A cephalometric analysis of the cranial base and frontal part of the face in patients with mandibular prognathism

Tatjana Čutović; Nebojša Jović; Ljiljana Stojanović; Julija Radojičić; Irena Mladenović§; Stevo Matijević; Ružica Kozomara

doi:10.2298/3078

Tatjana Čutović Department of Orthodontics, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Nebojša Jović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Department of Maxillofacial Surgery, Military Medical Academy, Belgrade, Serbia
Ljiljana Stojanović Department of Orthodontics, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia
Julija Radojičić Department of Orthodontics, Faculty of Medicine, University of Niš, Niš, Serbia
Irena Mladenović§ §Department of Prosthodontics, Faculty of Medicine, University of East Sarajevo, Bosnia Herzegovina
Stevo Matijević Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Department of Oral Surgery, Military Medical Academy, Belgrade, Serbia
Ružica Kozomara Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Department of Maxillofacial Surgery, Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/3078

Keywords: mandible, prognathism, cephalometry, skull, facial bones, sella turcica,

Abstract

Bacground/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.

References

Bishara SE. Textbook of orthodontics. Philadelphia: Saunders 2001.

Proffit WR, Fields HW, Sarver DM. Orthodontics. Jastrebarsko: Naklada Slap; 2009. (Croatian)

Dhopatkar A, Bhatia S, Rock P. An investigation into the rela-tionship between the cranial base angle and malocclusion. An-gle Orthod 2002; 72(5): 456−63.

Enlow DH. Facial growth. 3rd ed. Philadelphia: Saunders; 1990.

Proff P, Will F, Bokan I, Fanghänel J, Gedrange T. Cranial base features in skeletal Class III patients. Angle Orthod 2008; 78(3): 433−9.

Singh GD, Mcnamara JA, Lozanoff S. Finite element analysis of the cranial base in subjects with Class III malocclusion. Br J Orthod 1997; 24(2): 103−12.

Singh GD, McNamara JA, Lozanoff S. Thin-plate spline analysis of the cranial base in subjects with Class III malocclusion. Eur J Orthod 1997; 19(4): 341−53.

Hayashi I. Morphological relationship between the cranial base and dentofacial complex obtained by reconstructive computer tomographic images. Eur J Orthod 2003; 25(4): 385−91.

Singh GD, McNamara JA, Lozanoff S. Morphometry of the cra-nial base in subjects with Class III malocclusion. J Dent Res 1997; 76(2): 694−703.

Anderson D, Popovich F. Relation of cranial base flexure to cranial form and mandibular position. Am J Phys Anthropol 1983; 61(2): 181−7.

Choi WJ, Hwang EH, Lee SE. The study of shape and size of normal sella turcica in cephalometric radiographs. Korean J Oral Maxillofac Radiol 2001; 31: 43−9.

Axelsson S, Storhaug K, Kjaer I. Post-natal size and morphology of the sella turcica: Longitudinal cephalometric standards for Norwegians between 6 and 21 years of age. Eur J Orthod 2004; 26(6): 597−604.

Weisberg LA. Asymptomatic enlargement of the sella turcica. Arch Neurol 1975; 32(7): 483−5.

Nielsen BW, Mølsted K, Kjaer I. Maxillary and sella turcica mor-phology in newborns with cleft lip and palate. Cleft Palate Craniofac J 2005; 42(6): 610−7.

Kjaer I, Wagner A, Madsen P, Blichfeldt S, Rasmussen K, Russell B. The sella turcica in children with lumbosacral myelomeningo-cele. Eur J Orthod 1998; 20(4): 443−8.

Kjaer I, Hansen N, Becktor KB, Birkebaek N, Balslev T. Craniofa-cial morphology, dentition, and skeletal maturity in four sib-lings with Seckel syndrome. Cleft Palate Craniofac J 2001; 38(6): 645−51.

Koshino T, Konno T, Ohzeki T. Bone and joint manifestations of Rieger's syndrome: a report of a family. J Pediatr Orthop 1989; 9(2): 224−30.

Becktor JP, Einersen S, Kjaer I. A sella turcica bridge in subjects with severe craniofacial deviations. Eur J Orthod 2000; 22(1): 69−74.

Jones RM, Faqir A, Millett DT, Moos KF, McHugh S. Bridging and dimensions of sella turcica in subjects treated by surgical-orthodontic means or orthodontics only. Angle Orthod 2005; 75(5): 714−8.

Čutović T, Pavlović J, Kozomara R. Analysis of dimensions of sella turcica in patients with mandibular prognathism. Vojnosanit Pregl 2008; 65(6): 456−61. (Serbian)

Leonardi R, Barbato E, Vichi M, Caltabiano M. A sella turcica bridge in subjects with dental anomalies. Eur J Orthod 2006;28(6):580-585.

Alkofide EA. The shape and size of the sella turcica in skeletal Class I, Class II, and Class III Saudi subjects. Eur J Orthod 2007; 29(5): 457−63.

Holly SB, Crummett TL, Brandt KL. Ages of eruption of primate teeth: A compendium for aging individuals and comparing life histories. Am J Phys Anthropol 1994; 37(S19): 177−231.

Dostálová S, Sonka K, Smahel Z, Weiss V, Marek J. Cephalometric assessment of cranial abnormalities in patients with ac-romegaly. J Craniomaxillofac Surg 2003; 31(2): 80−7.

Reyes BC, Baccetti T, McNamara JA. An estimate of craniofacial growth in Class III malocclusion. Angle Orthod 2006; 76(4): 577−84.

Baccetti T, Reyes BC, McNamara JA. Craniofacial changes in Class III malocclusion as related to skeletal and dental matura-tion. Am J Orthod Dentofacial Orthop 2007; 132(2): 171−8.

Ellis E, McNamara JA. Components of adult Class III maloc-clusion. J Oral Maxillofac Surg 1984; 42(5): 295−305.

Singh GD. Morphologic determinants in the etiology of class III malocclusions: A review. Clin Anat 1999; 12(5): 382−405.

Chang JZ, Chen Y, Chang FH, Yao JC, Liu P, Chang C, et al. Morphometric analysis of mandibular growth in skeletal Class III malocclusion. J Formos Med Assoc 2006; 105(4): 318−28.

Hoyte DAN. The cranial base in normal and abnormal skull growth. Neurosurg Clin North Am 1991; 2: 515−37.

Baccetti T, Franchi L, McNamara JA. Cephalometric variables predicting the long-term success or failure of combined rapid maxillary expansion and facial mask therapy. Am J Orthod Dentofacial Orthop 2004; 126(1): 16−22.