Arch parameters and dental discrepancy (crowding and spacing) in a sample of an Afro-Colombian population / Parámetros de arco y discrepancia dental (apiñamiento y espaciamiento) en una muestra de población Afrocolombiana

The aim of this study was to determine the differences in arch length, inter-canine distance, inter-premolar distance, intermolar distance and arch shape between dental discrepancies (crowding and spacing) in a sample of dental casts from the Afro-Colombian population of San Basilio de Palenque. An analytical, cross-sectional study was conducted on a convenience sample of 63 subjects aged 11 to 57years, of Afro-Colombian origin, with full dentition from first molar to first molar, without extensive caries or restorations, and excluding casts with defects due to loss. The differences between arch (upper and lower) variables were analyzed according to dental discrepancies. Plaster models digitalized with a TR1OS3 Mono scanner with exactitude (6.9 ± 0.9 pm) and precision (4.5 ± 0.9 pm) were analyzed with Orthonalyzer software. Statistical analyses were done on SPSS software (Version 20 for Windows) and Real Statistics. Spacing discrepancy of68.25% was found for upper arch and 66.66% for lower arch; crowding discrepancy of 19.04% for upper arch and 20.63% for lower arch, and an adequate ratio of 12.69% for both arches. No statistically significant difference (p>0.05) was found between arch parameters except for inter-premolar distance on the lower arch. The most frequent arch shape in the population was oval for both upper arch, with 76.19%, and lower arch, with 71.42%. Tooth size was larger in males than females but the difference was not statistically significant.

El objetivo de este estudio fue determinar las diferencias en longitud de arco, distancia intercanina, interpremolar, intermolar y la forma de arco entre discrepancias dentales (apiñamiento y espaciamiento), en una muestra de modelos dentales de la población afrocolombiana de San Basilio de Palenque. Se realizó un estudio analítico transversal, en una muestra por conveniencia de 63 sujetos con un rango de edad entre 11 y 57 años, de origen afrocolombiano, quienes tuvieron dentición completa de primer molar a primer molar, sin caries extensas, ni restauraciones; se excluyeron los modelos con defectos por el vaciado. Se analizaron las diferencias entre las variables de los maxilares (superior e inferior) con las discrepancias dentales. Se utilizaron modelos de yeso que fueron digitalizados con el escánerTR1OS3 Mono con una exactitud de (6.9 ± 0.9 pm) y una precisión de (4.5 ± 0.9 pm)y analizados con el software Orthonalyzer. Los análisis estadísticos se llevaron a cabo utilizando el software SPSS (Versión 20 para Windows) y Real Statistics. Se encontró una discrepancia de espaciamiento de un 68,25% para el arco superior y 66,66% en el arco inferior; y una discrepancia de apiñamiento en el arco superior de 19,04% e inferior de 20,63% y una relación adecuada de 12,69% para los dos arcos. No se encontraron diferencias estadísticamente significativas (p>0.05) en los parámetros de arco a excepción de la distancia interpremolar del arco inferior. La forma de arco más frecuente en la población fue ovalada tanto en el arco superior con un 76,19% como en el arco inferior con un 71,42%. En cuanto al tamaño dental, se presentó mayor tamaño en los hombres que en las mujeres, pero este no fue estadísticamente significativo.

Relationship between dental age, chronological age and cervical vertebral maturation in children and adolescents from Bucaramanga, Colombia

Objective: to determine the relationship between chronological age and dental age using Demirjian's method and Baccetti's method of cervical vertebral maturation in radiographs of children and adolescents aged 5 to 16 years in the city of Bucaramanga, Colombia. methods: an analytical observational cross-sectional study was performed in 1385 cephalometric and panoramic radiographs of 775 females and 610 males. sex, dental age according to the Demirjian's method, chronological age and degree of maturation of the cervical vertebrae according to Baccetti's method were analyzed. the univariate analysis included the calculation of measures of central tendency for quantitative variables, and frequencies and proportions for qualitative variables. spearman correlation coefficients were calculated in the bivariate analysis. in the multivariate analysis a multiple linear regression was performed. a value of p<0.05 was considered statistically significant. results: the mean chronological age was 10.8±3.3 years [Median: 11; 95 percent CI:10.6-10.6]. there was no statistically significant difference according to sex (p=0.3409). the mean of the differences between dental age and chronological age was 0.60±1.44 years. there was a strong and positive correlation between dental age and chronological age with each stage of maturation. females reached skeletal maturity at an earlier age. conclusions: chronological age shows a direct and positive relationship with dental age and stages of skeletal maturation in a colombian population.

Correlation between craniofacial growth and upper and lower body heights in subjects with Class I occlusion

ABSTRACT Objective: To correlate skeletal age, standing height, upper and lower body lengths, and selected craniofacial growth features in a sample of growing individuals, and to model craniofacial growth using multivariate regression. Methods: This was a retrospective cross-sectional study with 447 African black boys and girls, between the ages 8 and 16 years, who attended the dental clinic at one hospital. The skeletal maturational age was determined from hand-wrist radiographs using the Greulich and Pyle atlas. Craniofacial measurements representing maxillary length (Ar-ANS), mandibular length (Ar-Gn), and lower facial height (ANS-Me) were calculated from lateral cephalograms in habitual occlusion. Body lengths were clinically measured in centimeters. Results: Moderate correlations (r=0.42 to 0.68) were observed between skeletal age and the three selected craniofacial measurements. Statistically significant correlations were also found between the craniofacial measurements and both upper and lower body lengths. The mandibular length had a stronger correlation with the upper body length than with the lower body length. Multiple regression analyses to determine maxillary and mandibular lengths suggested that sex, upper and lower body lengths might be used to determine maxillary length; while skeletal age, upper and lower body lengths might help determine mandibular length. Conclusions: Based on the relatively strong correlation between upper body length and mandibular length, further research in this area may warrant its use as a predictor for mandibular growth modification timing.

RESUMO Objetivo: correlacionar a idade esquelética, a estatura, as alturas corporais superior e inferior, e algumas características específicas do crescimento craniofacial, em uma amostra de indivíduos em crescimento, e delinear o crescimento craniofacial usando regressão multivariada. Métodos: esse estudo transversal retrospectivo foi feito com 447 meninos e meninas negros africanos, com idades entre 8 e 16 anos, atendidos na clínica odontológica de um hospital. A maturação esquelética, em anos, foi determinada a partir de radiografias de mão e punho, usando o atlas de Greulich e Pyle. As medidas craniofaciais representando o comprimento maxilar (Ar-ENA), o comprimento mandibular (Ar-Gn) e a altura facial anterior inferior (ENA-Me) foram calculadas a partir de cefalogramas laterais em oclusão habitual. Os comprimentos corporais foram medidos clinicamente, em centímetros. Resultados: correlações moderadas (r = 0,42 a 0,68) foram observadas entre a idade esquelética e as três medidas craniofaciais selecionadas. Também foram encontradas correlações estatisticamente significativas entre as medidas craniofaciais e as alturas corporais superior e inferior. O comprimento mandibular teve uma correlação mais forte com a altura corporal superior do que com a inferior. As análises de regressão múltipla para determinar os comprimentos maxilar e mandibular sugeriram que o sexo e as alturas corporais superior e inferior podem ser usados para determinar o comprimento maxilar, enquanto a idade esquelética e as alturas corporais superior e inferior podem ajudar a determinar o comprimento mandibular. Conclusões: com base na correlação relativamente forte entre a altura corporal superior e comprimento mandibular, pesquisas adicionais nessa área poderiam justificar seu uso como indicador para o período de modificação do crescimento mandibular.

Avaliação do tratamento da classe II com o distalizador First Class em ancoragem convencional e esquelética / Evaluation of class II treatment with First Class distalizer in conventional and skeletal anchorage

O objetivo deste estudo longitudinal foi avaliar as alterações dentoesqueléticas e tegumentares de jovens com má-oclusão de classe II, tratados com distalizador First Class em dois tipos diferentes de ancoragem. Foram selecionados 30 pacientes e divididos em dois grupos de 15: G1 (recebeu o distalizador com ancoragem convencional no botão de Nance); e G2 (recebeu o distalizador com ancoragem esquelética apoiado em dois mini-implantes no palato). As telerradiografias foram obtidas antes e após a distalização dos molares para a realização das análises cefalométricas. O tempo médio de tratamento foi de 4,51 e 6,28 meses para G1 e G2, respectivamente. Ambos os grupos apresentaram alterações dentárias significantes com distalização (G1=2,39 mm; G2=2,21 mm), angulação distal (G1=10,51°; G2=4,49°) e intrusão (G1=0,53 mm; G2=0,10 mm) dos primeiros molares superiores. A perda de ancoragem foi semelhante entre os dois grupos, com significante mesialização (G1=2,78 mm; G2=3,11 mm) e angulação mesial (G1=4,95°; G2=4,69°) dos segundos pré-molares, protrusão (G1=1,55 mm; G2=1,94 mm) e vestibularização (G1=5,78°; G2=3,13°) significantes dos incisivos superiores e um aumento significante no trespasse horizontal (G1=1,07 mm; G2=0,81 mm). A mecânica de distalização não interferiu nos componentes esqueléticos e tegumentares dos pacientes. Em ambos os grupos, o distalizador First Class promoveu correção da relação molar, porém, apresentou efeitos de perda de ancoragem verificada nos pré-molares e incisivos superiores, mesmo quando associado a mini-implantes. Não houve diferença significante entre os grupos quanto às alterações dentárias lineares, porém, as angulares foram significantemente menores no grupo com ancoragem esquelética.

The aim of this prospective study was to evaluate the dental, skeletal and soft tissue changes in youngsters with class II malocclusion treated with First Class distalizer in two different types of anchorage. Thirty patients were included and divided in two groups of 15. G1 that received distalizers with conventional anchorage (Nance button) and G2 that received distalizers with skeletal anchorage supported in two palatal mini-implants. Lateral cephalometric radiographs were taken before and after molar distalization for cephalometric analysis. The mean treatment period was 4.51 and 6.28 months for G1 and G2, respectively. Both groups showed significant dental changes with distalization (G1=2.39 mm; G2=2.21 mm), distal tipping (G1=10.51°; G2=4.49°) and intrusion (G1=0.53 mm; G2=0.10 mm) of maxillary first molars. Anchorage loss showed similar results in both groups with significant mesialization (G1=2.78 mm; G2=3.11 mm) and mesial tipping (G1=4.95°; G2=4.69°) of maxillary second premolars, significant protrusion (G1=1.55 mm; G2=1.94 mm) and proclination (G1=5.78°; G2=3.13°) of maxillary incisors and significant increase in overjet (G1=1.07 mm; G2=0.81 mm). The distalization mechanics did not interfere in patient's skeletal and soft tissue measurements. In both groups, the First Class distalizer corrected the molar relationship, however it showed anchorage loss effects in maxillary premolars and incisors even when associated to mini-implants. There was no significant difference between groups on dental linear changes, however the dental angular changes were significantly lower in the skeletal anchorage group.

Reliability of CBCT in the diagnosis of dental asymmetry

Objective: The aim of this study was to validate a method used to assess dental asymmetry, in relation to the skeletal midline, by means of CBCT. Methods: Ten patients who had CBCT scans taken were randomly selected for this study. Five different observers repeated 10 landmarks (x, y and z variables for each) and 12 linear measurements within 10 days. Measurements were taken in both arches to evaluate symmetry of first molars, canines and dental midline in relation to the skeletal midline. Intraclass correlation coefficient (ICC) was carried out to assess intra- and interobserver reliability for landmarks and distances. Average mean difference was also assessed to check measurement errors between observers. Results: ICC landmarks was ≥ 0.9 for 27 (90%) and 25 (83%) variables for intra- and interobserver, respectively. ICC for distances was ≥ 0.9 for 7 (58%) and 5 (42%), respectively. All ICC landmarks for distances were >0.75 for both intra- and interobserver. The mean difference between observers was ≤ 0.6 mm for all the distances. Conclusion: The method used to assess dental asymmetry by means of CBCT is valid. Measurements of molars, canines and dental midline symmetry with the skeletal midline are reproducible and reliable when taken by means of CBCT and by different operators. .

Objetivo: validar um método para avaliar assimetria dentária, em relação à linha média esquelética, usando TCFC. Métodos: dez pacientes que realizaram TCFC foram selecionados aleatoriamente para esse estudo. Cinco diferentes observadores repetiram 10 pontos de referência (com variáveis x, y e z, para cada ponto) e 12 medidas lineares em um intervalo de 10 dias. As medições foram realizadas em ambas as arcadas, para avaliar a simetria de primeiros molares, caninos e linha média dentária, em relação à linha média esquelética. Índice de correlação intraclasse (ICC) foi realizado para verificar a confiabilidade intraobservador e interobservadores para os pontos de referência e distâncias. A diferença média também foi avaliada, para checar os erros de mensuração entre os observadores. Resultados: ICC para os pontos de referência foram ≥ 0,9 para 27 (90%) e 25 (83%) das variáveis para intra- e interobservadores respectivamente. ICC para distâncias foi ≥ 0,9 para 7 (58%) e 5 (42%), respectivamente. Todas as medidas de ICC para distâncias foram > 0,75 para intraobservador e interobservadores. A diferença média entre observadores foi ≤ 0,6mm para todas as distâncias. Conclusão: o método de verificação de assimetria dentária utilizando TCFC é válido. Medições de molares, caninos e linha média dentária com a linha média esquelética são reproduzíveis e confiáveis quando feitas utilizando TCFC, mesmo que por diferentes operadores. .

The Wits appraisal among a Nigerian sub-population: an assessment of dental base geometric factors

The Wits appraisal is a common linear cephalometric analytic tool established by Jacobson. It has been reported to be superior to angular cephalometric measures as it is not dependent on pericranial structures and their variations both during growth and orthodontic treatment. AIM: To obtain reference values for the Wits appraisal among Nigerians and assess the effect of the dental base geometry on it. METHODS: Lateral cephalometric radiographs of 100 Nigerian subjects with normal occlusion were analyzed to obtain the Wits appraisal, and the effect of the vertical distance from subspinale to supramentale, length of the palatal and mandibular planes, the mandibular plane angle as well as the palatal plane angle were assessed using the ANOVA and linear regression analysis. RESULTS: The mean age was 20.69 ± 4.9 years. Thirty-four (34%) were males and 66(66%) were females. Mean Wits value of -3.43 ± 3.24 mm was obtained based on the functional occlusal plane (FOP). Linear regression analysis showed that the vertical height from subspinale (A point) to supramentale (B point) caused a significant change in the Wits appraisal reading in participants still undergoing active growth process (less than 16 years of age) (p=0.02). CONCLUSIONS: It is advocated that the Wits appraisal be used as a moderator to the ANB angle among Nigerians. However, as a result of dental height variations its use in growing Nigerian children requires caution.

Impact of landmark identification and standard measurement error on cephalometric analysis using a mathematical simulation model / Impacto da identificação do ponto anatômico e do erro padrão de mensuração na análise cefalométrica utilizando um modelo de simulação matemática

Objective: To assess, using a mathematical simulation model, the participation of each coordinate involved in the formation of cephalometric angles and to determine the extent to which errors in the identification of cephalometric landmarks can, individually and collectively, influence the measurement of these angles. Material and Methods: The reference values and standard errors of 13 landmarks obtained from the analysis of 30 cephalograms were used. For each landmark, 1000 observations were simulated using the Monte Carlo method. On the basis of linear regression models, equations designed to estimate measurement errors due to landmark identification errors were obtained and analysed. Results: The coordinates most involved in the formation of the angles SNA, SNB, ANB, FMA, PPL, DFC, and AEF were Ny, Ny, Ax, Goy, Poy, Poy, and Ptmx, respectively, and the standard measurement errors for these angles were 1.2, 0.9, 0.8, 1.6, 1.5, 1.5, and 1.4, respectively. Conclusion: The standard measurement error of the angle depends on the geometric impact coefficient and the standard error of the coordinates involved in the formation of the angles, and the geometric impact coefficient varies according to the angle analysed.

Objetivos: Avaliar, empregando um modelo matemático de simulação, a participação de cada coordenada envolvida na formação de ângulos cefalométricos, assim como determinar a extensão da influência dos erros na identificação dos pontos cefalométricos, individual e coletivamente, na mensuração destes ângulos. Materiais e métodos: Foram utilizados os valores de referência e os erros padrão de 13 pontos anatômicos obtidos a partir da análise de 30 cefalogramas. Para cada ponto anatômico, foram simuladas 1000 observações utilizando o método de Monte Carlo. Com base em modelos de regressão linear, foram obtidas e analisadas equações destinadas a estimar os erros de medição devido a erros na identificação dos pontos cefalométricos. Resultados: As coordenadas mais envolvidas na formação dos ângulos SNA, SNB, ANB, FMA, PPL, DFC, e AEF foram Ny, Ny, Ax, Goy, Poy, Poy, e Ptmx, respectivamente, e os erros padrão de mensuração destes ângulos foram 1,2; 0,9; 0,8; 1,6; 1,5; 1,5 e 1,4, respectivamente. Conclusões: O erro padrão de mensuração de cada ângulo cefalométrico depende do coeficiente de impacto geométrico e do erro padrão das coordenadas dos pontos anatômicos envolvidos na formação dos mesmos, sendo que o coeficiente de impacto geométrico varia de acordo com o ângulo analisado.

Avaliação cefalométrica do padrão facial do respirador oral / Cephalometric evaluation of the facial pattern of mouth breathers

Objetivo: na literatura, a respiração oral normalmente é associada com padrão facial hiperdivergente. O objetivo deste estudo foi avaliar o padrão de crescimento facial de crianças respiradoras orais, comparando quatro análises cefalométricas diferentes. Método: um estudo de caso controle foi realizado. Um grupo de 87 crianças respiradoras orais entre quatro e 14 anos e 28 respiradores nasais(controle) foi avaliado pelo otorrinolaringologista. Os sujeitos foram considerados respiradores orais quando apresentavam respiração oral, pelo menos durante a noite, por um período mínimo de seis meses. Radiografias cefalométricas em norma lateral foram utilizadas para avaliar o padrão de crescimento facial através de quatro análises diferentes: Ricketts, Jarabak, USP e McNamara. Resultados: os resultados demonstraram prevalência de indivíduos hiperdivergentes(estudo = 4,42%; controle = 46,42%) comparados com o número de indivíduos normodivergentes (estudo = 24.13%; controle = 17,85%) e hipodivergentes (estudo = 26,43%; controle = 35,78%) em ambos os grupos. A diferença entre os testes de proporção para as análises de Ricketts e Jarabak, comparando os grupos de estudo e controle, não foi significante. Mas, para as análises USP e McNamara, o teste foi significativo. Quando comparados os resultados dos índices de padrão facial das outras três análises, com os índices da análise de Ricketts, não foi encontrada relação significativa. Conclusão: com os resultados encontrados, pôde-se concluir que não existe diferença estatisticamente significativa entre o padrão facial das crianças respiradoras orais e respiradoras nasais, quando a análise de Ricketts é aplicada. Sugere-se que pesquisas futuras considerem análises cefalométricas mais acurada para obtenção do padrão facial de crianças respiradoras orais.

Objective/aim: in literature, mouth breathing is in most cases associated with hiperdivergent face growth pattern. The goal of this study is to evaluate the facial skeletal pattern oi mauth-breathing children, comparing four different cephalometric analyses. Method: a case-control study was performed. A group of 87 mouth-breathing subjects, with average age between 4 - 14 years, and 28 nasal breathing subjects were evaluated. Subjects were considered mouth breathers when presented mouth breathing at least during the night,for a minimum period of 6 months. Cephalometric x-rays in lateral norm were used to evaluate the facial pattern by four different analyses: Ricketts, Jarabak, USP and McNamara. Results: results showed a prevalence of hyperdivergent subjects (E = 49.42%; C = 46.42%) compared to the normodivergent (E = 24.13%; C = 17.85%) and hypodivergent (E = 26.43%; C = 35.78%) facial types in both groups. The differences between proportions tests for Ricketts and Jarabak cephalometric analysis, comparing the study and the control groups, were not significant. But, for USP and McNamara analysis, the test was statistically significant. The results of three other facial pattern indexes in cephalometric analysis were compared to the Ricketts analysis and it was not found a significant relationship. Conclusion: with the achieved results in this research, we conclude that there are no statistically significant differences in facial pattern of mouth breathing and nasal breathing children, when Ricketts analysis is applied. We suggest that Future researches should consider a more accurate cephalometric analysis to obtain facial growth pattern in mouth-breathing children.

Statistical methods for assessing agreement between double readings of clinical measurements

Statistical analysis of data is crucial in cephalometric investigations. There are certainly excellent examples of good statistical practice in the field, but some articles published worldwide have carried out inappropriate analyses. OBJECTIVE: The purpose of this study was to show that when the double records of each patient are traced on the same occasion, a control chart for differences between readings needs to be drawn, and limits of agreement and coefficients of repeatability must be calculated. MATERIAL AND METHODS: Data from a well-known paper in Orthodontics were used for showing common statistical practices in cephalometric investigations and for proposing a new technique of analysis. RESULTS: A scatter plot of the two radiograph readings and the two model readings with the respective regression lines are shown. Also, a control chart for the mean of the differences between radiograph readings was obtained and a coefficient of repeatability was calculated. CONCLUSIONS: A standard error assuming that mean differences are zero, which is referred to in Orthodontics and Facial Orthopedics as the Dahlberg error, can be calculated only for estimating precision if accuracy is already proven. When double readings are collected, limits of agreement and coefficients of repeatability must be calculated. A graph with differences of readings should be presented and outliers discussed.

Craniofacial characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion

OBJECTIVE: The objective of this study was to compare the skeletal, dental and soft tissue characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion and to evaluate sexual dimorphism within the groups. MATERIAL AND METHODS: The sample comprised lateral cephalograms of untreated normal occlusion subjects, divided into 2 groups. Group 1 included 40 Caucasian subjects (20 of each sex), with a mean age of 13.02 years; group 2 included 40 Afro-Caucasian subjects (20 of each sex), with a mean age of 13.02 years. Groups 1 and 2 and males and females within each group were compared with t tests. RESULTS: Afro-Caucasian subjects presented greater maxillary protrusion, smaller upper anterior face height and lower posterior face height, larger upper posterior face height, greater maxillary and mandibular dentoalveolar protrusion as well as soft tissue protrusion than Caucasian subjects. The Afro-Caucasian female subjects had less mandibular protrusion and smaller total posterior facial height and upper posterior facial height than males. CONCLUSIONS: Brazilian Afro-Caucasian subjects have greater dentoalveolar and soft tissue protrusion than Brazilian Caucasian subjects, with slight sexual dimorphism in some variables.

Accuracy of linear measurements before and after digitizing periapical and panoramic radiography images

The aim of this study was to evaluate the accuracy of linear measurements made on conventional and digitized periapical and panoramic radiographic images of dry human hemi-mandibles. Images from the posterior region of 22 dry human hemi-mandibles were obtained by conventional panoramic and periapical radiography technique. Using a digital caliper, 3 vertical measurements were marked directly on the dry hemi-mandibles (reference measurements) as well as on the tracing from the conventional radiographic images of the specimens made onto acetate paper sheet: Distance 1: between the upper limit of the alveolar ridge and the lower limit at the mandible base; Distance 2: between the upper limit of the alveolar ridge and the upper limit of the mandibular canal; Distance 3: between the lower limit of the mandibular canal and the lower limit of the mandible base. Next, the radiographs were digitized and the three measurements were made on the digital images using UTHSCSA Image Tool software. Data were analyzed statistically by one-way ANOVA (α=0.05). There was no statistically significant differences (p>0.05) between periapical and panoramic radiographs or between the measurements recorded using the digital caliper and UTHSCSA software compared with dry mandible specimens for Distances 1 (p=0.783), 2 (p=0.986) and 3 (p=0.129). In conclusion, the radiographic techniques evaluated in this study are reliable for vertical bone measurements on selected areas and the UTHSCA Image Tool software is an appropriate measurement method.

O objetivo deste estudo foi avaliar a acurácia de medidas lineares realizadas em radiografias panorâmicas e periapicais convencionais e digitalizadas de hemimandíbulas humanas secas. Imagens da região posterior de 22 hemimandíbulas humanas secas foram obtidas pelas técnicas panorâmica e periapical convencionais. Com o paquímetro eletrônico digital, foram realizadas três medições verticais diretamente sobre as hemimandíbulas (medidas referenciais), bem como sobre o decalque das imagens convencionais, em papel de acetato: Distância 1: Distância entre o limite superior do rebordo alveolar e o limite inferior da base da mandíbula; Distância 2: Distância entre o limite superior do rebordo alveolar e o limite superior do canal mandibular e Distância 3: Distância entre o limite inferior do canal mandibular e o limite inferior da base da mandíbula. Posteriormente, as radiografias foram digitalizadas e as três medidas foram realizadas nas imagens digitais utilizando o programa UTHSCSA Image Tool. Os dados foram analisados estatisticamente pelo teste ANOVA a um critério (α=0,05). Não houve diferenças estatisticamente significantes (p>0,05) entre as radiografias panorâmicas e periapicais, assim como para as medidas obtidas com o paquímetro e pelo programa UTHSCSA Image Tool, quando comparados aos espécimes mandibulares, avaliando as distâncias 1 (p=0,783), 2 (p=0,986) e 3 (p=0,129). Em conclusão, as técnicas radiográficas avaliadas neste estudo mostraram-se confiáveis para mensurações ósseas verticais na área selecionada e o programa de digitalização de imagens UTHSCSA Image Tool é um método adequado de aferição.

Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities

In this study, a survey was conducted on the occurrence of skeletal malocclusions presented by patients of the Center for Research and Treatment of Buccofacial Deformities (CEDEFACE) in the city of Araraquara, SP, Brazil. The clinical charts of 381 patients with dentoskeletal deformities, who underwent combined orthodontic-surgical treatment in the period between 2000 and 2006, were reviewed. After sample selection (convenience method), based on the data of the pre- and post-surgical documentation, the number of patients was reduced to 171. For classification of the survey, the anteroposterior discrepancy (Class I, II and III), race, age, gender, absence or presence of asymmetry, vertical maxillary excess and maxillary biprotrusion were considered, in addition to determining in which bony base the surgical procedure was performed. Patients' documentations were analyzed by one examiner previously calibrated by repetition of the process until the method was considered adequate (intraclass correlation coefficient > 0.94). Patients' mean age was 23.59 (SD 6.93) years, the majority (102 patients) were women, and Caucasians (160 patients). Class III malocclusion was the most prevalent (81 patients). Asymmetry, vertical maxillary excess and biprotrusion were present in 54, 33, and 7 patients, respectively. The majority of surgeries for correction of dentoskeletal deformities were combined, involving the maxilla and mandible. In conclusion, Class III was the most prevalent skeletal deformity and Class I was the least prevalent; in general, the prevalence of skeletal deformities was higher in women; in the majority of patients with skeletal malocclusions there was a combination of maxillary and mandibular problems, which interferes directly in the decision regarding the most adequate treatment plan, and a higher incidence of asymmetry was observed in skeletal Class III; vertical excess occurred in a similar manner in Class II and III and there was a low incidence of biprotrusion among the malocclusions evaluated.

Este estudo avaliou a ocorrência de más oclusões esqueléticas apresentadas pelos pacientes do Centro de Pesquisa e Tratamento das Deformidades Bucofaciais (CEDEFACE), na cidade de Araraquara, SP, Brasil. Foram avaliados prontuários de 381 pacientes com deformidades dentoesqueléticas, que fizeram tratamento combinado ortodôntico-cirúrgico no período entre 2000 e 2006. Após a seleção da amostra (método de conveniência), baseado nos dados da documentação pré e pós-cirúrgica, o número de pacientes foi reduzido para 171. Para classificação do levantamento, considerou-se a discrepância ântero-posterior (Classe I, II e III), raça, idade, gênero, ausência ou presença de assimetria, excesso vertical maxilar e biprotrusão maxilar, além de determinar em qual base óssea o procedimento cirúrgico foi realizado. As documentações dos pacientes foram analisadas por um examinador previamente calibrado pelo processo de repetição até que o método fosse considerado adequado (correlação intraclasse >0,94). A idade média dos pacientes foi de 23,59 anos (DP 6,93), a maioria do gênero feminino (102 pacientes) e leucoderma (160 pacientes). A má oclusão mais prevalente foi a Classe III (81 pacientes). A assimetria, o excesso maxilar vertical e biprotrusão maxilar estavam presentes em 54, 33, e 7 pacientes, respectivamente. Na maioria dos casos, as cirurgias para correção de deformidades dentoesqueléticas foram combinadas, envolvendo os dois maxilares. Com base nos resultados, conclui-se que a Classe III foi a deformidade esquelética mais prevalente e a Classe I a menos prevalente. Em geral, a prevalência de deformidades esqueléticas foi maior entre as mulheres e a maioria dos pacientes apresentou uma combinação de problemas maxilares e mandibulares, o que interfere diretamente na decisão sobre o plano de tratamento mais adequado. Houve uma maior incidência de assimetria na Classe III esquelética; o excesso vertical ocorreu de forma semelhante na Classe II e III e a biprotrusão teve baixa incidência entre as más oclusões avaliadas.

Inner canthal distance and golden proportion as predictors of maxillary central incisor width in south Indian population.

Objectives: Even though the constant relation of golden proportion and inner canthal distance (ICD) with the width of the maxillary central incisor (CIW) has been found in European population, it may not be applied to Indian population as we differ from Europeans racially and genetically. Hence, this study was carried out with the objectives of determining if these parameters are applicable to our population also. Materials and Methods: Three hundred south Indian subjects between 18 and 26 years of age, free from facial and dental deformities were examined. Inner canthus of each eye was used as soft tissue landmark. The maxillary central incisors were measured at the contact point area with the help of digital vernier caliper. The CIW was also calculated using golden proportion ratio to obtain the calculated central incisor width. A comparison was made with measured width. Statistical analyses were done to identify any significant difference using "Z" tests. Pearson's Correlation Coefficient test was used to evaluate the measured and the calculated width of the central incisor. Results: ICD and the width of two maxillary incisors were in golden proportion in south Indian population. Also, ICD when multiplied by a decreasing function value of the golden proportion and divided by 2 is a reliable predictor of determining CIW. Conclusion: As in the European population, the ICD and the golden proportion are reliable predictors for determining the width of the maxillary central incisors in the south Indian population also.

A comparison of skeletal, dentoalveolar and soft tissue characteristics in white and black Brazilian subjects

OBJECTIVE: This study aimed to compare skeletal, dentoalveolar and soft tissue characteristics in white and black Brazilian subjects presenting normal occlusions. MATERIAL AND METHODS: The sample comprised the lateral cephalograms of 106 untreated Brazilian subjects with normal occlusion, divided into two groups: Group 1- 50 white subjects (25 of each gender), at a mean age of 13.17 years (standard deviation 1.07); and Group 2- 56 black subjects (28 of each gender), at a mean age of 13.24 years (standard deviation 0.56). Variables studied were obtained from several cephalometric analyses. Independent t tests were used for intergroup comparison and to determine sexual dimorphism. RESULTS: black subjects presented a more protruded maxilla and mandible, a smaller chin prominence and a greater maxillomandibular discrepancy than white subjects. Blacks presented a more horizontal craniofacial growth pattern than whites. Maxillary and mandibular incisors presented more protruded and proclined in black subjects. The nasolabial angle was larger in whites. Upper and lower lips were more protruded in blacks than in whites. CONCLUSIONS: The present study found a bimaxillary skeletal, dentoalveolar and soft tissue protrusion in black Brazilian subjects compared to white Brazilian subjects, both groups with normal occlusion. Upper and lower lips showed to be more protruded in blacks, but lip thickness was similar in both groups.

Cephalometry in 14-18 years old girls and boys of Shiraz-Iran high school / Cefalometría en niñas y niños de 14-18 años de la secundaria de Shiraz, Irán

Cephalometry or skull measurement are used in pediatrics, forensic medicine, plastic surgery, oral surgery and diagnostic comprehension between patient and normal populations. Cephalic index is an important parameter for detecting the race and sex of an individual whose identity is unknown. The most important of cephalometric dimension are height and width of head which determine cephalic index. On the basis of cephalic index four head shapes are determined in international categories, that including dolichocephal, brachycephal, mesocephal and hyperbrachycephal. With noticing the lack of documented research about 14-18 years old girls and boys in this area, this study was planned for determining normal range of head shapes in 867girls and 960 boys in the age of 14-18 in fars-Iran. In regards of cephalic index our results showed that dominent type of head in girls was brachycephalic with 42.5 percent and in boys was hyperbrachycephalic with 34.3 percent, rare type of head shape in girls was dolicocephalic with 4.80 percent and in boys was 7.5 percent. There is significant difference between boys and girls cephalic index.

La cefalometría o medición del cráneo se utiliza en pediatría, medicina forense, cirugía plástica, cirugía oral, diagnóstico del paciente y el entendimiento de las poblaciones normales. El índice cefálico es un parámetro importante para la detección de la raza y el sexo de una persona cuya identidad se desconoce. Las dimensiones cefalométricas más importantes son la altura y peso de la cabeza que determinan el índice cefálico. En base al índice cefálico cuatro formas de la cabeza son clasificadas en categorías internacionales: dolicocefálica, braquicefálica, mesocefálica e hiperbraquicefálica. Debido a la falta de información sobre las niñas y niños de 14-18 años, en este ámbito, se planificó el presente estudio para la determinar el rango normal de la forma de la cabeza, en 867 niñas y 960 niños, de 14 al 8 años de edad en Fars, Irán. Los resultados mostraron que el tipo dominante de cabeza en las niñas fue braquicefálico (42,5 por ciento) y en niños fue hiperbraquicefálico (34,3 por ciento). El tipo de cabeza de forma dolicocefálico en niñas en un 4,80 por ciento y en niños en el 7,5 por ciento. Existen diferencias significativas entre el índice cefálico de niños y niñas.

Sexual dimorphism determination from the lineal dimensions of skulls / Determinación del dimorfismo sexual utilizando las dimensiones lineales del cráneo

The sex determination from human skulls can be made by means of morphologic and morphometric methods have been broadly studied. These methods contribute with objective data; however, they present interpopulational variability. The purpose of this article is to determine sexual dimorphism using lineal dimensions in a sample of human skulls collection belonging to the Universidade Federal de Sao Paulo (UNIFESP), calculating the discriminant function. To complete the selection approaches, 226 skulls were analyzed. Mensurements were carried out among the following reference points of the skull: right Eurion- left Eurion (Eu - Eu), Glabella-Opisthocranion (Gla - Op), Basion - Bregma (Ba-Br), Nasion - Prosthion (Na-Pr), Bizigomatic (Zi-Zi), Maximal width of the piriform aperture (MWPA), and Nasion - Spinal (Na-ANS). Descriptive and inferential statistics (student's t-test proved p <0.05, analysis of discriminant function) for sex were calculated. Statistically significant differences were seen in the following dimensions: Gla - Op, Na - Pro, Zi - Zi, and Na - ANS. Only for the distances Zi - Zi and Na-ANS, a discriminant function with a yield of 82 percent was identified for the correct classification for sex. The authors conclude that the lineal dimensions present a limited utility for sexual dimorphism in this sample.

La determinación del sexo a partir de cráneos humanos por métodos morfológicos cualitativos y morfométricos ha sido ampliamente estudiada. Éstos últimos se destacan por aportar datos objetivos; sin embargo, presentan variabilidad inter-poblacional. Los objetivos de este trabajo fueron: a) evaluar el dimorfismo sexual por medio de las dimensiones lineales, en una muestra de cráneos adultos pertenecientes a la Universidade F ederal de Sao Paulo (UNIFESP); b) construir una función discriminante y c) evaluar su rendimiento. Se analizaron 226 cráneos que cumplieron los criterios de selección. Se realizaron las mediciones entre los siguientes puntos craneométricos: Eurion derecho- eurion izquierdo (Eu - Eu), Glabella- Opistocráneo (Gla - Op), Basion - Bregma (Ba-Br), Nasion - Prostion (Na-Pr), Bicigomática (Zi-Zi), Ancho máximo de la Apertura Piriforme (AMAP), Nasion - Espinal (Na-Es). Se calcularon estadísticos descriptivos e inferenciales (prueba t student p< 0.05, análisis de función discriminante) por sexo. Se establecieron diferencias estadísticamente significativas en las dimensiones Gla - Op, Na - Pro, Zi - Zi, Na - Es. Sólo las distancias Zi - Zi y Na-Es fueron capaces de componer una función discriminante con un rendimiento del 82 por ciento, para la correcta clasificación por sexo. Concluimos que las dimensiones lineales presenta una limitada utilidad para dimorfismo sexual en nuestra muestra.

Frecuencia del hueso interparietal o incaico en cráneos atácamenos (Lican antai) prehispánicos del norte de Chile / Frequency of interparietal bone or inca bone in pre-hispanic Atacamenos (Lican Antai) skulls of the north of Chile

El hueso interparietal se considera un hueso intercalar originado de centros independientes de osificación y rodeado por sus propias suturas. Se encontró en fósiles homínidos y humanos tempranos. Se cree que el occipucio sufre transformaciones por mutaciones al iniciarse la evolución humana reforzando esta teoría las variaciones suturales que presenta el occipital. Sería un rasgo genéticamente dominante, propuesta ratificada por estudios experimentales. Se observa con variadas formas según la fusión de los núcleos de osificación, por lo que todos los huesos ubicados en la zona de la escama del occipital no se pueden clasificar como suturales o wormianos y deben considerarse como parte del hueso interparietal. Tratando de confirmar la alta frecuencia obtenida en investigaciones anteriores realizadas en cráneos de individuos originarios del norte de Chile, se analizaron 83 cráneos de atacamenos prehispánicos de ambos sexos, seleccionados al azar entre 293 individuos exhumados del cementerio Coyo-Oriente, datados entre 300-1200 D.C período post-Tiwanaku y que forman parte del Museo R.P. Gustavo Le Paige en San Pedro de Atacama, dependiente del Instituto de Investigaciones Arqueológicas de la Universidad Católica del Norte, que fueron fotografiados en todas sus normas anatómicas y que se midieron paras obtener el índice craneal o cefálico. El hueso interparietal está presente en 23 de 83 cráneos, con una frecuencia de 27,71 por ciento, sin diferencias estadísticas significativas al 95 por ciento con investigaciones realizadas en cráneos de origen étnico similar y en otras etnias que presentan alta frecuencia de hueso interparietal. Por el contrario, se encontraron diferencias estadísticamente significativas al 95 por ciento con frecuencias determinadas en cráneos europeos caucásicos y euroasiáticos. Los autores integraron las tablas clasificatorias de Kadanoff y Hanihara-Ishida, para obtener una tabla modificada que permitiera clasificar ...

The interparietal bone is considered an intercalary bone originated by independent ossification centers and surrounded by its own sutures. It is found in early hominids and human fossils. It is believed that the occipital bone undergoes transformations by mutations at the beginning of human evolution. Reinforcing this theory are the suture variations that presents the occipital bone. It would be a dominant genetic characteristic, proposal ratified by experimental studies. It is observed with varied forms according to the fusion of the ossification nuclei; reason why all the bones located in the zone of the occipital flake cannot be classified as sutures or wormians and must be considered part of the interparietal bone. Trying to confirm the high frequency obtained in previous investigations realized in skulls of original individuals of the north of Chile, we analyzed 83 skulls of pre-Hispanic atácamenos (lican antai) of both sexes, selected at random between 293 individuals of the Coyo-Orient cementery, dated between 300-1200 A.C, post-Tiwanaku period and these remains are part of R.P Gustavo Le Paige's Museum in San Pedro de Atacama, which is part of the Institute of Archaeological Investigations of the North Catholic University. The remains were photographed in all anatomical norms and that were measured to obtain the cranial or cephalic Index. The interparietal bone is present in 23 of 83 skulls, with a frequency of 27.71 percent, without significant statistical differences to 95 percent with investigations realized in skulls of similar ethnic origin and other ethnic groups who present high frequency of interparietal bone. On the contrary, statistically significant differences to 95 percent were found with frequencies determined in caucasian and euroasiatics european skulls. The authors integrated the classificatory tables of Kadanoff and Hanihara-Ishida, to obtain a modified table that allowed to classify all the found variations ...