Lateral cephalometric diagnosis of asymmetry in Angle Class II subdivision compared to Class I and II

Abstract

IntroductionLateral cephalometric radiographs are traditionally required for orthodontic treatment, yet rarely used to assess asymmetries.ObjectiveThe objective of the present study was to use lateral cephalometric radiographs to identify existing skeletal and dentoalveolar morphological alterations in Class II subdivision and to compare them with the existing morphology in Class I and II relationship.Material and MethodsNinety initial lateral cephalometric radiographs of male and female Brazilian children aged between 12 to 15 years old were randomly and proportionally divided into three groups: Group 1 (Class I), Group 2 (Class II) and Group 3 (Class II subdivision). Analysis of lateral cephalometric radiographs included angular measurements, horizontal linear measurements and two indexes of asymmetry that were prepared for this study.ResultsIn accordance with an Index of Dental Asymmetry (IDA), greater mandibular dental asymmetry was identified in Group 3. An Index of Mandibular Asymmetry (IMA) revealed less skeletal and dental mandibular asymmetry in Group 2, greater skeletal mandibular asymmetry in Group 1, and greater mandibular dental asymmetry in Group 3.ConclusionBoth IDA and IMA revealed greater mandibular dental asymmetry for Group 3 in comparison to Groups 1 and 2. These results are in accordance with those found by other diagnostic methods, showing that lateral cephalometric radiography is an acceptable method to identify existing skeletal and dentoalveolar morphological alterations in malocclusions.

Cone-beam computed tomographic evaluation of the temporomandibular joint and dental characteristics of patients with Class II subdivision malocclusion and asymmetry

“…Some previous studies using two-dimensional (2D) radiography have proven that asymmetry in the mandibular and/or maxillary arches are the primary factors resulting in Class II subdivision malocclusion, 1 2 3 and several scholars have shown the presence of skeletal asymmetries. 4 Recent studies employing cone-beam computed tomography (CBCT) have concluded that Class II subdivision malocclusion might be caused by dental, skeletal, and functional asymmetries. 5 6 7 These results suggested that the asymmetry characteristics of Class II subdivision malocclusion were complex.…”

A 3D mirroring and colormap asymmetry study of Class II subdivision patients

“…Several studies using 2D radiographs did not find any significant mandibular asymmetry in patients with Class II subdivision malocclusion. [5][6][7][8][9]22,24 In the present study, significant differences were found in the two mandibular areas evaluated. The gonion area of the Class II side is positioned more posterior, lateral and inferior than the same area on the Class I side.…”

“…4 Anthropologic and radiographic investigations have shown that it is more common than not to have skeletal and dental differences between the two sides of the craniofacial complex. [5][6][7][8][9][10]…”

“…These studies show contradictory results, probably due to using different approaches and methodology. [5][6][7][8][9] One now obsolete approach for the study of asymmetry is the use of 2D radiography. [11][12][13][14] The studies that used CBCT analysis to evaluate skeletal and dental asymmetries in Class II subdivision patients also cannot agree on their results.…”

Prevalencia de patrones Máxilo-Mandibulares en pacientes de 8,5 a 12 años, utilizando Cefalometría de Ricketts en servicios de ortopedia universitarios

“…La Técnica de Ricketts es un análisis cefalométrico, que se basa en el plano horizontal de Frankfort (4)(5) . El razonamiento de Ricketts se basa en un método de superposición en la región posterior de la base del cráneo y la línea nasion-basión, (6) fundamentándose que el crecimiento de la sincondrosis esfeno-occipital desempeña un papel importante hasta el final de la pubertad, (7)(8) establece un análisis preciso que permite determinar la clase esqueletal, con trazados desde puntos de referencia anatómicos, (9) considerando los dientes, maxilares, cráneo, cuello e incluso la edad y sexo como variables determinantes en el crecimiento facial (10)(11) .…”