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Evaluation of the infrazygomatic crest and mandibular buccal shelf in different sagittal skeletal patterns: a cone-beam computed tomography study

Elif Dilara Seker
Elif Dilara Seker
, 
Elif Kaymakcioglu
Elif Kaymakcioglu
, 
Serife Sahin
Serife Sahin
 e 
Gokmen Kurt
Gokmen Kurt
   | 19 feb 2024
Australasian Orthodontic Journal's Cover Image
INFORMAZIONI SU QUESTO ARTICOLO
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Pubblicato online: 19 feb 2024
Pagine: 1 - 12
Ricevuto: 01 set 2023
Accettato: 01 gen 2024
DOI: https://doi.org/10.2478/aoj-2024-0002
© 2024 Elif Dilara Seker et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

A, Bone thickness measurement in the infrazygomatic crest at the apex of the root at 70° angulation. B, Total bucco-lingual bone thickness measurement in the mandibular buccal shelf. Two different horizontal reference lines positioned apically at 6 mm and 11 mm from the cemento-enamel junction were used. Total thickness at 6 mm; bucco-lingual thicknesses of bone on a horizontal reference line positioned apically at 6 mm from the cemento-enamel junction, Total thickness at 11 mm; total bucco-lingual thicknesses of bone on horizontal reference lines positioned apically at 11 mm from the cemento-enamel junction. C, Total inciso-apical bone height measurement in the mandibular buccal shelf. Two different vertical reference lines buccally positioned at 4 mm and 6 mm from the cemento-enamel junction, were used. Total height at 4 mm; total inciso-apical height thicknesses of bone on vertical reference line buccally positioned at 4 mm from the cemento-enamel junction, Total height at 6 mm; total inciso-apical height thicknesses of bone on a vertical reference line buccally positioned at 6 mm from the cemento-enamel junction.
A, Bone thickness measurement in the infrazygomatic crest at the apex of the root at 70° angulation. B, Total bucco-lingual bone thickness measurement in the mandibular buccal shelf. Two different horizontal reference lines positioned apically at 6 mm and 11 mm from the cemento-enamel junction were used. Total thickness at 6 mm; bucco-lingual thicknesses of bone on a horizontal reference line positioned apically at 6 mm from the cemento-enamel junction, Total thickness at 11 mm; total bucco-lingual thicknesses of bone on horizontal reference lines positioned apically at 11 mm from the cemento-enamel junction. C, Total inciso-apical bone height measurement in the mandibular buccal shelf. Two different vertical reference lines buccally positioned at 4 mm and 6 mm from the cemento-enamel junction, were used. Total height at 4 mm; total inciso-apical height thicknesses of bone on vertical reference line buccally positioned at 4 mm from the cemento-enamel junction, Total height at 6 mm; total inciso-apical height thicknesses of bone on a vertical reference line buccally positioned at 6 mm from the cemento-enamel junction.

Figure 2.

Bone density measurements (mean value of Hounsfield units-HU) from outside the 2 mm isometric voxel.
Bone density measurements (mean value of Hounsfield units-HU) from outside the 2 mm isometric voxel.

Demographic data of the patients

Class II Class I Class III post-hoc p-value
Variables mean ± sd mean ± sd mean ± sd p-value I-II II-III I-III
Age 30.08 ± 5.9 26.46 ± 6.1 26.21 ± 5.3 0.18
Sex
Female 28 (90.3 %) 24 (85.7 %) 22 (84.6 %) 0.63
Male 3 (9.6 %) 4 (14.2 %) 4 (15.3 %)
Upper Third Molar
Present 20 18 16 0.72
Absent 11 10 10
Lower Third Molar
Present 18 16 20 0.81
Absent 13 12 6
SNA° 82.7 ± 4.6 82.8 ± 5.6 79.3 ± 3.4 0.09
SNB° 75.8 ± 4.6 80.6 ± 5.9 83.3 ± 3.5 0.001 0.04 0.001 NS
ANB° 6.8 ± 2.4 2.1 ± 1.1 -4 ± 3.5 <0.001 <0.001 <0.001 <0.001
SN-GoMe° 35.2 ± 7.5 31.2 ± 4.4 32.5 ± 5.5 0.26

Comparison of the quantitative bone characteristics between different sites in IZC and MBS on right side for each group

M1mr (I) M1dr (II) M2mr (III) M2dr (IV) post hoc pvalue
Class II mean ± sd mean ± sd mean ± sd mean ± sd p-value I-II I-III I-IV II-III II-IV III-IV
IZC (mm)
Total thickness at 70° 2.5 ± 1.5 2.6 ± 1.5 2.2 ± 1.3 2.4 ±1.5 0.85
MBS (mm)
Total thickness at 6 mm 4.2 ± 3.2 5 ± 3.4 6.5 ± 2.2 7.5 ±2.3 <0.001 NS 0.04 0.001 NS 0.01 NS
Total thickness at 11 mm 5.2 ± 2.9 6.3 ± 3.1 7.2 ± 1.9 8 ±2.2 0.002 NS 0.04 0.002 NS NS NS
Total height at 4 mm 18.4 ±7.1 19.9 ± 6.5 22.7 ± 2.9 23.8 ±2.9 0.002 NS 0.03 0.003 NS NS NS
Total height at 6 mm 14.6 ±7.4 16.5 ± 6.4 20.4 ± 3.6 22.1 ±3.7 <0.001 NS 0.003 <0.001 NS 0.005 NS
Class I
IZC (mm)
Total thickness at 70° 3.5 ± 1.9 3.2 ± 1.7 3.3 ± 1.8 3.71 ±1.9 0.75
MBS (mm)
Total thickness at 6 mm 2.6 ± 2 4 ± 3.1 5.8 ± 2.3 7.2 ±2.3 <0.001 NS <0.001 <0.001 0.04 <0.001 NS
Total thickness at 11 mm 4.2 ± 2.6 6 ± 2.5 6.6 ± 2.4 7.4 ±2.4 <0.001 0.03 0.002 <0.001 NS NS NS
Total height at 4 mm 17.7 ±9.7 20 ± 7.7 19.8 ± 7.3 20.9 ±6.1 0.46
Total height at 6 mm 15.3 ±9.4 17.2 ± 8.5 17.6 ± 8.1 19 ±7.6 0.4
Class III
IZC (mm)
Total thickness at 70° 3 ± 2.1 2.9 ± 1.9 3 ± 1.5 3.3 ± 1.9 0.89
MBS (mm)
Total thickness at 6 mm 2.8 ± 2 4.4 ± 2.4 7.1 ±1.9 8.5 ± 2 <0.001 0.03 <0.001 <0.001 <0.001 <0.001 NS
Total thickness at 11 mm 5 ± 2.6 6.7 ± 1.8 7.9 ± 1.6 8.6 ± 1.9 <0.001 0.01 <0.001 <0.001 NS 0.004 NS
Total height at 4 mm 17 ± 5.1 19.6 ±4 20.1 ± 3.1 20.4 ± 2.9 0.007 NS 0.02 0.01 NS NS NS
Total height at 6 mm 13.1 ± 6.7 17 ± 5.1 17.9 ± 3.9 19.7 ± 3.8 <0.001 0.02 0.003 <0.001 NS NS NS

Correlation between cephalometric parameters and quantitative bone characteristics

SNA SNB Maxillary Length Mandibular Length
r p-Value r p-Value r p-Value r p-Value
M1mr
Total thickness at 70° 0.070 0.66 0.048 0.76 -0.186 0.24 0.238 0.13
Total thickness at 6 mm 0.202 0.2 -0.034 0.83 0.295 0.06 0.207 0.19
Total thickness at 11 mm 0.301 0.05 0.328 0.03 0.212 0.18 0.331 0.03
Total height at 4 mm 0.174 0.27 0.140 0.38 0.124 0.44 0.440 0.004
Total height at 6 mm 0.284 0.07 0.246 0.12 0.220 0.16 0.357 0.02
M1dr
Total thickness at 70° 0.032 0.84 0.035 0.83 -0.120 0.45 0.267 0.09
Total thickness at 6 mm 0.131 0.41 0.031 0.84 0.164 0.3 0.268 0.09
Total thickness at 11 mm 0.293 0.06 0.346 0.02 0.030 0.85 0.375 0.01
Total height at 4 mm 0.028 0.86 0.059 0.71 0.018 0.90 0.504 0.001
Total height at 6 mm 0.139 0.38 0.211 0.18 0.087 0.58 0.450 0.003
M2mr
Total thickness at 70° -0.088 0.58 0.089 0.57 -0.001 0.99 0.210 0.08
Total thickness at 6 mm 0.189 0.23 0.358 0.02 -0.059 0.71 0.508 0.001
Total thickness at 11 mm 0.085 0.59 0.358 0.02 -0.023 0.88 0.346 0.02
Total height at 4 mm 0.059 0.71 -0.092 0.56 0.155 0.33 0.384 0.01
Total height at 6 mm 0.089 0.57 0.002 0.99 0.124 0.44 0.508 0.001
M2dr
Total thickness at 70° -0.190 0.23 -0.044 0.78 -0.069 0.66 0.233 0.14
Total thickness at 6 mm 0.042 0.79 0.355 0.02 -0.043 0.79 0.523 <0.001
Total thickness at 11 mm 0.150 0.34 0.281 0.07 0.051 0.73 0.431 0.005
Total height at 4 mm 0.035 0.82 -0.208 0.19 0.132 0.41 0.293 0.03
Total height at 6 mm -0.012 0.94 -0.115 0.47 0.081 0.61 0.430 0.005

Comparison of the quantitative bone characteristics in IZC and MBS among Class I, II and III groups

M1mr M1dr M2mr M2dr
Class II Class I Class III Class II Class I Class III Class II Class I Class III post-hoc pvalue Class II Class I Class III post-hoc p-value
mean ± sd mean ± sd mean ± sd p-value mean ± sd mean ± sd mean ± sd p-value mean ± sd mean ± sd mean ± sd p-value I-II II-III I-III mean ± sd mean ± sd mean ± sd p-value I-II II-III I-III
IZC Thickness (rnrnļ
Total_thick at 70° 2.5 ± 1.5 3.5 ± 1.9 3 ± 2.1 NS 2.6 ± 1.5 3.2 ± 1.7 2.9 ± 1.9 NS 2.2 ± 1.3 3.3 ± 1.8 3 ± 1.5 0.04 0.04 NS NS 2.4 ± 1.5 3.7 ± 1.9 3.3 ± 1.9 0.04 0.03 NS NS
MBS Thickness (mm)
Total thickness at 6 mm 4.2 ± 3.2 2.6 ± 2 2.8 ± 2 NS 5 ± 3.4 4 ± 3.1 4.4 ± 2.4 NS 6.5 ± 2.2 5.8 ± 2.3 7.1 ± 1.9 NS 7.5 ±2.3 7.2 ±2.3 8.5 ± 2 NS
Total thickness at 11 mm 5.2 ± 2.6 4.2 ± 2.6 5 ± 2.6 NS 6.3 ± 3.1 6 ± 2.5 6.7 ± 1.8 NS 7.2 ± 1.9 6.6 ± 2.4 7.9 ± l.6 NS 8 ±2.2 7.4 ±2.4 8.6 ± 1.9 NS
Total height at 4 mm 18.4 ± 7.1 17.7 ± 9.7 17 ± 5.1 NS l9.9± 6.5 20 ± 7.7 19.6 ± 4 NS 22.7 ± 2.9 19.8 ±7.3 20.1 ± 3.1 NS 23.8 ± 2.9 20.9 ±6.l 20.4 ± 2.9 0.01 0.04 0.01 NS
Total height at 6 mm 14.6 ± 7.4 15.3 ± 9.4 13.1 ± 6.7 NS 16.5 ± 6.4 17.2 ± 8.5 17 ± 5.1 NS 20.4 ± 3.6 17.6 ± 8.1 17.9 ± 3.9 NS 22.1 ± 3.7 19 ± 7.6 19.7 ± 3.8 0.04 0.01 NS NS
HU Value
Class II Class I Class III
mean ± sd mean ± sd mean ± sd p-value
Maxilla 681.7± 221.3 676 ± 185.6 728 ± 127.8 NS
Mandible 1187.5 ± 400.6 902.2 ± 473.3 902.7 ± 294.5 NS
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