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Craniofacial features affecting mandibular asymmetries in skeletal Class II patients

Einfluss kraniofazialer Merkmale auf Unterkieferasymmetrien bei skelettalen Klasse-II-Patienten

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objectives

The aim of this study was to evaluate the characteristics affecting different intensities of mandibular asymmetry in skeletal Class II adults using three-dimensional images. This study is clinically relevant since it allows professionals to evaluate the morphological components related to these deformities and more carefully obtain correct diagnosis and treatment plan for such patients.

Methods

Cone-beam computed tomography data of 120 Class II patients (40 with relative symmetry, 40 with moderate asymmetry, and 40 with severe asymmetry) were imported to SimPlant Ortho Pro® 2.0 software (Dental Materialise, Leuven, Belgium). Three reference planes were established and linear measurements were performed from specific landmarks to these planes, comparing the deviated side and the contralateral side in each group, as well as the differences between groups. The correlation between midline mandibular asymmetry and other variables was also evaluated. Statistical analyses considered a significance level of 5%.

Results

Comparing the values obtained on the deviated side and on the contralateral side, there were significant differences for patients with moderate asymmetry and severe asymmetry. However, differences were seen more often in severe mandibular asymmetries. In those patients, there was a significant correlation of the gnathion deviation with lower dental midline deviation, difference in the lateral gonion positions, difference in the mandibular rami heights, and difference in the jugale vertical displacements.

Conclusions

For skeletal Class II patients with mandibular asymmetry, some craniofacial features are related to chin deviation and require proper evaluation, including the bilateral differences in the ramus height, mandibular body length, transverse and vertical positioning of the gonion and jugale points.

Zusammenfassung

Ziele

In der Studie sollten mittels dreidimensionaler Bildgebung die Charakteristika evaluiert werden, welche die unterschiedlich starke Ausprägung von Unterkieferasymmetrien bei erwachsenen Klasse-II-Patienten beeinflussen. Die klinische Relevanz der Untersuchung besteht darin, dass sie die Möglichkeit bietet, mit diesen Deformitäten verbundene morphologische Komponenten zu evaluieren und auf sorgfältigere Weise sowohl die zutreffende Diagnose zu stellen als auch die Behandlung zu planen.

Methoden

Daten der digitalen Volumentomographien (DVT) von 120 Klasse-II-Patienten (40 mit relativer Symmetrie sowie 40 mit mäßiger und 40 mit ausgeprägter Asymmetrie) wurden in die Software SimPlant Ortho Pro® 2.0 (Dental Materialise, Leuven, Belgien) importiert. Anhand von 3 definierten Bezugsebenen und spezifischen Referenzpunkten wurden Messungen durchgeführt, um die abweichende und die kontralaterale Seite miteinander zu vergleichen und um Intergruppenunterschiede zu ermitteln. Ebenso evaluiert wurde die Korrelation zwischen Mittellinienasymmetrie und anderen Variablen. Als Signifikanzniveau für die statistischen Berechnungen wurde p = 0,05 festgelegt.

Ergebnisse

Zwischen den Werten auf der abweichenden und der kontralateralen Seite zeigten sich statistisch signifikante Unterschiede für Patienten mit mäßiger und mit ausgeprägter Asymmetrie. Allerdings ließen sich häufiger Unterschiede beobachten bei den ausgeprägten Unterkieferasymmetrien. Bei diesen Patienten bestanden eine signifikante Korrelation zwischen der Gnathion-Abweichung und der unteren dentalen Mittellinienabweichung, ein Unterschied in den Gnathion-Positionen, ein Unterschied in den Höhen der Rami und in den Längen des Corpus mandibulae und ein Unterschied in den transversalen und vertikalen Abweichungen der Punkte Gonion und Jugale.

Schlussfolgerungen

Bei skelettalen Klasse-II-Patienten stehen einige kraniofaziale Besonderheiten—u. a. bilaterale Unterschiede in der Ramushöhe, der Unterkieferlänge sowie der horizontalen und vertikalen Positionierung der Punkte Gonion und Jugale—in Beziehung zu Abweichungen des Kinns. Diese Eigenschaften sind angemessen zu evaluieren.

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Authors and Affiliations

  1. Department of Orthodontics, University of Southern Santa Catarina, Av. Madre Benvenuta, 1285 Santa Monica, 88035-001, Florianopolis, SC, Brazil

    Guilherme Thiesen

  2. Department of Orthodontics, Saint Louis University, St. Louis, MO, USA

    Guilherme Thiesen, D. R. Oliver & K. B. Kim

  3. Belo Horizonte, MG, Brazil

    B. F. Gribel

  4. Department of Orthodontics, Luteran University of Brazil, Canoas, Brazil

    M. P. M. Freitas

Authors
  1. Guilherme Thiesen
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  2. B. F. Gribel
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  3. M. P. M. Freitas
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  4. D. R. Oliver
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  5. K. B. Kim
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Correspondence to Guilherme Thiesen.

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Conflict of interest

G. Thiesen, B. F. Gribel, M. P. M. Freitas, D. R. Oliver, and K. B. Kim declare that they have no conflict of interest.

Human and animal rights statement

This study had no funding. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. For this retrospective study, the Ethics Committee dismissed formal consent.

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Professor Guilherme Thiesen.

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Thiesen, G., Gribel, B.F., Freitas, M.P.M. et al. Craniofacial features affecting mandibular asymmetries in skeletal Class II patients. J Orofac Orthop 78, 437–445 (2017). https://doi.org/10.1007/s00056-017-0100-6

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  • DOI: https://doi.org/10.1007/s00056-017-0100-6

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