Study of horizontal skeletal pattern and dental arch in skeletal Class III malocclusion patients

Hee-Chan Park; Jin-Woo Lee

doi:10.4041/kjod.2008.38.5.358

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Study of horizontal skeletal pattern and dental arch in skeletal Class III malocclusion patients

Original Article

Korean J Orthod 2008;38(5):358-370.

Published online: 19 January 2008

DOI: https://doi.org/10.4041/kjod.2008.38.5.358

Study of horizontal skeletal pattern and dental arch in skeletal Class III malocclusion patients

Hee-Chan Park, DDS, MSD, PhD^a, Jin-Woo Lee, DDS, MSD, PhD^b

^aGraduate student, Department of Orthodontics, School of Dentistry, Dankook University.

^bProfessor, Department of Orthodontics, School of Dentistry, Dankook University.

Corresponding author: Jin-Woo Lee. Department of Orthodontics, School of Dentistry, Dankook University, San 7-1, Shinbu-dong, Cheonan 330-714, Korea +82 41 550 1941; e-mail, jwlee@dankook.ac.kr.

Received 19 February 2008 Revised 24 July 2008 Accepted 26 July 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective:

The purpose of this study was to investigate the horizontal skeletal pattern and dental arch differences between Class III malocclusion patients and normal occlusion patients.

Methods:

Twenty skeletal Class III malocclusion patients and ten normal occlusion patients were selected and 3D facial CT were taken to analyze the horizontal skeletal differences between the two groups.

Results:

In the horizontal comparison of the maxilla, skeletal width and perimeter were significantly smaller in skeletal Class III patients on ANS and A point reference planes. The difference between maxillary width of ANS and A point reference planes showed that there was greater constriction of the first and second premolar in skeletal Class III patients. In the horizontal comparison of the mandible, the widths of the canine and premolar area were significantly larger in skeletal Class III patients on B point reference plane. The differences between width of the upper and lower jaws (comparison of A and B reference planes) were significantly large in the canine and premolar area.

Conclusions:

From this study, the characteristics of Class III malocclusion patients were shown through horizontal constriction of the maxilla. But to make clear further detailed characteristics of Class III malocclusion patients, additional studies are necessary.

Keywords: 3-D imaging, Prognathism

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Fig 1.

Reference plane. 1, Maxillary midsagittal plane (Na-ANS-Ba); 2, ANS horizontal plane (A plane passing ANS perpedicular to Maxillary midsagittal plane); 3, A point horizontal plane (A plane passing A point parallel to ANS horizontal plane); 4, B point horizontal plane (B point-Gonion Lt.-Gonion Rt.); 5, antegonion horizontal plane (A plane passing center of gonion parallel to B point horizontal plane).

Fig 2.

Maxillary reference plane. 5 reference planes (A) perpendicular to ANS horizontal plane and reference points (B, C) for linear measurement.

Fig 3.

Mandibular reference plane. 5 reference planes (A) perpendicular to B point horizontal plane and reference points (B, C) for linear measurement.

Fig 4.

ANS (A) and A point (B) horizontal plane and maxillary measurements. The landmarks are described in Table 1.

Fig 5.

B point (A) and antegonion (B) horizontal plane and mandibular measurements. The landmarks are described in Table 2.

Fig 6.

The coordinates in A point reference plane (A) and superimposition (B), Class III group is red and normal group is blue.

Fig 7.

The coordinates in B point reference plane (A) and superimposition (B), Class III group is red and normal group is blue.

Table 1.

Maxillary measurements

Measurement	Definition
① #13-#23	The distance between #13-#23 (ANS, A point)
② #14-#24	The distance between #14-#24 (ANS, A point)
③ #15-#25	The distance between #15-#25 (ANS, A point)
④ #16-#26	The distance between #16-#26 (ANS, A point)
⑤ #17-#27	The distance between #17-#27 (ANS, A point)
⑥ Canine arch length	The distance between (ANS, A point) and #13-#23 plane
⑦ Premolar arch length	The distance between (ANS, A point) and #14-#24 plane
⑧ Molar arch length	The distance between (ANS, A point) and #16-#26 plane
⑨ Oblique canine height Lt.	The distance between (ANS, A point) -#23
⑩ Oblique canine height Rt.	The distance between (ANS, A point) -#13
⑪ Oblique molar height Lt.	The distance between (ANS, A point) -#26
⑫ Oblique molar height Rt.	The distance between (ANS, A point) -#16

Table 2.

Mandibular measurements

Measurement	Definition
① #33-#43	The distance between #33-#43 (B point, Antegonion)
② #34-#44	The distance between #34-#44 (B point, Antegonion)
③ #35-#45	The distance between #35-#45 (B point, Antegonion)
④ #36-#46	The distance between #36-#46 (B point, Antegonion)
⑤ #37-#47	The distance between #37-#47 (B point, Antegonion)
⑥ Canine arch length	The distance between B point and #13-#23 plane
⑦ Premolar arch length	The distance between B point and #14-#24 plane
⑧ Molar arch length	The distance between B point and #16-#26 plane
⑨ #36 Width	The distance between #36 (B point) -#36 lingual point
⑩ #46 Width	The distance between #46 (B point) -#46 lingual point
⑪ #37 Width	The distance between #37 (B point) -#37 lingual point
⑫ #47 Width	The distance between #47 (B point) -#47 lingual point
⑬ Oblique canine height Lt.	The distance between B point - #33
⑭ Oblique canine height Rt.	The distance between B point - #43
⑮ Oblique molar height Lt.	The distance between B point - #36
⑯ Oblique molar height Rt.	The distance between B point - #46
⑰ Body length Lt.	The distance between B point - Go Lt.
⑱ Body length Rt.	The distance between B point - Go Rt.

Table 3.

Transverse comparison of basal bone in ANS horizontal plane

Measurement	Group 1		Group 2		Significance
Measurement	Mean	SD	Mean	SD	Significance
#13-#23	14.94	7.43	25.07	7.94	†
#14-#24	33.69	6.80	42.32	7.52	†
#15-#25	51.30	7.03	66.23	9.37	‡
#16-#26	70.12	7.36	74.96	3.29	NS
#17-#27	54.31	4.36	58.15	5.24	∗
Canine arch length	7.69	2.61	9.27	2.57	NS
Premolar arch length	12.01	3.24	13.75	2.62	NS
Molar arch length	25.80	2.73	28.51	3.09	∗
OCH Lt	10.84	4.57	15.52	4.35	∗
OCH Rt	10.85	4.26	15.92	4.38	†
OMH Lt	39.09	3.09	47.25	2.03	‡
OMH Rt	44.41	3.81	47.11	2.47	NS

Mann-Whitney U test, NS means non-significance;

^∗ p＜ 0.05;

^† p＜ 0.01;

^‡ p＜ 0.001.

Table 4.

Transverse comparison of basal bone in A point horizontal plane

Measurement	Group 1		Group 2		Significance
Measurement	Mean	SD	Mean	SD	Significance
#13-#23	22.98	9.08	30.13	7.85	NS
#14-#24	38.56	3.96	42.65	5.39	∗
#15-#25	49.33	4.32	56.88	5.29	‡
#16-#26	62.62	4.80	67.27	2.09	∗
#17-#27	64.56	5.47	68.00	2.19	NS
Canine arch length	5.36	1.94	7.15	1.22	∗
Premolar arch length	9.84	2.18	11.75	1.57	∗
Molar arch length	23.43	3.31	26.11	2.20	∗
OCH Lt	14.29	9.24	16.58	3.85	NS
OCH Rt	13.40	4.60	17.45	4.65	∗
OMH Lt	38.96	2.83	42.61	1.59	†
OMH Rt	39.73	3.38	42.68	1.59	∗

Mann-Whitney U test, NS means non-significance;

^∗ p＜ 0.05;

^† p＜ 0.01;

^‡ p＜ 0.001.

Table 5.

Basal bone width difference between ANS, A point horizontal plane (bone width on ANS plane-bone width on A point plane)

Difference of basal bone width	Group 1		Group 2		Significance
Difference of basal bone width	Mean	SD	Mean	SD	Significance
Canine area	-8.04	8.36	-5.06	3.48	NS
1st premolar	-4.87	5.11	-0.33	4.37	∗
2nd premolar	1.96	4.78	9.35	5.40	†
1st molar	7.50	3.56	7.69	2.82	NS
2nd molar	-10.3	5.92	-9.85	4.67	NS

Significance determined by Mann-Whitney U test, NS means non-significance;

^∗ p＜ 0.05;

^† p＜ 0.001.

Table 6.

Transverse comparison in B point horizontal plane

Measurement	Group 1		Group 2		Significance
Measurement	Mean	SD	Mean	SD	Significance
#33-#43	32.13	7.11	24.96	7.36	∗
#34-#44	41.62	3.92	38.28	4.56	NS
#35-#45	52.52	3.32	50.97	4.30	NS
#36-#46	66.33	4.35	66.56	7.03	NS
#37-#47	81.91	4.83	83.61	5.92	NS
Canine arch length	6.31	2.92	3.27	2.18	†
Premolar arch length	10.70	2.93	7.49	2.03	†
Molar arch length	25.88	2.68	26.03	10.60	∗
#36 width	15.63	2.84	18.50	4.25	∗
#46 width	19.46	4.70	21.40	3.21	NS
#37 width	15.41	2.49	17.49	4.69	NS
#47 width	17.96	2.57	21.04	4.10	∗
Oblique canine height Lt.	17.04	4.22	12.65	4.01	†
Oblique canine height Rt.	17.53	4.28	13.29	4.24	∗
Oblique molar height Lt.	42.13	3.43	40.57	3.53	NS
Oblique molar height Rt.	42.23	2.98	40.12	3.83	NS
Body length Lt.	87.79	7.04	86.99	4.35	NS
Body length Rt.	87.68	8.69	86.59	2.61	NS

Significance determined by Mann-Whitney U test, NS means non-significance;

^∗ p＜ 0.05;

^† p＜ 0.01.

Table 7.

Transverse comparison in antegonion horizontal plane

Measurement	Group 1		Group 2		Significance
Measurement	Mean	SD	Mean	SD	Significance
#33-#43	35.92	7.30	26.49	9.28	∗
#34-#44	45.77	4.98	40.91	5.96	NS
#35-#45	57.81	4.68	54.72	5.80	NS
#36-#46	71.69	4.16	71.09	6.16	NS
#37-#47	83.48	3.81	85.92	4.82	NS

Significance determined by Mann-Whitney U test, NS means non-significance;

^∗ p＜ 0.05.

Table 8.

Basal bone width difference between A point, B point horizontal plane (Bone width on A point plane-bone width on B point plane)

Difference of basal bone width	Group 1		Group 2		Significance
Difference of basal bone width	Mean	SD	Mean	SD	Significance
Canine	-9.14	9.24	5.17	12.88	∗
1st premolar	-3.06	3.59	4.38	6.47	†
2nd premolar	-3.18	4.31	5.91	3.78	†
1st molar	-3.71	5.60	0.72	5.61	NS
2nd molar	-17.35	4.84	-15.61	5.26	NS

Significance determined by Mann-Whitney U test, NS means non-significance;

^∗ p＜ 0.01;

^† p＜ 0.001.

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