Distribution of Various Maxilla-Mandibular Positions and Cephalometric Comparison in Chinese Skeletal Class II Malocclusions
Xin Xiong, Yanmei Huang, Wei Liu, Yange Wu, Yating Yi, Jun Wang
Citation Information :
Xiong X, Huang Y, Liu W, Wu Y, Yi Y, Wang J. Distribution of Various Maxilla-Mandibular Positions and Cephalometric Comparison in Chinese Skeletal Class II Malocclusions. J Contemp Dent Pract 2020; 21 (8):822-828.
Aim: To obtain the distribution of different maxilla-mandibular characteristics in Chinese skeletal class II mixed dentition patients and to compare the differences of cephalometric variables among different maxilla-mandibular types. Materials and methods: A cross-sectional study was conducted among 310 skeletal class II patients in mixed dentition. The patients were divided into 6 groups according to SNA and SNB angle of the cephalogram. A total of 38 cephalometric measurements were measured on their cephalograms. Differences among groups were tested by one-way analysis of variance. Results: There were 34 (10.97%) patients in group I, 10 (3.23%) in group II, 4(1.29%) in group III, 69 (22.26%) in group IV, 133 (42.90%) in group V, and 60 (19.35%) in group VI. In all, 14.19% of the patients exhibited maxillary protrusion (MxP), and 62.26% exhibited mandibular retrusion (MnR) with either normal or retruded maxilla. Groups II and III were excluded for statistical comparison due to a limited sample size. Statistical differences were found in 25 cephalometric measurements among the other 4 groups. Patients with MnR (groups V and VI) exhibited bigger sella angle, gonial angle, Frankfort mandibular plane angle, and smaller mandibular body length and ramus height than patients without MnR (p value < 0.05). Conclusion: The most common etiology forming skeletal class II malocclusion in Chinese children was MnR, which was mainly caused by the small size and hyperdivergent growth direction of mandible. Clinical significance: The study presents various cephalometric characteristics of Chinese skeletal class II malocclusions. The results indicated that for the early orthodontic treatment of Chinese class II children with mixed dentition, orthodontists might emphasize more importance to mandibular length augmentation and growth direction change in mandible.
Proffit WR. Contemporary orthodontics 5th ed, United States: Mosby; 2014.
Buschang PH, Roldan SI, Tadlock LP. Guidelines for assessing the growth and development of orthodontic patients. Semin Orthod 2017;23(4):321–335. DOI: 10.1053/j.sodo.2017.07.001.
Zhao M, Luo S, Chen Y. Functional orthopaedics of dental and maxillofacial deformities. 1st ed., Beijing, China: Science and Technology Literature Publishing House; 2016.
Zymperdikas VF, Koretsi V, Papageorgiou SN, et al. Treatment effects of fixed functional appliances in patients with class II malocclusion: a systematic review and meta-analysis. Eur J Orthod 2015;38(2):113–126. DOI: 10.1093/ejo/cjv034.
Koretsi V, Zymperdikas V, Papageorgiou S, et al. Treatment effects of removable functional appliances in patients with class II malocclusion: a systematic review and meta-analysis. Eur J Orthod 2015;37(4):418–434. DOI: 10.1093/ejo/cju071.
Perinetti G, Primožič J, Franchi L, et al. Treatment effects of removable functional appliances in Pre-pubertal and pubertal class II patients: a systematic review and meta-analysis of controlled studies. PLoS ONE 2015;10(10):e0141198. DOI: 10.1371/journal.pone.0141198.
Celikoglu M, Buyuk SK, Ekizer A, et al. Treatment effects of skeletally anchored Forsus FRD EZ and Herbst appliances: a retrospective clinical study. Angle Orthod 2016;86(2):306–314. DOI: 10.2319/040315-225.1.
Kinzinger GSM, Lisson JA, Frye L, et al. A retrospective cephalometric investigation of two fixed functional orthodontic appliances in class II treatment: functional mandibular dvancer vs. Herbst appliance. Clin Oral Investig 2017;22(1):1–12. DOI: 10.1007/s00784-017-2111-5.
Graber LW, Vanarsdall RL, Vig KW, et al. Orthodontics-E-Book: current principles and techniques: Elsevier Health Sciences; 2016.
Stupar I, Yetkiner E, Wiedemeier D, et al. Influence of lateral cephalometric radiographs on orthodontic treatment Planning of class II patients. Open Dent J 2018;12(1):296. DOI: 10.2174/1874210601812010296.
Rosenblum RE. Class II malocclusion: Mandibular retrusion or maxillary protrusion? Angle Orthod 1995;65(1):49–62. DOI: 10.1043/0003-3219(1995)0652.0.CO;2.
Pancherz H, Zieber K, Hoyer B. Cephalometric characteristics of class II division 1 and class II division 2 malocclusions: a comparative study in children. Angle Orthod 1997;67(2):111–120. DOI: 10.1043/0003-3219(1997)0672.3.CO;2.
Oh E, Ahn SJ, Sonnesen L. Ethnic differences in craniofacial and upper spine morphology in children with skeletal class II malocclusion. Angle Orthod 2018;88(3):283–291. DOI: 10.2319/083017-584.1.
Joshi N, Hamdan AM, Fakhouri WD. Skeletal malocclusion: a developmental disorder with a life-long morbidity. J Clin Med Res 2014;6(6):399–408. DOI: 10.14740/jocmr1905w.
Li J. Craniomaxillofacial characteristics of adult skeletal class II patients and discriminant analysis of surgical and non-surgical treatment. Xi'an. China: The Fourth Military Medical University;; 2013.
Chen Y. Orthodontics foundation, technology and clinical. Beijing, China: People's Medical Publishing House; 2012. p. 783.
van VO, Bergé S, Swennen G, et al. Comparison of cephalometric radiographs obtained from cone-beam computed tomography scans and conventional radiographs. J Oral Maxillofac Surg 2009;67(1): 92–97. DOI: 10.1016/j.joms.2008.04.025.
Rothstein T, Yoon-Tarlie C. Dental and facial skeletal characteristics and growth of males and females with class II, division 1 malocclusion between the ages of 10 and 14 (revisited)—part I: Characteristics of size, form, and position. Am J Orthod Dentofacial Orthop 2000;117(3):320–332. DOI: 10.1016/s0889-5406(00)70237-x.
Moyers RE, Riolo ML, Guire KE, et al. Differential diagnosis of class II malocclusions: Part 1. Facial types associated with class II malocclusions. Am J Orthod 1980;78(5):477–494. DOI: 10.1016/0002-9416(80)90299-7.
De Castrillon FS, Baccetti T, Franchi L, et al. Lateral cephalometric standards of Germans with normal occlusion from 6 to 17 years of age. J Orofac Orthop 2013;74(3):236–256. DOI: 10.1007/s00056-013-0140-5.
Yan G, Mcnamara JA, Sigler LM, et al. Comparison of craniofacial characteristics of typical chinese and caucasian young adults. Eur J Orthod 2011;33(2):205–211. DOI: 10.1093/ejo/cjq054.
Fushima K, Kitamura Y, Mita H, et al. Significance of the cant of the posterior occlusal plane in class II division 1 malocclusions. Eur J Orthod 1996;18(1):27–40. DOI: 10.1093/ejo/18.1.27.
Andria LM, Leite LP, Prevatte TM, et al. Correlation of the cranial base angle and its components with other dental/skeletal variables and treatment time. Angle Orthod 2004;74(3):361–366. DOI: 10.1043/0003-3219(2004)0742.0.CO;2.
Haralabakis NB, Sifakakis IB. The effect of cervical headgear on patients with high or low mandibular plane angles and the “myth” of posterior mandibular rotation. Am J Orthod Dentofacial Orthop 2004;126(3):310–317. DOI: 10.1016/j.ajodo.2003.08.028.
Kim J-E, Mah S-J, Kim T-W, et al. Predictors of favorable soft tissue profile outcomes following class II twin-block treatment. Korean J Orthod 2018;48(1):11–22. DOI: 10.4041/kjod.2018.48.1.11.
Lei J, Yap AUJ, Liu MQ, et al. Condylar repair and regeneration in adolescents/young adults with early-stage degenerative temporomandibular joint disease: a randomised controlled study. J Oral Rehabil 2019;46(8):704–714. DOI: 10.1111/joor.12805.
Du X, Hägg U, Rabie ABM. Effects of headgear Herbst and mandibular step-by-step advancement versus conventional Herbst appliance and maximal jumping of the mandible. Eur J Orthod 2002;24(2):167–174. DOI: 10.1093/ejo/24.2.167.
Del Santo M. Jr. Influence of occlusal plane inclination on ANB and wits assessments of anteroposterior jaw relationships. Am J Orthod Dentofacial Orthop 2006;129(5):641–648. DOI: 10.1016/j.ajodo.2005.09.025.
McNamara JA, Jr. Components of class II malocclusion in children 8-10 years of age. Angle Orthod 1981;51(3):177–202. DOI: 10.1043/0003-3219(1981)0512.0.CO;2.