Thoracic-lumbar-sacral spine sagittal alignment and cranio-mandibular morphology in adolescents.

PURPOSE: The relationship between thoracic-lumbar-sacral spine sagittal alignment and craniofacial morphology is still controversial. Evidence-based results are difficult to obtain and scientific studies are inhomogeneous. The aim of this study was to investigate the difference of thoracic-lumbar-sacral spine posture and cephalometric values comparing two groups of subjects with different cranial structure in the sagittal plane. METHODS: Eighty-one subjects were consecutively selected and divided into two groups, according to the orientation of the condyle-orbital plane (CoOr) with respect to the superior maxilla (SpP): Group1: 49 subjects 11.6 (2.1) years showing posterior-rotation of CoOr: SpP^CoOr ≤ -2°, -4.1°(2.1°); Group2: 32 subjects 12.9 (2.3)years showing anterior-rotation of CoOr: SpP^CoOr ≥ 2°, 3.7°(1.9°). Each patient underwent in blinding, Spinal Mouse recording and cephalometry of the skull. RESULTS: Group1 showed a significant forward tilting of the spine 4.4°(1.8°) with respect to Group2 2.4°(1.3°) (p < 0.0001) and higher values related to the vertical dimension of the skull: higher maxillary divergency (p < 0.0001), steep occlusal plane (p < 0.0007), higher gonial angle (p < 0.001). DISCUSSION: The results of this study showed a difference in the thoracic-lumbar-sacral spine inclination between groups with different craniofacial morphology. The achievement of this outcome is important to improve our multidisciplinary evaluation and treatment planning.

Analysis on correlation of sagittal craniofacial structures with different classes of malocclusion based on genetic algorithms method / 吉林大学学报(医学版)

Objective:To optimize the parameters of the equation of sagittal craniofacial structures with different classes of malocclusion using genetic algorithms(GAS), and to explore the rules .Methods:A total of 240 patients with average angle malocclusion aged 8-18 years old were divided into three groups: Angle Class Ⅰ(n=79), Angle Class Ⅱ(n=76)and Angle Class Ⅲ(n=85) groups.In each group 10 cases were randomly selected as the test samples, the rest as the experimental samples.The cephalometric analysis was performed on all the patients'' cephalograms, and the results of Ba-N,Ba-A,Ba-S,S-Ptm,Ptm-A,Ba-Ar,Ar-Go,Go-PoG,Ba-PoG and N-S-Ar were analyzed by two independent samples t-test and One-Way ANOVA. The relevant influencing factors of craniofacial structures were found.The parameters of the equation was optimized to obtain the relevant equations using GAS.The predicted values of the optimized equation were compared with the measured values.Results:There were no significant differences in sex between Angle Class Ⅰ, Class Ⅱ and Class Ⅲ groups(P> 0.05);when the men and women with the same type were combined,the Ba-A,Ptm-A,Ar-Go,and Ba-PoG had statistically significant differences between Angle Class Ⅰ, Class Ⅱ, and Class Ⅲ groups (P 0.05), and the error was small.Conclusion: The optimal relation equation of craniofacial structure of sagittal malocclusion is established by GAS with the quantitative regularity.

Do prenatal and postnatal hypothyroidism affect the craniofacial structure?: An experimental study.

OBJECTIVE: To investigate the effect of experimental prenatal and postnatal hypothyroidism (HT) on the craniofacial structure in rats. MATERIALS AND METHODS: Female Wistar albino rats were mated with males for fertilization. Pregnant rats were divided into three groups. Group 1 (methimazole [MMI]-induced prenatal hypothyroidism group) mother rats were given MMI water during and after pregnancy. Group 2 (MMI-induced postnatal hypothyroidism group) mother rats were given MMI water after pregnancy. After the breast-feeding period, group 1 and 2 rat pups received the same water as their lactating mothers drank. Group 3 (control group) pregnant rats and rat pups were given normal tap water. When the rat pups were 90 days of age, lateral cephalometric and posteroanterior films were taken under anesthesia. RESULTS: Posteroanterior radiographs revealed that palatal, cranial, bizygomatic arch, and bigonial width measurements were significantly shorter in prenatal HT and postnatal HT groups compared to the control group (P < .001). Intragroup comparisons in lateral cephalometric radiographs showed that, nearly all of the comparisons were statistically significant (P < .05), with the exception of the Co-Gn, E-Pg/S-Gn measurements between the prenatal and postnatal HT groups. CONCLUSIONS: Sagittal and transverse measurements showed that untreated HT has detrimental effects on the growth of the maxilla and mandible.

Maxillomandibular Volume Influences the Relationship between Weight Loss and Improvement in Obstructive Sleep Apnea.

STUDY OBJECTIVES: Obesity is the major risk factor for OSA; however, weight loss reduces OSA to a variable extent. We aimed to assess whether size of the maxillomandibular skeletal enclosure influences the relationship between weight loss and OSA reduction. METHODS: Obese males (≥ 30 kg/m2) with moderate-severe OSA (AHI > 15/h) participating in a 6-mo open-label weight loss program had craniofacial computed tomography (CT) scans before and after weight loss. CT scans were analysed using three-dimensional cephalometry. Maxillomandibular volume was calculated from skeletal landmarks on the mandible (condyle, gonion, menton) and maxilla (anterior nasal spine). Multiple regression analysis was used to test for moderating effects of maxillomandibular volume on relationship between changes in weight and apnea-hypopnea index (AHI). RESULTS: Fifty-two men (age 44.3 ± 8.8 y, AHI 42.9 ± 21.3 events/h, body mass index [BMI] 34.0 ± 2.7 kg/m2) had 7.4 ± 4.1% weight loss and 34.1 ± 32.4% AHI reduction at 6 months. BMI reduction modestly predicted AHI change (r2 = 0.17, P = 0.002). The interaction term of maxillomandibular volume and BMI change was a predictor of OSA improvement (P = 0.03), indicating maxillomandibular volume moderates this relationship. Subgroup analyses of patients by small, medium, and large maxillomandibular volume showed a strong correlation between weight loss and OSA improvement only in the small volume group (r = 0.654, P = 0.004). There was no relationship evident in those with large maxillomandibular volume (r = 0.05, P = 0.9). CONCLUSION: Maxillomandibular volume influences the relationship between weight loss and OSA improvement with an effect on AHI more evident in those with a smaller craniofacial skeleton.

Proporção divina em indivíduos oclusões classes I, II e III esqueléticas em radiografias cefalométricas laterais / Proporción divina en pacientes con oclusión clases I, II y III esqueléticas en radiografías cefalométricas laterales / Divine proportion in patients with skeletal occlusion classes I, II and III on lateral cephalometric radiographs

Introdução: o conceito inicial de beleza remete a um conjunto que engloba harmonia e equilíbrio das proporções faciais estabelecidas pelas estruturas esqueléticas, dentárias e de tecidos moles. Objetivo: o objetivo deste estudo foi analisara proporção divina em radiografias cefalométricas laterais de 93 indivíduos brasileiros adultos, acima de 18 anos, de ambos os gêneros, com classes I, II e III esqueléticas, não submetidos a tratamento ortodôntico, por meio do software de cefalometria Aurea Ceph. Métodos: para análise estatística, foi aplicada a análise de variância ANOVA, teste Tukey e T de Studentem nível de significância de 5 porcento. Resultados: das sete razões estudadas, quando se avaliou as classes, evidenciou-se diferença estatisticamente significante entre a relação (N-Ena/V1S-DM16) nas classes I e III eas relações (A-Pog/V1-C1MS e A-Pog/V1S-MD16) nas classes II e III. Quando se comparou as razões nas diferentes classes em relação ao número áureo (1 618) houve diferença estatisticamente significante na classe I para as razões (N-Ena/V1S-DM16, V1S-C1MS/C1MS-DM16 e Ena-Me/AB); na classe II para as razões (A-Pog/V1-C1MS e A-Pog/V1S-MD16); e na classe III para as razões (N-Ena/V1S-DM16, Ena-Enp/V1S-C1MS, V1S-C1MS/C1MS-DM16 e Ena-Me/AB). Conclusões: de acordo com a metodologia empregada e os resultados obtidos, concluiu-se que das sete razões analisadas, a classe I apresentou três razões divinas, a classe II duas e a classe III quatro. O grupo classe II apresentou razões divinas com componente dentário e medidas verticais, sugerindo que a magnitude do erro sagital é importante no conceito da estética facial(AU)

Introducción: el concepto inicial de la belleza se refiere a un conjunto con la armonía y el equilibrio de las proporciones faciales establecidos por el tejido óseo, dental y suave. Objetivo: el objetivo de este estudio fue analizar la divina proporción en las radiografías cefalométricas de 93 individuos brasileños adultos, de 18 años, de uno y otro géneros, con las clases I, II y III del esqueleto, y no sometidos a un tratamiento de ortodoncia por medio de software de cefalometría Áurea Ceph". Métodos: el análisis estadístico se aplicó al análisis de varianza ANOVA, prueba de Tukey y prueba t de Student. El nivel de significación fue de 5 por ciento. Resultados: de los siete ratios estudiados, hubo una diferencia estadísticamente significativa entre las proporciones al comparar las clases en (N-Ena/V1S-DM16) clases I y III y (A-Pog/V1-C1MS, A-Pog/V1S-MD16) clases II y III. Cuando se comparó con las proporciones en las diferentes clases en relación con el número de oro (1 618), hubo diferencia estadísticamente significativa en la clase I para las (N-Ena/V1S-DM16, razones V1S-C1MS/C1MS-DM16, Ena-Me/AB), y en clase II de (A-Pog/V1-C1MS razones, A-Pog/V1S-MD16) y clase III para los (N-Ena/V1S-DM16 razones, Ena-Enp/V1S-C1MS, V1S-C1MS/C1MS-DM16, Ena-Me/AB). Conclusiones: de acuerdo con la metodología utilizada y los resultados obtenidos, se concluyó que en siete de las razones expuestas, la clase que tenía tres razones áureas se observó en dos y cuatro, clase II a clase III. El grupo de clase II fueron razones áureas con componente dental y horizontal, lo que sugiere que la magnitud del error es importante en el concepto de estética facial sagital. El grupo de clase II fueron razones áureas con componente dental y medidas verticales, y también sugiere que la magnitud del error es importante en el concepto de estética facial sagital(AU)

Introduction: the original concept of beauty refers to a set of harmony and balance features determined by bone, dental and soft tissue. Objective: the purpose of this study was to analyze divine proportion as reflected on cephalometric radiographs of 93 Brazilian subjects of both sexes aged 18 with skeletal classes I, II and III, not undergoing orthodontic treatment. The analysis was based on cephalometric software Aurea Ceph. Methods: statistical analysis was performed with ANOVA, Tukey's test and Student's t test. The significance level was 5 percent. Results: the seven ratios studied showed a statistically significant difference between proportions when comparing (N-Ena/V1S-DM16) classes I and III, and (A-Pog/V1-C1MS, A-Pog/V1S-MD16) classes II and III. When proportions in the different classes were compared with the golden number (1 618), a statistically significant difference was found in class I for (N-Ena/V1S-DM16, V1S-C1MS/C1MS-DM16, Ena-Me/AB), in class II for (A-Pog/V1-C1MS, A-Pog/V1S-MD16) and in class III for (N-Ena/V1S-DM16, Ena-Enp/V1S-C1MS, V1S-C1MS/C1MS-DM16, Ena-Me/AB). Conclusions: based on the methodology used and the results obtained, it was concluded that in seven of the ratios presented, the class with three golden ratios was found in two and four, class II to class III. The class II group were golden ratios with a dental and horizontal component, suggesting that the magnitude of the error is relevant to the concept of sagittal facial aesthetics. The class II group were golden ratios with a dental component and vertical measurements, also suggesting that the magnitude of the error is relevant to the concept of sagittal facial aesthetics(AU)

A CEPHALOMETRIC COMPARATIVE STUDY OF SKELETAL CLASS III MALOCCLUSION AND CLASS I NORMAL OCCLUSION BY RICKETTS' ANALYSIS

The purpose of this study was to evaluate the parts of discrepancy on orthognathic surgical cases with skeletal Class III malocclusion. For this study, Ricketts' analysis that has suggested visual treatment objective, as named for growth predictable blue print, was used. The results of this study were as follows: 1. In the denture problem, mandibular incisor and molar was positioned more anteriorly in Class III malocclusion. 2. The location of A point was characteristically posteriorly positioned in the Class III group, and mandible plane angle was within normal range in the groups. 3. Position of upper and lower anterior teeth to A-Pogonion line was anteriorly positioned, and angulation of upper anterior tooth was lingually positioned in the Class III group, but angulation of lower anterior tooth was not significant in the both groups. 4. Esthetic line of Ricketts' analysis was not significant statistically. 5. Facial depth and axis was larger, but facial taper(facial plane mandible plane) was smaller in the Class III group. So, protruded and concave profile was seen in the Class III group. 6. Cranial deflection was larger in the Class III male group, ramus location was anteriorly positioned and mandibular length was enlarged in the male and female of Class III group.

Characteristics of craniofacial structures in severe adult Class III malocclusion / 대한치과교정학회지

The purpose of this study is to define the characteristics of the skeleton and soft tissues of severe adult class III malocclusion. The materials selected for this study were lateral cephalograms of 112 adult class III malocclusion patients with ANB difference below -2 degrees. and the mean age was 22.9 years old. The normal control samples consisted of lateral cephalograms of 50 adults in normal occlusion and the mean age was 22.1 years old. The Horizontal reference line was FH line and the vertical reference line was nasion perpendicular to FH line. The skeletal and soft tissue characteristics of Class III malocclusion are as follows: 1. In the skeletal profile evaluated by vertical reference line (Nasion perpendicular to FH), the forehead and maxilla was similar to normal, but the mandible was protruded significantly. 2. The soft tissue profile is concave. The thickness of soft tissue covering forehead area and nose is within normal range. but the upper lip is thicker and the nasolabial angle is smaller than normal. The lower lip and inferior labial sulcus is thinner than normal. The degree of eversion of lower lip is lesser than normal. 3. The cranial base of class III malocclusion is shorter and saddle angle is smaller than normal. 4. The location of midface evaluated in relations to cranial base is within normal range but, the length of midface is shorter than normal when compared from the deep portion of the facial skeleton. 5. The location of maxilla in reference to cranial base is within normal range but the length of maxilla was shorter in class III malocclusion. 6. The mandible was protruded, ramus height and body length, gonial angle were greater than normal, and the chin angle was smaller. 7. Upper incisor was proclined, lower incisor was retroclined.

Craniofacial structure and arch dimension of adult Class III malocclusion / 대한치과교정학회지

This study was conducted to discern-differences of craniofacial, dentnalveolar structure and model measurements between sex and between class III openbite group and non-openbite group. The sample consisted of 49 adult patients with class III malocclusion. 24 linear measurements, 22 angular measurements and 12 ratios were -selected in lateral cephalometry. Also, arch width, length, antericr crowding, average molar relation were measured or calculated in diagnostic model. The data were evaluated by t-test and multiple discriminant analysis. The results were as follows ; 1. Most linear measurements, with the exception of MnBL and AUDH, were significantly larger in male(p0.05). but openbite group showed significantly increased gonial angle(p<0.05), FH-CoGo(p<0.01), FH-NA(p<0.01) and FH-NB, FH-NPog (p<0.05). 4. ALFH and PUDH were larger(p<0.05) in openbite group. this result served as compensation for the spatial position of mandible relative to cranial base. AUPUDH (p<0.001) and ALPLDH(p<0.05) were lower in openbite group. upper anterior crowding was the only measurement which showed difference between openbite and non-openbite group(p<0.05). 5. For the purpose of classifying adult class III openbite and non-openbite group, multiple discriminant analysis was done. gonial angle, ALPLDH, AUPUDH, FH-NA were included in multiple discrinunant equation. 39 cases(92.86%) were correctly classified when applied to the sample used in this study.

The longitudinal growth changes of craniofacial structure in Korean adult (during the age of 24 to 31) / 대한치과교정학회지

Recently, according to the increase of adult patient, it is neccessory to understand the growth changes of adult after cessation of active pubertal growth in clinical orthodontics. The purpose of this study was to investigate the growth changes of craniofacial structure after active growth period(afult) in order to use reference in clinical orthodontics. Authors followed the 40 sample(male 25, female 15) from 24 to 31 years of age. By analyzing the serial cephalograms, authors could get the following findings. ? The mandible rotated clockwise in female, but not in male, and no incremental growth change in both genders. ? The anterior facial height and lower anterior facial height were increased in both genders, the increase of lower anterior facial height exceed the posterior facial height increase in famale. ? The cranial base was stable throughout observation period. ? The upper incisors uprighted slightly in female. ? There were quite great the individual variation in the growth change of ceaniofacial structure in adult.