Thin-plate spline analysis of mandibular growth

The analysis of mandibular growth changes around the pubertal spurt in humans has several important implications for the diagnosis and orthopedic correction of skeletal disharmonies. The purpose of this study was to evaluate mandibular shape and size growth changes around the pubertal spurt in a longitudinal sample of subjects with normal occlusion by means of an appropriate morphometric technique (thin-plate spline analysis). Ten mandibular landmarks were identified on lateral cephalograms of 29 subjects at 6 different developmental phases. The 6 phases corresponded to 6 different maturational stages in cervical vertebrae during accelerative and decelerative phases of the pubertal growth curve of the mandible. Differences in shape between average mandibular configurations at the 6 developmental stages were visualized by means of thin-plate spline analysis and subjected to permutation test. Centroid size was used as the measure of the geometric size of each mandibular specimen. Differences in size at the 6 developmental phases were tested statistically. The results of graphical analysis indicated a statistically significant change in mandibular shape only for the growth interval from stage 3 to stage 4 in cervical vertebral maturation. Significant increases in centroid size were found at all developmental phases, with evidence of a prepubertal minimum and of a pubertal maximum. The existence of a pubertal peak in human mandibular growth, therefore, is confirmed by thin-plate spline analysis. Significant morphological changes in the mandible during the growth interval from stage 3 to stage 4 in cervical vertebral maturation may be described as an upward-forward direction of condylar growth determining an overall "shrinkage" of the mandibular configuration along the measurement of total mandibular length. This biological mechanism is particularly efficient in compensating for major increments in mandibular size at the adolescent spurt.     

Correlations among craniofacial angles and dimensions in Class I and Class II malocclusions

In normal and Class I malocclusions, ramus and mandibular angles are found to correlate most strongly with cranial base dimensions rather than angles, whereas in Class II malocclusions these angles tend to relate more closely to the cranial base angles.     

Thin-plate spline analysis of treatment effects of rapid maxillary expansion and face mask therapy in early Class III malocclusions.

An effective morphometric method (thin-plate spline analysis) was applied to evaluate shape changes in the craniofacial configuration of a sample of 23 children with Class III malocclusions in the early mixed dentition treated with rapid maxillary expansion and face mask therapy, and compared with a sample of 17 children with untreated Class III malocclusions. Significant treatment-induced changes involved both the maxilla and the mandible. Major deformations consisted of forward displacement of the maxillary complex from the pterygoid region and of anterior morphogenetic rotation of the mandible, due to a significant upward and forward direction of growth of the mandibular condyle. Significant differences in size changes due to reduced increments in mandibular dimensions were associated with significant shape changes in the treated group.     

The effect of Class II elastic forces on craniofacial growth in rats

Full-time Class II elastic forces were applied to eight rats in order to evaluate their effects on the growth of the snout and the mandible. Eight animals served as controls. Lateral cephalograms were taken at the start of the experiment and again at the end, 23 days later. The pre- and post-treatment tracings were superimposed on the cranial base to measure alterations in snout growth, and on metallic implants to measure differences in mandibular growth. As judged by t tests, Class II elastic forces caused a significant antero-posterior growth inhibition both in the snout and in the mandible.     

Thin-plate spline analysis of the short- and long-term effects of rapid maxillary expansion

The aim of this study was to investigate the short- and long-term effects induced by rapid maxillary expansion (RME) on the shape of the maxillary and circummaxillary structures by means of thin-plate spline (TPS) analysis. The sample consisted of 42 patients who were compared with a control sample of 20 subjects. The treated subjects underwent Haas-type RME, followed by fixed appliance therapy. Postero-anterior (PA) cephalograms were analysed for each treated subject at T1 (pre-treatment), T2 (immediate post-expansion), and T3 (long-term observation), and were available at T1 and T3 for the control group (CG). The mean age at T1 was 11 years and 10 months for both groups. The mean chronological ages at T3 were 20 years, 6 months for the treated group (TG) and 17 years, 8 months for the control group. The study focused on shape changes in the maxillary, nasal, zygomatic, and orbital regions. TPS analysis revealed significant shape changes in the TG. They consisted of an upward and lateral displacement of the two halves of the naso-maxillary complex as a result of active expansion in the short-term, and normalization of maxillary shape in the transverse dimension in the long-term (the initial transverse deficiency of the maxilla in the treated group was eliminated by RME therapy both in the short- and long-term). At the end of the observation period, the nasal cavities were larger when compared with both their pre-expansion configuration and the final configuration in the controls. RME with the Haas appliance appears to be an efficient therapeutic means to induce permanent favourable changes in the shape of the naso-maxillary complex.     

Comparisons of craniofacial features of English children with Angle Class II division 1 and Angle Class I occlusions

This study was based on a cephalometric analysis of 68 English children composed of two groups: one group exhibiting Angle Class II division 1 occlusion and the other with Angle Class I occlusion.

The object of this study was to investigate differences in the dimensions of the craniofacial complex between the Class II division 1 group and the Class I group.

It was found that the only significant differences between the Class II division 1 and Class I groups with regard to craniofacial dimensions were a shorter mandible, a higher maxillary-mandibular plane angle, and a marked proclination of the upper incisor teeth in the former group.     

Thin-plate spline analysis of arch form in a Southern European population with an ideal natural occlusion

The purpose of the present study was to identify the mean configuration of the clinical arch form in a sample of Southern European subjects with ideal natural occlusion by means of Procrustes analysis, and to compare the identified configuration with 10 commercially produced arch forms by means of thin-plate spline (TPS) analysis. The sample comprised the study casts of 50 subjects (26 males and 24 females). The mean age of the sample was 26 years +/- 4 years. All subjects were young Caucasian adults of Southern European ancestry, and presented with an ideal natural occlusion. The three-dimensional (3D) co-ordinates of all dental points (facial axis points) were digitized using a 3D electromagnetic digitizer. The morphometric technique of TPS analysis with permutation tests was used to compare the configurations of landmarks in the various specimens. No sexual dimorphism was found for either upper or lower arch forms when the shape of the arches was assessed independently from size. The commercially available arch form that showed the least, though statistically significant, shape difference with respect to the average calculated configuration was the Brader arch form.     

Ethnicity and skeletal Class III morphology: a pubertal growth analysis using thin-plate spline analysis

A longitudinal retrospective study using thin-plate spline analysis was used to investigate skeletal Class III etiology in Japanese female adolescents. Headfilms of 40 subjects were chosen from the archives of the Orthodontic department at Niigata University Dental Hospital, and were traced at IIIB and IVA Hellman dental ages. Twenty-eight homologous landmarks, representing hard and soft tissue, were digitized. These were used to reproduce a consensus for the profilogram, craniomaxillary complex, mandible, and soft tissue for each age and skeletal group. Generalized least-square analysis revealed a significant shape difference between age-matched groups (P < .001), except for the craniomaxillary complex at stage IVA. T test for size analysis showed unequivocally increased mandibular size in skeletal Class III, which directly increased the craniofacial size collectively (P < .05). A deviant profilogram showed anisotropy displaying as maxillary deficiency, acute cranial base, and obtuse gonial angle in addition to increased facial height at stage IIIB. Maxillary retrusion decreased while the mandible showed excessive incremental growth and a forward position caused by deficient orthocephalization at stage IVA. Craniomaxillary complex total spline and partial warps (PW)3 and 2 showed a maxillary retrusion at stage IIIB opposite an acute cranial base at stage IVA. Mandibular total spline and PW4, 5 showed changes affecting most landmarks and their spatial interrelationship, especially a stretch along the articulare-pogonion axis. In soft tissue analysis, PW8 showed large and local changes which paralleled the underlying hard tissue components. Allometry of the mandible and anisotropy of the cranial base, the maxilla, and the mandible asserted the complexity of craniofacial growth and the difficulty of predicting its outcome.     

Mandibular growth comparisons of Class I and Class II division 1 skeletofacial patterns

Objective:To determine class and sex differences in mandibular growth and modeling.Materials and Methods:A mixed-longitudinal sample of 130 untreated French-Canadian adolescents, 77 (45 boys and 32 girls) with Class I (normal or abnormal) occlusion and 53 (26 boys and 27 girls) with Class II division 1 malocclusion, was used. Based on eight landmarks, eight traditional measurements were used to compare the anteroposterior position of the maxilla and mandible, relationship between the jaws, and mandibular size. Mandibular superimpositions were used to compare the horizontal and vertical changes of condylion, gonion, and menton.Results:While there were no differences in maxillary position based on the SNA angle, Class IIs had more retrognathic mandibles than did Class Is. Total mandibular length was greater in Class Is than in Class IIs at 15 years of age. Superior and total growth and modeling changes at condylion and gonion, respectively, were greater for Class Is than Class IIs. Boys were more prognathic than girls; they had larger mandibles and exhibited greater size increases and growth changes than girls did.Conclusions:There are both class and sex differences in mandibular growth and modeling.     

Evaluation of apical root resorption following extraction therapy in subjects with Class I and Class II malocclusions

The purpose of this study was to determine the amount of root resorption during orthodontic treatment, and to examine the relationship between tooth movement and apical root resorption. Twenty-seven Class I and 27 Class II patients treated with edgewise mechanics following first premolar extractions were selected. The following measurements were made on the pre- and post-treatment cephalograms: upper central incisor to palatal plane distance, the inclination of upper central incisor to the FH and AP planes, the perpendicular distances from the incisor tip to the AP and PTV planes, and incisor apex to PTV. The amount of apical root resorption of the maxillary central incisors was determined for each patient by subtracting the post-treatment tooth length from the pre-treatment tooth length measured directly on cephalograms. Intra-group differences were evaluated by the Student's t-test and inter-group differences by the Mann-Whitney U-test. For correlations the Pearson correlation coefficient was used. The results show that there was a mean of approximately 1 mm (P < 0.01) of apical root shortening in Class I patients, but in Class II division I subjects the mean root resorption was more than 2 mm (P < 0.001). The inter-group differences were statistically significant. No significant correlations were found between the amount of apical root resorption and tooth inclination, or the duration of active treatment.     

An estimate of craniofacial growth in Class III malocclusion

OBJECTIVE: To provide an estimate of growth in Class III malocclusion by means of the analysis of a large population of males and females. MATERIALS AND METHODS: The examined sample consisted of pretreatment lateral cephalometric records of 949 (492 females and 457 males) untreated Class III patients of Caucasian ancestry. Cephalometric dentoskeletal measurements at subsequent age periods in Class III subjects were compared with the population values from subjects included in the University of Michigan Growth Study (UMGS) at 11 consecutive age periods (from 6 through 16 years of age), in male and female groups separately. RESULTS: No difference was found between the Class III and normal groups for the sagittal position of the maxilla at any of the age intervals examined. Sagittal mandibular position and dimensions in Class III subjects were consistently larger than in normal subjects, with the interval of largest "increase" in mandibular length occurring on average 1 year later in both female and male Class III subject with respect to subjects with normal occlusion. CONCLUSIONS: Increases in mandibular length were substantially larger in Class III subjects than in subjects with normal occlusion even during the more mature age interval (15 to 16 years). Lower anterior facial height was significantly larger in Class III individuals during the late developmental stages.     

Craniofacial growth in untreated skeletal Class II subjects: A longitudinal study

Eighty-five (45 male and 40 female) skeletal Class II untreated subjects with low (< 27 degrees ), average (27 degrees - 36 degrees ), and high (> 36 degrees ) mandibular plane angles (MP-SN) were selected from the Bolton-Brush and the Burlington Growth Studies. Cephalograms of each subject at ages 9 and 18 were traced, and 28 parameters were measured. The difference in each parameter from ages 9 to 18 was calculated, and comparisons were made between the groups with low, average, and high angles. Results showed that for children at age 9, the high-angle group showed greater convexity, larger Y-axis and gonial angles, and greater anterior facial height, and the low-angle group had larger SNA and SNB angles, and greater posterior cranial base, mandibular body, ramus height, and posterior facial height. From ages 9 to 18, all the low-, average-, and high-angle groups showed a decrease of convexity (more flattened face) and a mandibular forward rotation (decreased MP-SN). The low-angle group displayed significantly more facial flattening and more mandibular forward rotation than did the high-angle group. Moreover, the mandibular incisors became more retroclined in the low-angle group and more proclined in the high-angle group with age. Comparisons between males and females showed similar skeletal growth patterns in angular measurements. However, a significant sex difference was noted in some linear measurements.