Dento-skeletal characteristics of cleft patients with missing teeth

Figures & data

Figure 1 The skeletal, dental, and soft tissue landmarks used in the study.

Notes: S, sella turcica, center of the pituitary fossa of the sphenoid bone; N, nasion, the junction of the frontonasal suture at the most posterior point on the curve at the bridge of the nose; Po, porion, the most superior point of the external auditory meatus; Or, orbital, the lowest point on average of the right and left lower borders of the bony orbit; Ba, basion, the most inferior posterior point of occipital bone at the anterior margin of the occipital foramen; Co, condyloid, the most posterior superior point of the condyle; ANS, anterior nasal spine, the tip of the anterior nasal spine; PNS, posterior nasal spine, the tip of posterior nasal spine; A, Point A, the most posterior (deepest) point on the curve of maxilla between the ANS and supradental (dental alveolus); UIA, upper incisor apex; UIE, upper incisor edge; LIE, lower incisor edge; LIA, lower incisor apex; B, Point B, the deepest point on the bony curvature along the anterior border of the symphysis; Pog, pogonion, the most anterior point on the contour of the mandible bony chin; Me, menton, the most inferior point on the symphysis of the mandible; Ar, articulare, intersection between the contour of the external cranial base and the dorsal contour of the condylar head; Go, gonion, the most convex point along the inferior border of the ramus; and Gn, gnathion, the point midway between the Me and Pog.

Table 1 Skeletal measurements used in this study

	Variable measured	Definition	Definition using landmarks
Anteroposterior measurements
1	SNA (°)	Prognathism of the maxillary alveolar bone to the	S, N, A
		anterior cranial base
2	SNB (°)	Prognathism of the mandibular alveolar bone to the	S, N, B
		anterior cranial base
3	ANB (°)	Sagittal jaw relationship angle	SNB minus SNA
4	Wits appraisal (mm)	Difference between the maxilla and the mandible in the	Difference between point A and point B perpendicular
		AP position	to the functional occlusal plane (U6 occlusal and U4L4
			bisection)
5	Convexity (°)	Convexity of the skeletal tissue	N-A-Pog
6	Harvold analysis (mm)	Difference in length between the two jaws	CoPog minus CoANS
7	Maxilla position (mm)	Maxillary prognathism based on the McNamara analysis	Distance from point A to a line perpendicular to Po Or
			from N
8	Mandible position (mm)	Mandibular prognathism based on the McNamara	Distance from Pog point to a line perpendicular to Po
		analysis	Or from N
Vertical measurements
9	MPA (°)	Mandibular plane angle	Me-Go line and S-N line (MP-SN)
10	PPA (°)	Palatal plane inclination	ANS-PNS and Or-Po
11	Y-Axis (°)	Growth pattern	N-S-Gn
12	ALFH (mm)	Lower anterior facial height	ANS-Me distance
13	PLFH (mm)	Lower posterior facial height	Ar-Go distance
14	Vertical ratio	Facial height Index	LAFH/PLFH

Notes: S, sella turcica, center of the pituitary fossa of the sphenoid bone; N, nasion, the junction of the frontonasal suture at the most posterior point on the curve at the bridge of the nose; Po, porion, the most superior point of the external auditory meatus; Or, orbital, the lowest point on average of the right and left lower borders of the bony orbit; Ba, basion, the most inferior posterior point of occipital bone at the anterior margin of the occipital foramen; Co, condyloid, the most posterior superior point of the condyle; ANS, anterior nasal spine, the tip of the anterior nasal spine; PNS, posterior nasal spine, the tip of posterior nasal spine; A, Point A, the most posterior (deepest) point on the curve of maxilla between the ANS and supradental (dental alveolus); UIA, upper incisor apex; UIE, upper incisor edge; LIE, lower incisor edge; LIA, lower incisor apex; B, Point B, the deepest point on the bony curvature along the anterior border of the symphysis; Pog, pogonion, the most anterior point on the contour of the mandible bony chin; Me, menton, the most inferior point on the symphysis of the mandible; Ar, articulare, intersection between the contour of the external cranial base and the dorsal contour of the condylar head; Go, gonion, the most convex point along the inferior border of the ramus; and Gn, gnathion, the point midway between the Me and Pog.

Table 2 Dental measurements used in this study

	Variable measured	Definition	Definition using landmarks
Anteroposterior measurements
1	UI – SN (°)	Upper incisors to anterior cranial base	SN to UIA – UIE
2	UI – NA (°)	Upper incisor inclination relative to the jaw position	NA to UIA – UIE
3	UI – NA (mm)	Upper incisor protrusion relative to the jaw position	NA to UIE distance
4	UI – PP (°)	Upper incisor inclination relative to the palatal plane	ANS-PNS to UIA – UIE
5	LI – MP (°)	Lower incisor inclination to the mandibular plane	Me-Go to LIE – LIA
6	LI – NB (°)	Lower incisor inclination relative to the lower jaw	NB to L1 LIE - LIA
7	LI – NB (mm)	Lower incisor protrusion relative to the lower jaw	NB to LIE distance
8	LI – APog (mm)	Lower incisor protrusion relative to the chin	A Pog line to LIE distance
9	Interincisal angle (°)	The angle formed between the upper and lower incisors	UIA-UIE to LIE-LIA angle
10	Overjet (mm)	The horizontal overlap between the upper and lower incisors (labial to labial)	UIE-LIE (horizontally)
Vertical measurements
11	Overbite (mm)	The vertical overlap between the upper and lower incisors	UIE-LIE (vertically)

Notes: S, sella turcica, center of the pituitary fossa of the sphenoid bone; N, nasion, the junction of the frontonasal suture at the most posterior point on the curve at the bridge of the nose; ANS, anterior nasal spine, the tip of the anterior nasal spine; PNS, posterior nasal spine, the tip of posterior nasal spine; A, Point A, the most posterior (deepest) point on the curve of maxilla between the ANS and supradental (dental alveolus); UIA, upper incisor apex; UIE, upper incisor edge; LIE, lower incisor edge; LIA, lower incisor apex; B, Point B, the deepest point on the bony curvature along the anterior border of the symphysis; Pog, pogonion, the most anterior point on the contour of the mandible bony chin; Me, menton, the most inferior point on the symphysis of the mandible; Go, gonion, the most convex point along the inferior border of the ramus.

Table 3 Descriptive data of the sample

	Distribution of recruited sample
	Group 1	Group 2A	Group 2B
Age, years	11.36 SD±1.7	10.6 SD±1.1	11.4 SD±1.5
Gender (n)	Male (17)	Male (20)	Male (7)
	Female (16)	Female (30)	Female (6)
Total	33	50	13

Table 4 Distribution of missing teeth in the sample

Missing teeth	Number of subjects	%
1 Lateral incisor only	44	69.84
1 Central incisor and 1 lateral incisor	3	4.76
1 Lateral incisor and 1 premolar	8	12.7
2 Lateral incisors and 1 premolar	2	3.17
1 Central incisor	1	1.59
1 Premolar	4	6.35
2 Lateral incisors	1	1.59
Total	63	100

Table 5 Comparison of skeletal measurements between Groups 1, 2A and 2B using one-way ANOVA and Kruskal–Wallis test*

Variable	Group 1 Mean ± SD	Group 2A Mean ± SD	Group 2B Mean ± SD	P-value
Skeletal anteroposterior measurements
SNA (°)	76.66±4.89	76.34±3.22	76.07±4.34	0.081
SNB (°)	74.33±4.58	74.18±4.86	74.48±4.92	0.259
ANB (°)	2.33±3.85	2.16±3.61	1.59±3.22	0.763*
Wits appraisal (mm)	–3.82±5.06	–4.43±5.00	–4.10±10.32	0.325*
Convexity (°)	4.08±9.64	2.91±7.91	2.00±7.69	0.716*
Harvold analysis (mm)	23.53±6.37	22.45±5.94	22.75±5.93	0.675
Maxilla position (mm)	–1.89±5.72	–3.47±6.01	–5.49±2.85	0.094*
Mandible position (mm)	–7.35±7.57	–9.14±9.52	–12.01±7.08	0.161*
Skeletal vertical measurements
MPA (°)	43.14±8.09	42.08±5.78	44.55±5.98	0.119
PPA (°)	–0.46±5.33	–1.60±4.71	–1.89±3.77	0.470
Y-Axis (°)	72.02±5.39	71.48±4.34	73.74±4.34	0.290
ALFH (mm)	63.22±5.72	60.87±4.07	62.67±4.48	0.083
PLFH (mm)	40.06±4.15	39.18±3.73	40.00±2.91	0.623
Vertical ratio	1.59±0.16	1.57±0.14	1.59±0.03	0.821

Note:

* Indicates which P-value came from the Kruskal Wallis test.

Table 6 Comparison of dental measurements between Groups 1, 2A, and 2B using one-way ANOVA and Kruskal-Wallis test

Variable	Group 1 Mean ± SD	Group 2A Mean ± SD	Group 2B Mean ± SD	P-value
Dental anteroposterior measurements
UI – SN (°)	91.63±10.62	91.62±12.35	85.04±12.13	0.198
UI – NA (°)	14.96±9.65	15.12±10.89	11.48±11.80	0.583*
UIE – NA (mm)	0.76±3.69	0.79±3.85	–0.82±2.91	0.290
UI – palatal plane (°)	103.49±8.52	104.11±13.01	98.02±9.32	0.253
IMPA (°)	86.1±5.63	85.16±7.12	87.62±7.16	0.618
LI – NB (°)	23.56±5.70	21.37±6.13	24.13±8.23	0.242
LIE – NB (mm)	5.34±2.29	4.34±2.20	5.19±2.47	0.089
LI – APog (mm)	3.58±2.43	2.48±2.61	3.89±2.23	0.027
Interincisal angle (°)	139.15±8.97	141.2±12.97	142.78±9.44	0.503
Overjet (mm)	–1.44±3.81	–0.69±3.55	–3.89±2.75	0.015**
Dental vertical measurements
Overbite (mm)	0.60±2.97	0.86±3.07	1.16±2.47	0.901

Notes:

* Kruskal–Wallis test.

** The significant finding after the statistical significant level was adjusted to 0.025 with Bonferroni. S, sella turcica, center of the pituitary fossa of the sphenoid bone; N, nasion, the junction of the frontonasal suture at the most posterior point on the curve at the bridge of the nose; ANS, anterior nasal spine, the tip of the anterior nasal spine; PNS, posterior nasal spine, the tip of posterior nasal spine; A, Point A, the most posterior (deepest) point on the curve of maxilla between the ANS and supradental (dental alveolus); UIA, upper incisor apex; UIE, upper incisor edge; LIE, lower incisor edge; LIA, lower incisor apex; B, Point B, the deepest point on the bony curvature along the anterior border of the symphysis; Pog, pogonion, the most anterior point on the contour of the mandible bony chin.