO

PURPOSE: We sought to identify the hard tissue points and vectors that have the greatest effect on soft tissue movement after orthognathic surgery in patients with mandibular prognathism. PATIENTS AND METHODS: The present retrospective study involved patients who had undergone mandibular setback surgery with or without maxillary advancement. Multiple linear regression models were adapted to evaluate the association between the 8 hard tissue landmark (predictor variables) changes and 11 soft tissue responses (outcome variables) using the x and y coordinates assessed from superimposed pre- and postoperative 3-dimensional computed tomography images. RESULTS: A total of 50 patients (42 patients had undergone 2-jaw surgery; 8 patients had undergone 1-jaw surgery; mean age 23 ± 4 years) were included in the present study. Our statistical models demonstrated that the horizontal hard tissue changes had a greater influence on the soft tissue responses than did the vertical changes, and these changes were more notable in the lower facial area (lower lip contour and chin profile) than the midfacial area (nasal profile, upper lip contour, upper lip length, and nasolabial angle). In the horizontal soft tissue response model, the soft tissue A point/A point ratio was 0.86:1 (95% confidence interval [CI] 0.674-1.049); the soft tissue B point/B point ratio was almost 1:1 (95% CI 0.919-1.071); and the soft tissue pogonion/pogonion ratio was 0.88:1 (95% CI 0.805-0.963). CONCLUSIONS: Horizontal or vertical bone tissue changes affected both the horizontal and vertical soft tissue changes in most areas. Our study demonstrated that the soft tissue response is not linear but a more complicated and dynamic reaction.


Assuntos
Lábio/anatomia & histologia , Nariz/anatomia & histologia , Procedimentos Cirúrgicos Ortognáticos , Prognatismo/cirurgia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Pontos de Referência Anatômicos , Feminino , Seguimentos , Humanos , Modelos Lineares , Lábio/diagnóstico por imagem , Masculino , Nariz/diagnóstico por imagem , Osteotomia de Le Fort , Prognatismo/diagnóstico por imagem , Prognatismo/patologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
5.
Prog Orthod ; 18(1): 43, 2017 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-29243002

RESUMO

BACKGROUND: The purpose of this study was to elucidate the factors that cause facial asymmetry by comparing the characteristics of the mandibular morphology in patients with mandibular prognathism with or without facial asymmetry using three-dimensional computed tomography (3D-CT). METHODS: We studied 28 mandibular prognathism patients whose menton deviated by ≥ 4 mm from the midline (FA group, n = 14) and those with a < 4-mm deviation (NA group, n = 14). DICOM data from multislice CT images were reconstructed and analysed using 3D image analysing software. Mandibular structures were assessed via linear, angular, or volumetric measurements and analysed statistically. RESULTS: The lengths of the ramal and body components and condylar volume in the FA group were significantly greater on the nondeviated side than those on the deviated side. The mandibular body length of the nondeviated side in the FA group was significantly longer than that of the NA group. Other components of the FA group did not significantly differ from those of the NA group. CONCLUSIONS: Imbalances in the sizes of the ramal and body components as well as the increased body length of the nondeviated side in the FA group compared with that of the NA group may contribute to facial asymmetry in patients with mandibular prognathism.


Assuntos
Assimetria Facial/patologia , Mandíbula/patologia , Prognatismo/patologia , Assimetria Facial/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Mandíbula/diagnóstico por imagem , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Tomografia Computadorizada Multidetectores , Prognatismo/diagnóstico por imagem
6.
Medicine (Baltimore) ; 96(25): e7240, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28640125

RESUMO

To identify variants of the genes in fibroblast growth factors/fibroblast growth factor receptors (FGF/FGFR) signal pathway that predispose to mandibular prognathism (MP) in the general Chinese population systematically.Targeted sequencing of the FGF/FGFR genes was conducted in 176 MP individuals and 155 class I malocclusion controls. The associations of common and rare variants with MP as a categorical phenotype and also continuous malocclusion phenotypes generated by principal component (PC) analysis were analyzed.One common variant, rs372127537, located in the 3'-untranslated region of FGF7 gene, was significantly related to PC1 (P  =  4.22 × 10), which explained 23.23% of the overall phenotypic variation observed and corresponded to vertical discrepancies ranging from short anterior face height to long anterior face height, after Bonferroni correction. Also, 15 other variants were associated with PC1-4, although not significant after multiple corrections (P < .05). We also identified 3 variants: rs13317 in FGFR1, rs149242678 in FGF20, and rs79176051 FGF12 associated with MP (P < .05). With respect to rare variant analysis, variants within the FGF12 gene showed significant association with MP (P  =  .001).Association between FGF/FGFR signaling pathway and MP has been identified. We found a previously unreported SNP in FGF7 significantly related to increased facial height. Also, rare variants within the FGF12 were associated with MP. Our results provide new clues for genetic mechanisms of MP and shed light on strategies for evaluating rare variants that underlie complex traits. Future studies with larger sample sizes and more comprehensive genome coverage, and also in other population are required to replicate these findings.


Assuntos
Fator 7 de Crescimento de Fibroblastos/genética , Fatores de Crescimento de Fibroblastos/genética , Predisposição Genética para Doença , Prognatismo/genética , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/genética , Povo Asiático/genética , Cefalometria , China , Feminino , Frequência do Gene , Estudos de Associação Genética , Variação Genética , Técnicas de Genotipagem , Humanos , Masculino , Análise de Componente Principal , Prognatismo/patologia , Adulto Jovem
7.
Am J Med Genet A ; 173(4): 1056-1060, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28328127

RESUMO

Intrachromosomal triplications are complex chromosomal rearrangements which arise during meiosis or mitosis and lead to a tetrasomic dose of the affected genomic regions. We describe a female patient harboring an intrachromosomal triplication who presented to the Genetics clinic with dysmorphic features, including telecanthus, flat facial profile, and prognathism, short stature, widely spaced nipples, multiple allergy complaints, loose bowel movements, and mild speech delay. Microarray analysis showed a copy number gain of a 22.37 Mb region of chromosome 11 between bands 11q14.1 and 11q22.1. This region contains 95 genes and seven microRNAs, none of which have been implicated in a disease resulting from increased gene dosage. FISH analysis using a probe targeted to the middle of the segment of the copy number gain yielded a pattern indicative of a tetrasomy via an intrachromosomal triplication, with three signals on the long arm of one homologue of chromosome 11 and the fourth on the other homologue. Subsequent FISH analysis showed that the middle triplicated fragment was positioned in an inverted orientation relative to the outer fragments. To investigate the mechanism by which the intrachromosomal triplication occurred, SNP microarray analysis was performed. These results were consistent with the presence of multiple haplotypes in the tetrasomic region and suggest that the intrachromosomal triplication in our patient arose in one parent during meiosis. © 2017 Wiley Periodicals, Inc.


Assuntos
Anormalidades Múltiplas/genética , Cromossomos Humanos Par 11/química , Anormalidades Craniofaciais/genética , Deficiência Intelectual/genética , Prognatismo/genética , Tetrassomia , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/patologia , Criança , Anormalidades Craniofaciais/diagnóstico , Anormalidades Craniofaciais/patologia , Feminino , Dosagem de Genes , Humanos , Hibridização in Situ Fluorescente , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/patologia , Cariotipagem , Análise em Microsséries , Análise de Sequência com Séries de Oligonucleotídeos , Prognatismo/diagnóstico , Prognatismo/patologia
8.
Eur J Orthod ; 39(2): 176-187, 2017 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-27169757

RESUMO

Background: Although the headgear appliance has been used extensively to correct anteroposterior discrepancies, its treatment effects have not yet been adequately assessed in an evidence-based manner. Objective: Aim of this systematic review was to assess the therapeutic and adverse effects of early headgear treatment from controlled clinical trials on human patients in an evidence-based manner. Search methods: An unrestricted electronic search of six databases from inception to December 2015. Selection criteria: Randomized and prospective non-randomized controlled trials assessing the effects of headgear treatment on human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs) and relative risks (RRs), including their 95% confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of 18 unique studies with a total of 930 (56% male/44% female) patients were included. Headgear treatment was associated with a posterior translation of the anterior maxilla border in the short term, as seen by the mean annualized change in the SNA angle (MD = -1.63°/year; 95% CI = -2.20 to -1.06°/year; high quality evidence) compared to untreated patients. This effect was independent of the rotation of the palatal plane and the inclination of the upper incisors, while a proportional relationship with the initial discrepancy in SNA was seen. The clinical significance of this improvement diminished in the long term, although only limited evidence existed. Additionally, early headgear treatment might decrease the risk of dental trauma during the following years (RR = 0.34; 95% CI = 0.14 to 0.80; moderate quality evidence). Low quality evidence on the effect of headgear on the rotation of the palatal plane, the nasolabial angle, the occlusal outcome, and signs of temporomandibular disorders precluded robust assessments, due to risk of bias, inconsistency, imprecision, and small-study effects. Conclusions: Based on existing trials, headgear is a viable treatment option to modify sagittal growth of the maxilla in the short term in Class II patients with maxillary prognathism. Registration: PROSPERO (CRD42015029837). Funding: None.


Assuntos
Aparelhos de Tração Extrabucal , Ortodontia Corretiva/métodos , Prognatismo/terapia , Medicina Baseada em Evidências/métodos , Aparelhos de Tração Extrabucal/efeitos adversos , Humanos , Incisivo/patologia , Maxila/crescimento & desenvolvimento , Maxila/patologia , Ortodontia Corretiva/instrumentação , Prognatismo/patologia , Estudos Prospectivos , Rotação , Prevenção Secundária/métodos
9.
Aust Orthod J ; 32(1): 48-54, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27468591

RESUMO

AIM: To assess the sagittal soft tissue morphology of patients with acromegaly in comparison with a healthy control group. METHODS: Twenty-seven patients with acromegaly (11 male, 16 female; mean age 47.3 ± 11.5 years) and 30 healthy subjects (15 male, 15 female; mean age 42.2 ± 17.4 years) were included in the study. Linear and angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. The intergroup comparisons were analysed with the Student's t-test. RESULTS: Facial convexity (p < 0.01) and the nasolabial angle (p < 0.001) were reduced in patients with acromegaly, whereas nose prominence (p < 0.01), upper lip sulcus depth (p < 0.01), upper lip thickness (p < 0.01), basic upper lip thickness (p < 0.01), lower lip protrusion (p < 0.05), mentolabial sulcus depth (p < 0.05) and soft tissue chin thickness (p < 0.001) were increased. Anterior cranial base length (p < 0.05), the supraorbital ridge (p < 0.01), the length of the maxilla and mandible (p < 0.001, p < 0.01, respectively) were significantly increased, and mandibular prognathism was an acromegalic feature (p < 0.05). CONCLUSION: Acromegalic coarsening and thickening of the craniofacial soft tissues was identified from lateral cephalograms, which may therefore contribute to early diagnosis when evaluated together with other changes caused by the disease.


Assuntos
Acromegalia/patologia , Cefalometria/métodos , Face/patologia , Adulto , Queixo/patologia , Ossos Faciais/patologia , Feminino , Humanos , Lábio/patologia , Masculino , Mandíbula/patologia , Maxila/patologia , Pessoa de Meia-Idade , Osso Nasal/patologia , Nariz/patologia , Órbita/patologia , Prognatismo/patologia , Base do Crânio/patologia , Dimensão Vertical
10.
Homo ; 67(4): 294-312, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27132876

RESUMO

Subnasal prognathism is a morphological feature often described in studies of paleoanthropology, bioarchaeology, and forensic anthropology. This trait is commonly quantified using the gnathic index, which compares basion-prosthion and basion-nasion lengths. This study used geometric morphometrics to assess whether the gnathic index is a reliable indicator of subnasal prognathism and to explore the effects of sex, population, and allometry on this trait. Nineteen craniofacial landmarks were collected from three-dimensional cranial surface scans of 192 individuals across five population groups. Generalized Procrustes analysis and principal components analysis were employed to identify shape components related to changes in subnasal prognathism, comparing component scores to gnathic index values. M/ANOVAs were used to determine the effects of sex and population on prognathism, and linear regression served to assess static allometry. The gnathic index was significantly correlated with PCs 1 and 3, which appeared to capture prognathic shape change, but also with PCs 2 and 6, which reflected other craniofacial shape changes. Population differences in levels of prognathism were identified, but no significant effects of sex or allometry were found. The results show that, although the gnathic index correlates with prognathic shape variation, it is also influenced by other variables, such as the relative position of basion. In this sense, the gnathic index serves to illustrate the shortcomings of linear measurement analysis as compared to landmark configurations. Further, the results demonstrate that subnasal prognathism is a complex feature in need of redefinition.


Assuntos
Prognatismo/patologia , Cefalometria/métodos , Cefalometria/estatística & dados numéricos , Feminino , Humanos , Imageamento Tridimensional , Masculino , Análise de Componente Principal , Prognatismo/diagnóstico por imagem , Caracteres Sexuais , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Crânio/patologia
11.
Homo ; 67(5): 417-432, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27129623

RESUMO

It has been suggested that facial traits are informative on the inherited susceptibility to tuberculosis and obesity, two current global health issues. Our aim was to compare the phenotypic characteristics of adolescents with dental markers for a concave (n=420), a convex (n=978), and a straight (n=3542) facial profile in a nationally representative sample of United States adolescents. The results show that adolescents with a concave facial profile, when compared to a straight facial profile, had an increased waist-to-height ratio (Δ, 1.1 [95% CI 0.5-1.7], p<0.003) and an increased acne prevalence (OR, 1.5 [95% CI 1.2-1.9], p<0.001). Adolescents with a convex facial profile, when compared to a straight facial profile, had an increased prevalence of tuberculosis (OR, 4.3 [95% CI 1.4-13.1], p<0.02), increased ectomorphy (Δ, 0.3 [95% CI 0.2-0.4], p<0.0001), increased left-handedness (OR, 1.4 [95% CI 1.1-1.7], p<0.007), increased color-blindness (OR, 1.7 [95% CI 1.3-2.3], p<0.004), and rhesus ee phenotype (OR, 1.3 [95% CI 1.1-1.5], p<0.008). Adolescents with a concave facial profile, when compared to a convex profile, had increased mesomorphy (Δ, 1.3 [95% CI 1.1-1.5], p<0.0001), increased endomorphy (Δ, 0.5 [95% CI 0.4-0.6], p<0.0001), lower ectomorphy (Δ, 0.5 [95% CI 0.4-0.6], p<0.0001), and lower vocabulary test scores (Δ, 2.3 [95% CI 0.8-3.8], p<0.008). It is concluded that population-based survey data confirm that distinct facial features are associated with distinct somatotypes and distinct disease susceptibilities.


Assuntos
Face/anatomia & histologia , Adolescente , Antropometria , Cefalometria , Criança , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Fenótipo , Prognatismo/patologia , Retrognatismo/patologia , Somatotipos , Estados Unidos
12.
Am J Orthod Dentofacial Orthop ; 149(1): 46-54, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26718377

RESUMO

INTRODUCTION: The frontal occlusal plane of the maxilla generally inclines toward the ipsilateral side of the mandibular deviation in subjects with facial asymmetry; however, a few patients with facial asymmetry have their frontal occlusal planes inclined toward the contralateral side. We aimed to investigate the morphologic and functional features of such patients. METHODS: The subjects were 40 patients with facial asymmetry divided into 2 groups based on the inclination of the frontal occlusal plane toward the ipsilateral or the contralateral side. We analyzed lateral and posteroanterior cephalometric radiographs and occlusal variables and evaluated temporomandibular joint symptoms. Statistical comparisons were performed between the 2 groups (P <0.05). RESULTS: The posteroanterior cephalometry significantly differed between the ipsilateral and contralateral groups. Occlusal force and occlusal contact area were significantly larger, and temporomandibular joint symptoms were more frequently found on the side of the upward-inclined frontal occlusal plane than on the opposite side in both groups. CONCLUSIONS: The features in the contralateral group in terms of occlusal force and temporomandibular disorders were clinically significant. Clinicians should note that the conditions associated with the contralateral group require less presurgical decompensation.


Assuntos
Cefalometria/métodos , Oclusão Dentária , Assimetria Facial/patologia , Mandíbula/patologia , Adulto , Força de Mordida , Corantes , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Registro da Relação Maxilomandibular/instrumentação , Masculino , Maxila/patologia , Pressão , Prognatismo/patologia , Transtornos da Articulação Temporomandibular/diagnóstico , Adulto Jovem
13.
Angle Orthod ; 86(1): 87-93, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25902183

RESUMO

OBJECTIVE: To clarify whether the concept of main occluding area, where hard food is initially crushed, exists in patients who have a jaw deformity. MATERIALS AND METHODS: Nineteen subjects with normal occlusion, 18 patients with mandibular prognathism, and 11 patients with mandibular prognathism who had undergone orthognathic surgery participated in this study. The main occluding area was identified by clenching Temporary Stopping. The coincidence, location of the main occluding area, and distance from the first molars to main occluding area were examined. RESULTS: High coincidence of the main occluding area was obtained in all groups, signifying that the main occluding area exists even in these patients. Mandibular main occluding area was located on the first molar in all groups. Maxillary main occluding area in subjects with normal occlusion was located on the first molar. However, it was located on the second premolar and first molar in patients with mandibular prognathism, and on the first and second molars in patients with mandibular prognathism who had undergone orthognathic surgery. There was a statistically significant difference in distance from the maxillary first molar to the main occluding area among groups, but there was no difference in the distance from the mandibular first molar among groups. CONCLUSION: The main occluding area is more stable on the mandibular first molar than the maxilla in all groups.


Assuntos
Oclusão Dentária , Má Oclusão Classe III de Angle/patologia , Mandíbula/cirurgia , Prognatismo/patologia , Humanos , Má Oclusão Classe III de Angle/cirurgia , Mastigação , Maxila , Dente Molar , Prognatismo/cirurgia
14.
Am J Orthod Dentofacial Orthop ; 148(5): 782-92, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26522038

RESUMO

INTRODUCTION: Our objectives were to compare different patterns of molar relationship changes from the mixed dentition to the permanent dentition and to discriminate the contributing dentoskeletal factors. METHODS: In this retrospective cohort study, we used a sample selected from 1212 untreated subjects who were longitudinally followed from the mixed to the permanent dentition. Eighty subjects (mean age, 8.69 years) had their right and left dental arch sides divided into 6 groups, according to molar relationship behavior: distal step kept in Class II (group 1A) or changed to Class I (group 1B); flush terminal plane kept in Class II (group 2A) or changed to Class I (group 2B); and mesial step kept in Class I (group 3A) or changed to Class III (group 3B). The groups were statistically evaluated at P <0.05. RESULTS: Class I and Class II defined by mesial and distal steps were stable. The flush terminal plane groups had a similar probability of maintaining the Class II relationship or changing to Class I. Groups 2A and 2B had significantly different changes in molar relationship, maxillary width, and mandibular skeletal traits as a whole. Class II maxillomandibular discrepancy, maxillary narrowing, and sagittal mandibular deficiency were the disadvantageous factors for favorable molar relationship adjustment. CONCLUSIONS: Mesial and distal steps produced stable molar relationships from the mixed to the permanent dentition. There were 2 distinct dentoskeletal parameters of subjects with flush terminal planes regarding transverse maxillary and sagittal mandibular dimensions that should be diagnosed early to define the prognosis for molar relationship adjustment and orthodontic treatment need.


Assuntos
Dentição Mista , Dente Molar/patologia , Cefalometria/métodos , Criança , Estudos de Coortes , Dente Canino/patologia , Arco Dental/crescimento & desenvolvimento , Arco Dental/patologia , Oclusão Dentária , Feminino , Seguimentos , Humanos , Incisivo/patologia , Estudos Longitudinais , Masculino , Má Oclusão Classe II de Angle/patologia , Má Oclusão Classe III de Angle/patologia , Mandíbula/crescimento & desenvolvimento , Mandíbula/patologia , Maxila/crescimento & desenvolvimento , Maxila/patologia , Modelos Dentários , Sobremordida/patologia , Prognatismo/patologia , Retrognatismo/patologia , Estudos Retrospectivos , Dente Decíduo/patologia
16.
Orthod Craniofac Res ; 18(1): 21-6, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25257381

RESUMO

OBJECTIVES: Several reports have demonstrated a relationship between second to fourth digit ratio (2D:4D) and facial shape, suggesting that prenatal sex hormones play a role in the development of the craniofacial complex. Using 3D surface imaging and geometric morphometrics, we test the hypothesis that decreased digit ratio (indicative of increased prenatal androgen exposure) is associated with a more masculine facial phenotype. METHODS: 3D facial surface images and digit measures were collected on a sample of 151 adult males. Facial landmarks collected from the images were aligned by Procrustes superimposition and the resulting shape coordinates regressed on 2D:4D. Variations in facial shape related to 2D:4D were visualized with deformable surface warps. RESULTS: A significant statistical relationship was observed between facial shape variation and 2D:4D (p = 0.0084). Lower 2D:4D ratio in adult males was associated with increased facial width relative to height, increased mandibular prognathism, greater nasal projection, and increased upper and lower lip projection. CONCLUSIONS: A statistical relationship between 2D:4D and facial shape in adult males was observed. Faces tended to look more masculine as 2D:4D decreased, suggesting a biologically plausible link between prenatal androgen exposure and the development of male facial characteristics.


Assuntos
Androgênios/fisiologia , Face/anatomia & histologia , Dedos/anatomia & histologia , Adolescente , Adulto , Pontos de Referência Anatômicos/anatomia & histologia , Antropometria/métodos , Cefalometria/métodos , Queixo/anatomia & histologia , Humanos , Imageamento Tridimensional/métodos , Lábio/anatomia & histologia , Masculino , Mandíbula/anatomia & histologia , Desenvolvimento Maxilofacial/fisiologia , Nariz/anatomia & histologia , Prognatismo/patologia , Adulto Jovem
18.
Br J Oral Maxillofac Surg ; 52(10): 965-9, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25193636

RESUMO

The aim of this study was to estimate skeletal and dental stability after maxillomandibular osteotomy with physiological positioning. Ten patients (7 men and 3 women) with skeletal mandibular prognathism were treated by conventional Le Fort I osteotomy for the maxilla and unfixed short lingual osteotomy for the mandible together with physiological positioning. We used cephalometric analysis to evaluate the skeletal and dental stability preoperatively, immediately after maxillomandibular osteotomy, and more than 1 year later. The immediately postoperative measurements for the SNA and the SN-palatal planes were 0.15° (p=0.67) and 1.0° (p=0.17), respectively. The positions of the anterior nasal spine, posterior nasal spine, and A point showed minimal changes 1 year postoperatively. The postoperative difference for SNB was 0.76° (p=0.04). Dental stability was apparent postoperatively. We conclude that reliable stability of both the maxilla and the mandible was achieved after maxillomandibular osteotomy with physiological positioning in patients with mandibular prognathism.


Assuntos
Osteotomia Mandibular/métodos , Osteotomia de Le Fort/métodos , Prognatismo/cirurgia , Adolescente , Adulto , Cefalometria/métodos , Queixo/patologia , Terapia por Exercício/métodos , Feminino , Seguimentos , Humanos , Incisivo/patologia , Masculino , Mandíbula/patologia , Maxila/patologia , Osso Nasal/patologia , Placas Oclusais , Palato/patologia , Planejamento de Assistência ao Paciente , Prognatismo/patologia , Sela Túrcica/patologia , Resultado do Tratamento , Adulto Jovem
19.
Int J Esthet Dent ; 9(3): 412-25, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25126620

RESUMO

INTRODUCTION: All parts of the face, other than jaw relationships, should be considered in orthodontic treatment planning. The role of forehead and neck in facial esthetics is well known; however, the majority of conventional facial analysis methods have not considered them. Neck and forehead may confer mutual effects on equilibrium and on esthetics of other facial components, and may change the overall convexity/concavity view of the profile. Therefore, the aim of this study was to assess the effect of anteroposterior position of the forehead and neck on the esthetics of skeletal class I, II and III jaw relationships using profile silhouettes. METHODS: Class II and III jaw relationships were constructed on the silhouette of a class I normal profile by altering the mandibular position. Retruded, normal and protruded positions were also applied for the forehead and neck. Three hundred Iranian laypeople (150 men, 150 women) scored the esthetics of profile silhouettes from 1 to 7. Half of the participants were told to consider the profiles as a man, and the other half were told to consider them as a woman. Data were analyzed using non-parametric methods. RESULTS: Class I jaw relation was found to be the most beautiful profile followed by class II and III respectively. Esthetics of different positions of the neck and forehead were significantly different (P < 0.05). In subjects with a normal neck and forehead position, and those with a retruded neck, the best esthetic relationship was class I, and the worst was class III. For protruded foreheads, the best jaw relationship was class II for females and class I for males, and the worst was class III for both. In a retruded forehead position, the most preferred jaw relationship was class I, and the worst was class II. For profiles with a protruded neck, the best esthetics was found to be in class III jaw relationship, and the worst was in class II. There was a small difference in scoring for male and female profiles (P < 0.05); there were also small differences in scoring trends of men and women (P < 0.05). CONCLUSION: This study showed that the anteroposterior position of the forehead and neck affects the esthetics of jaw relationships in profile view. In laypeople's opinions, in a normal profile, the overall appearance is more important compared to the independent position of the neck and forehead; however, having jaw abnormalities, the neck plays an important independent role. The preferred jaw relation for profiles with each forehead or neck position was introduced.


Assuntos
Estética Dentária , Testa/anatomia & histologia , Má Oclusão Classe III de Angle/patologia , Má Oclusão Classe II de Angle/patologia , Má Oclusão Classe I de Angle/patologia , Pescoço/anatomia & histologia , Adolescente , Adulto , Beleza , Oclusão Dentária , Feminino , Humanos , Masculino , Mandíbula/patologia , Pessoa de Meia-Idade , Prognatismo/patologia , Retrognatismo/patologia , Fatores Sexuais , Adulto Jovem
20.
Vojnosanit Pregl ; 71(6): 534-41, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25039106

RESUMO

BACKGROUND/AIM: The literature suggests different views on the correlation between the cranial base morphology and size and saggital intermaxillary relationships. The aim of this study was to investigate the cranial base morphology, including the frontal facial part in patients with mandibular prognathism, to clarify a certain ambiguities, in opposing viewspoints in the literature. METHODS: Cephalometric radiographies of 60 patients were analyzed at the Dental Clinic of the Military Medical Academy, Belgrade, Serbia. All the patients were male, aged 18-35 years, with no previous orthodontic treatment. On the basis of dental and sceletal relations of jaws and teeth, the patients were divided into two groups: the group P (patients with mandibular prognathism) and the group E (the control group or eugnathic patients). A total of 15 cephalometric parametres related to the cranial base, frontal part of the face and sagittal intermaxillary relationships were measured and analyzed. RESULTS: The results show that cranial base dimensions and the angle do not play a significant role in the development of mandibular prognathism. Interrelationship analysis indicated a statistically significant negative correlation between the cranial base angle (NSAr) and the angles of maxillary (SNA) and mandibular (SNB) prognathism, as well as a positive correlation between the angle of inclination of the ramus to the cranial base (GoArNS) and the angle of sagittal intermaxillary relationships (ANB). Sella turcica dimensions, its width and depth, as well as the nasal bone length were significantly increased in the patients with mandibular prognathism, while the other analyzed frontal part dimensions of the face were not changed by the malocclusion in comparison with the eugnathic patients. CONCLUSION: This study shows that the impact of the cranial base and the frontal part of the face on the development of profile in patients with mandibular prognathism is much smaller, but certainly more complex, so that morphogenetic tests of the maxillomandibular complex should be included in further assessment of this impact.


Assuntos
Cefalometria/métodos , Face/patologia , Mandíbula/anormalidades , Mandíbula/patologia , Prognatismo/patologia , Base do Crânio/patologia , Adolescente , Adulto , Humanos , Arcada Osseodentária/patologia , Masculino , Má Oclusão Classe III de Angle/patologia , Sérvia , Adulto Jovem
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