Title Vertikalni dentalni i skeletni odnosi kod ispitanika sa anomalijama progenijskog kompleksa Title (english) Vertical dental and skeletal relationships in subjects with class III malocclusions Author Zorica Radalj Miličić 53158628242022921732 Mentor Senka Meštrović Committee member Marina Lapter-Varga (predsjednik povjerenstva)Committee member Sandra Anić Milošević (član povjerenstva)Committee member Ivana Savić Pavičin (član povjerenstva)Committee member Jelena Dumančić (član povjerenstva)Committee member Dinko Leović (član povjerenstva)Committee member Martina Majstorović (član povjerenstva)Granter University of Zagreb Defense date and country 2019-06-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 616.31 - Stomatology Abstract Cilj ovog istraživanja bio je na uzorku ispitanika hrvatske populacije s anomalijama progenijskog kompleksa, bazirajući se na skeletne klase III, pomoću rendgenkefalometrijske analize utvrditi dentalne, skeletne i mekotkivne odnose i rotacijski obrazac rasta, zatim, utvrditi mogu li dužinske vrijednosti maksile, mandibule i kranijalne baze biti prediktori rotacijskog obrasca rasta, kao i procijeniti koji parametri su prediktori maksilarnog retrognatizma, odnosno mandibularnog prognatizma. Uzorak je dobiven iz baze podataka pacijenata Zavoda za ortodonciju, Stomatološke klinike, Kliničkog bolničkog centra Zagreb. Sastojao se od 201 laterolateralnih snimaka glave (111 ženskih, 90 muških) napravljenih prije početka ortodontske terapije. Sva mjerenja su klasificirana u sedam kategorija za analizu: kranijalna baza, skeletni maksilarni, mandibularni i međučeljusni odnosi, zatim dentoalveolarni, vertikalni i mekotkivni odnosi. Kao mjera za svrstavanje u kategoriju obrasca rasta lica korištena su tri parametra: Bjork, Jarabak analiza i kut kojeg zatvara ravnina mandibule prema prednjoj kranijalnoj bazi (N-S:Me-Go). Koristilo se pet modela multiple linearne regresije za procjenu rotacijskog obrasca rasta lica. Rađena je i multipla logistička regresija za procjenu koji parametri su prediktori maksilarnog retrognatizma odnosno mandibularnog prognatizma. Maksilarni retrognatizam bio je povezan s kraćom dužinom maksile (Co-A), kraćom dužinom korpusa mandibule (Go-Gn), visinom (Ar-Go) i efektivnom dužinom mandibule (Co-Gn), većim gonijalnim kutom (Me-Go-Ar) i s tendencijom vertikalnom obrascu rasta. Istaknuto svojstvo mandibularnog prognatizma bila je izraženija proklinacija gornjih sjekutića. Efektivna dužina mandibule bila je najznačajniji prediktor rotacijskog rasta lica pri čemu je povećana dužina u velikoj mjeri predisponirala tendenciju vertikalnom obrascu rasta. Rezultati ove studije pokazuju da je maksilarni retrognatizam češće povezan s vertikalnim obrascem rasta, što nije povoljno za terapiju obraznom maskom. Prediktori rotacijskog rasta lica, koji su pronađeni u ovoj studiji, mogli bi biti od pomoći ortodontima u odluci o vremenu i vrsti terapije pacijenata hrvatske populacije s malokluzijom klase III.
Abstract (english) Introduction: Class III malocclusions have been causing increased interest of clinicians for hundreds of years due to the complexity of therapy, the possibility of relapses conditioned by individual growth and development and due to the great influence on facial aesthetics. A complicating factor for diagnosis and treatment planning is its etiologic diversity. Accurate diagnosis of skeletal and dental components of a given malocclusion, especially the vertical growth pattern, is essential in determining the proper approach and treatment timing. Objective: The objective of this study is to determine dental, skeletal and soft tissue relations and rotational growth pattern in subjects pertaining to Croatian population with Class III malocclusion by using cephalometric radiographic analysis, furthermore to determine whether the linear measures of the maxilla, mandible and cranial base were predictors of facial growth rotation as well as to evaluate which parameters are predictors of maxillary retrognatism or mandibular prognathism. Material and methods: The sample was gained from the Department of Orthodontics patients database at the Clinic University Hospital Centre Zagreb. It consisted of 201 latero-lateral head records (111 females, 90 males) made before the initiation of the orthodontic therapy. On each cephalogram, eighteen cephalometric landmarks, representing hard and soft tissues, were identified. From these landmarks, 43 angular and linear measurements were recorded and analysed. All the necessary measurements were classified into seven categories for analysis: cranial base, skeletal maxillary and skeletal mandibular relationships, intermaxillary, dentoalveolar, vertical and soft tissue profile facial relationships. Three criteria were being used as a measure to classify into a category of facial growth pattern: Bjork and Jarabak analysis and angle between nasion-sella and gonion-menton (N-S:Go-Me). Five multiple linear regression models were used to identify predictors of facial rotation pattern. A multiple logistic regression was executed to estimate which parameters are predictors of maxillary retrognatism or mandibular prognathism. Results: Maxillary retrognathism was associated with shorter maxilla (Co-A), shorter length of mandibular corpus (Go-Gn), shorter height of mandibular ramus (Ar-Go) and shorter effective length of the mandible (Co-Gn), larger gonial angle (Me-Go-Ar) and a more pronounced vertical growth pattern. A significant feature of mandibular prognathism is more pronounced proclination of maxillary incisors. The effective length of the mandible was the most important predictor of facial rotation pattern, with the increased length largerly predisposing the tendency to the vertical growth pattern. No significant sexual dichotomy was found except in the fourth model where the posterior rotation of maxilla is related to female gender. Conclusion: From the results of the present study, it was concluded that maxillary retrognathism was more often associated with a vertical growth pattern, that means it is not favorable for the therapy with a protraction face mask. There are evident compensatory mechanisms as a result of skeletal discrepancies. They manifest as dentoalveolar compensation mechanisms and as a downward and backward rotation of the mandible. In contrast to maxillary retrognathism, mandibular prognathism was associated with a horizontal growth pattern as well as a more pronounced dentoalveolar compensatory mechanism, which was expressed by remarkably more protrusive maxillary incisors. Since the method of treatment between the surgical and non surgical patients is completely different, maybe these findings could help to better discern which patients are candidates for camouflage orthodontic treatment (horizontal growth pattern, protrusion of the upper incisors) and in which we will immediately decide for orthognathic surgery. Predictors of the facial rotation pattern which were found in this study could also help orthodontists in timing and therapy decision of Croatian patients with Class III malocclusion.
Keywords
Malokluzija
Angle klasa III
Cefalometrija
Prognatizam
Keywords (english)
Malocllusion
Angle III
Cephalometry
Prognathism
Language croatian URN:NBN urn:nbn:hr:127:812554 Promotion 2020 Study programme Title: dental medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-11-09 14:18:07
