Hwang, Soonshin
(Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University)
,
Noh, Yoonjeong
(Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University)
,
Choi, Yoon Jeong
(Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University)
,
Chung, Chooryung
(Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University)
,
Lee, Hye Sun
(Biostatistics Collaboration Unit, College of Medicine, Yonsei University)
,
Kim, Kyung-Ho
(Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University)
Objective: The aim of this study was to establish the normative data of dentofacial transverse dimensions according to the skeletal maturation stage in Korean adolescents with good occlusion, assess gender differences and determine correlations between transverse variables. Methods: A total of 577 K...
Objective: The aim of this study was to establish the normative data of dentofacial transverse dimensions according to the skeletal maturation stage in Korean adolescents with good occlusion, assess gender differences and determine correlations between transverse variables. Methods: A total of 577 Korean subjects between ages 7 to 19 years and exhibiting skeletal Class I occlusion were categorized by skeletal maturation index (SMI) of Fishman using hand-wrist radiographs. Dentofacial transverse dimensions were assessed using posteroanterior cephalograms. Independent two-sample t-tests were used to analyze differences between genders. Pearson correlation coefficient was used to determine the correlation between transverse measurements. Results: Dentofacial transverse norms relevant to skeletal maturation stages were established. The average maxillomandibular width difference and ratio at growth completion was 22.16 mm and 77.01% for males; 23.70 mm and 74.06% for females, respectively. Males had greater facial, maxillary and mandibular widths compared to females at every SMI stage. The maxillary and mandibular intermolar widths showed the strongest correlation for both sexes (r = 0.826 for males, r = 0.725 for females). Conclusions: Dentofacial transverse norms of Korean adolescents were established according to developmental stage. All dentofacial widths were greater in males at growth completion. Maxillary and mandibular intermolar widths were strongly correlated. This study may serve as a guideline for the assessment of dentofacial transverse growth according to skeletal maturation stage in Korean adolescents with good occlusion.
Objective: The aim of this study was to establish the normative data of dentofacial transverse dimensions according to the skeletal maturation stage in Korean adolescents with good occlusion, assess gender differences and determine correlations between transverse variables. Methods: A total of 577 Korean subjects between ages 7 to 19 years and exhibiting skeletal Class I occlusion were categorized by skeletal maturation index (SMI) of Fishman using hand-wrist radiographs. Dentofacial transverse dimensions were assessed using posteroanterior cephalograms. Independent two-sample t-tests were used to analyze differences between genders. Pearson correlation coefficient was used to determine the correlation between transverse measurements. Results: Dentofacial transverse norms relevant to skeletal maturation stages were established. The average maxillomandibular width difference and ratio at growth completion was 22.16 mm and 77.01% for males; 23.70 mm and 74.06% for females, respectively. Males had greater facial, maxillary and mandibular widths compared to females at every SMI stage. The maxillary and mandibular intermolar widths showed the strongest correlation for both sexes (r = 0.826 for males, r = 0.725 for females). Conclusions: Dentofacial transverse norms of Korean adolescents were established according to developmental stage. All dentofacial widths were greater in males at growth completion. Maxillary and mandibular intermolar widths were strongly correlated. This study may serve as a guideline for the assessment of dentofacial transverse growth according to skeletal maturation stage in Korean adolescents with good occlusion.
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문제 정의
In orthodontic practice, norms of transverse dentofacial dimensions according to skeletal maturation stage would be beneficial in diagnosis and delivery of appropriate orthopedic treatment for growing patients with transverse discrepancies. Therefore, the purpose of this study was to establish the norms of dentofacial transverse dimensions according to the skeletal maturation stage in growing Korean individuals with skeletal Class I occlusion, assess gender difference and recognize correlations between the transverse variables.
가설 설정
1. Cranial width (bieuryon width): distance between the most lateral points on the cranium. 2.
제안 방법
13. All landmarks were identified and transverse measurements were performed by this imaging program. The transverse measurements are shown in Figure 1.
From these subjects, further cases were selected based on the following inclusion criteria; skeletal Class I occlusion cases with A point-Nasion-B point (ANB) angle ranging from 0°to 4°, minimal dental crowding of less than 3 mm, absence of dental spacing, absence of skeletal asymmetry and dental crossbites, and no history of previous orthodontic treatment.
In order to overcome the limitations associated with the cross-sectional study design, the subjects were grouped into prepubertal (SMI stages 0–3), pubertal (SMI stages 4–7), and postpubertal (SMI stage 8–11) groups.
The subjects were evaluated for significant changes in the transverse maxillomandibular dimensions for every sequential increase in the SMI stage. The nasal and maxillary widths in males showed significant changes when the SMI stage progressed from 6 to 7.
K) with over 20 years of clinical experience in treating adolescent patients. The transverse skeletal measurements were measured by one investigator (Y.J.N), and intraexaminer reliability was determined by selecting 10 random subjects for each SMI stage (total, 120 radiographs) for a second measurement. The intraexaminer correlation coefficient indicated high reliability between the two measurements (r = 0.
대상 데이터
12 In this study, SMI stage 0 was defined as within 2 years of age before the subjects were screened as SMI stage 1. A total of 577 subjects (287 males, 290 females) were categorized into SMI stages and dentofacial transverse dimensions were evaluated. The mean age and number of subjects for each SMI stage are shown in Table 1.
From these subjects, further cases were selected based on the following inclusion criteria; skeletal Class I occlusion cases with A point-Nasion-B point (ANB) angle ranging from 0°to 4°, minimal dental crowding of less than 3 mm, absence of dental spacing, absence of skeletal asymmetry and dental crossbites, and no history of previous orthodontic treatment. All the patients were of Korean descent and were aged between 7 and 19 years. This retrospective study was approved by the institutional review board of the Gangnam Severance Dental Hospital (No.
In this study, SMI stage 0 was defined as within 2 years of age before the subjects were screened as SMI stage 1. A total of 577 subjects (287 males, 290 females) were categorized into SMI stages and dentofacial transverse dimensions were evaluated.
Patients who visited the Department of Orthodontics at Gangnam Severance Dental Hospital during years 2006 through 2016 for orthodontic consultations that had taken posteroanterior cephalograms and hand-wrist radiographs for diagnostic purposes were considered for this study. From these subjects, further cases were selected based on the following inclusion criteria; skeletal Class I occlusion cases with A point-Nasion-B point (ANB) angle ranging from 0°to 4°, minimal dental crowding of less than 3 mm, absence of dental spacing, absence of skeletal asymmetry and dental crossbites, and no history of previous orthodontic treatment.
데이터처리
Descriptive statistics including means and standard deviations of the transverse measurements were calculated for each SMI stage in both sexes. Independent two-sample t-tests were used to evaluate statistical differences between males and females. Transverse changes with sequential increases in the SMI stage were analyzed using oneway ANOVA followed by post hoc Bonferroni correction.
Pearson’s correlation coefficients were used to determine correlations between the transverse measurements.
Independent two-sample t-tests were used to evaluate statistical differences between males and females. Transverse changes with sequential increases in the SMI stage were analyzed using oneway ANOVA followed by post hoc Bonferroni correction. Pearson’s correlation coefficients were used to determine correlations between the transverse measurements.
이론/모형
In this study, dentofacial transverse development was evaluated according to Fishman’s skeletal maturation stages.
성능/효과
2,7,19-21 The difference in time of growth completion can be attributed to individual growth variation which was inevitably included in this cross sectional study. According to the findings of our study, growth of the maxillary width was about 95% to 96% complete at SMI stages 4 to 6 (age 12 to 14 years) in males and SMI stages 1 to 2 (age 8 to 10 years) in females which may be used as a timeline for including maxillary expansion earlier than this time (Table 4). The average maxillary widths at growth completion were also greater than previous growth studies carried out in the North American regions.
As for gender differences, males showed significantly greater transverse values for facial, maxillary and mandibular width in all SMI stages compared to females. All seven transverse measurements resulted in significantly greater values at growth completion for males as well. This is in accordance with the findings of previous studies that showed a significant difference of transverse width in most ages between genders.
Dentofacial transverse norms of Korean adolescent subjects in Class I normal occlusion were established according to skeletal maturation stages. Facial, maxillary and mandibular widths were significantly greater in males during all growth stages and all dentofacial width measurements were significantly greater in males at growth completion. Maxillary and mandibular intermolar widths were strongly correlated for both genders.
6 mm in females between 7 to 15 years of age. The facial width for this study were 131.78 mm for males and 125.28 mm for females at SMI 0 which increased to 147.80 mm and 136.77 mm at growth completion, respectively. The mean facial width for Korean subjects was greater than that reported for Chinese or Japanese subjects, who have been compared with American Caucasian subjects for their wide zygomatic widths, by approximately 15 to 19 mm.
17,18 Nevertheless, the average facial width for Korean subjects was within the range reported of Japanese subjects by Enoki et al.17The results of this study can reasonably imply that Korean subjects have relatively pronounced zygomatic widths compared with American Caucasian subjects.
후속연구
Furthermore, the cross-sectional design of our study and the assessment of subjects in a one-time frame inevitably included individual growth variations that should be considered during interpretation of descriptive data and comparisons between consecutive SMI stages. Even though the subjects were categorized into each skeletal maturation stage to minimize the magnitude of growth variations by chronological age, further studies including longitudinal data would be needed. Nonetheless, the results may serve as a guideline of dentofacial width development in Korean adolescents of good occlusion according to skeletal maturation.
Maxillomandibular width difference values may be greater for Korean adolescents compared to Caucasians. This study may be useful as a guide for dentofacial transverse growth of Korean adolescents in good occlusion according to skeletal maturation.
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