Abstract | Cilj istraživanja: Utvrditi kefalometrijske karakteristike skeletne klase III u adolescenata.
Materijali i metode: U ovo retrospektivno istraživanje uključeni su kefalogrami ispitanika koji su posjetili Laboratorij za dentalnu radiologiju 3D-Dent u Splitu u razdoblju od siječnja 2013. do travnja 2018. godine. Kraniogrami su napravljeni po standardnom protokolu snimanja aparatom Vatech i3D -Green s pripadajućim CEPH nastavkom. Na odabranim kefalogramima napravljena je kefalometrijska analiza (Zagreb MOD 82 i WITS) u programu AudaxCeph (Audax, Ljubljana, Slovenija).
Rezultati: U ovo istraživanje bilo je uključeno 60 ispitanika starosti od 10 do 17 godina. Iz istraživanja su isključeni ispitanici čiji kefalometrijski nalaz nije pokazao skeletnu klasu III. Preostao je 31 ispitanik, 19 djevojčica (61.29%) i 12 dječaka (38.70%).
U analizi sagitalnog položaja čeljusti, 16 ispitanika (51.61%) pokazalo je mandibularni prognatizam i normalan položaj maksile (MP), sedam ispitanika (22.58%) pokazalo je normalne sagitalne odnose obje čeljusti (NO), pet ispitanika maksilarni retrognatizam i normalan položaj mandibule (MR) (16.12%), dva ispitanika bimaksilarni prognatizam (BP) (6.45%) i jedan ispitanik bimaksilarni retrognatizam (BR) (3.22%). Najviše dječaka, njih sedam (22.58% svih ispitanika) i djevojčica, njih 9 (29.03% svih ispitanika) imalo je mandibularni prognatizam.
Analiza vertikalnih odnosa čeljusti određivanjem međučeljusnog kuta pokazala je da većina ispitanika (19, 61.27%) pokazuje normalan obrazac rasta čeljusti, 11 ispitanika (35.45%) pokazuje vertikalan obrazac rasta dok jedan ispitanik (3.22%) pokazuje horizontalan obrazac rasta. Slični rezultati dobiveni su analizom vrijednosti Björkovog poligona. U MP ispitanika najučestaliji obrazac rasta bio je normalan obrazac rasta (32.25% svih ispitanika, 50% MP ispitanika) dok je u MR i BR ispitanika prevladavao vertikalni obrazac rasta (3.22% - 9.67% svih ispitanika, 60% MR ispitanika i 100% BR ispitanika).
Analiza interincizalnog kuta pokazala je jednak broj ispitanika s normalnim i povećanim interincizalnim kutem (po 41.90%). Analiza inklinacije sjekutića na skeletne baze čeljusti pokazala je da najveći broj ispitanika ima normalan položaj gornjih inciziva - GI (24, 77.40%), a protruziju tipičnu za klasu III pokazuje tek 5 ispitanika (16.12%). Najveći broj ispitanika (22, 70.94%) ipak pokazuje tipičnu retruziju donjih inciziva - DI, a tek 9 ispitanika normalan položaj (29.02%). MP ispitanici u najvećem broju imali su normalan položaj GI (10, 62.50% MP ispitanika), 4 ispitanika pokazuje protruziju (25% MP ispitanika) dok jednak broj ispitanika (po 8, 50% MP ispitanika) pokazuje normalan položaj DI kao i retruziju DI. U slučaju MR ispitanika svi pokazuju normalnu inklinaciju GI i istovremenu retruziju DI (5, 100% MR ispitanika). Retruzija DI ili protruzija GI prisutna je kod MP i BP ispitanika, ukupno 45.14% svih ispitanika. Međutim, samo jedan ispitanik (3.22% ispitanika) pokazao je kombinaciju protruzije gornjih i retruzije donjih inciziva, a ujedno je imao vertikalni obrazac rasta.
Zaključak: U skeletnoj klasi III najučestaliji sagitalni položaj čeljusti je MP (51.61%) slijedi NO (22.58%) pa MR (16.12%). I u djevojčica i dječaka najučestaliji je MP (51.61% ispitanika). Najveći broj ispitanika pokazuje normalan obrazac rasta (58.06%) dok je vertikalni obrazac rasta zabilježen u 35.48% ispitanika. Vertikalni obrazac rasta pojavljuju se najčešće u MR pacijenata (60% MR ispitanika) dok je u MP pacijenata najčešći normalan obrazac rasta (62.5% MP ispitanika). Retruzija DI je prisutna kod 22 ispitanika (70.96%) ispitanika dok je protruzija GI prisutna kod 5 ispitanika (16.12%) ispitanika. Istovremena protruzija GI i retruzija DI uočena je u jednog ispitanika (3.22%) koji je ujedno imao i vertikalan obrazac rasta. |
Abstract (english) | Objective: To assess cephalometric characteristics of Class III Malocclusions in adolescents.
Materials and methods: In this retrospective study, we included cephalograms of patients who visited the ''3D-Dent'' Dental Radiology Laboratory in Split during the period from January, 2013 till April, 2018. The cephalograms were acquired by Vatech i3D-Green device and its pertaining CEPH extension, in accordance with the standard screening protocol. The cephalometric analysis (Zagreb Mod 82 and WITS) was performed on selected craniograms using AudaxCeph software (Audax, Ljubljana, Slovenia).
Results: The study included 60 children aged between 10 and 17 years. After the cephalometric analysis was performed on selected cephalograms, the patients not diagnosed with skeletal Class III were excluded from further research. 31 patients remained - 19 girls (61.29%) and 12 boys (38.70%).
Sagittal position analysis showed that 16 patients (51.61%) had mandibular prognathism and normal sagittal position of maxilla (MP), 7 patients (22.58%) had normal sagittal relationship (NO), 5 patients (16.12%) had maxillary retrognathism with normal sagittal position of mandible (MR), 2 of them (6.45%) had bimaxillary prognathism (BP) and 1 (3.22%) had bimaxillary retrognathism (BR). Most of the male patients showed mandibular prognathism (7, 22.58% of all patients) while 9 female patients (29.03% of all patients) showed the same results.
Vertical relationships analysis measured with basal plane angle showed normal growth pattern in most of the patients (19, 61.27%), 11 patients (35.45%) showed vertical growth pattern and just 1 patient (3.22%) showed horizontal growth pattern. Björk's polygone analysis showed the same results as the analysis of the basal plane angle: the most of MP patients had normal growth pattern (32.25% of all patients, 50% of MP patients) while MR and BR patients mostly showed vertical growth pattern (3.22% - 9.67% of all patients, 60% of MR petients and 100% of BR patients).
The incisor position analysis measured with interincisal angle showed equal number of patients with incisors retrusion and with normal incisor position (41.90% - in total 83.8%). Furthermore, analysis of inclination of incisors in relation to the maxillary or mandibular plane showed that most patients (24, 77.40%) had normal inclination of upper incisors (UI) while 5 patients (16.12%) showed typical protrusion. However, most patients (22, 70.94%) did show typical retrusion of the lower incisors (LI) while 9 of them (29.02%) showed normal inclination. MP patients mostly showed (10, 62.50% of MP patients) normal inclination of UI, 4 of them (25% of MP patients) showed protrusion of UI while the same number of patients (8, 50% of MP patients) showed retrusion and normal inclination of LI. All MR patients (5, 100% of MR patients) showed normal inclination of UI and at the same time retrusion of LI. The typical protrusion of upper incisors and retrusion of lower incisors was shown in MP and BP patients, in total 45.14% of all patients. However, only one patient (3.22% of all patients) showed typical combination of retrusion of LI and protrusion of UI and at the same time vertical growth pattern.
Conclusion: In skeletal Class III the most common sagittal position is MP (51.61%), then NO (22.58%) and MR (16.12%). MP is the most common both in female and male patients. Most patients showed normal facial growth pattern (58.06%) while 11 patients showed vertical growth pattern (35.48%). Vertical growth pattern was the most frequent in MR patients (60% of MR patients) as well as the normal growth pattern in MP patients (62.50% of MP patients). Retrusion of LI was diagnosed in 22 patients (70.96%) while protrusion of UI was diagnosed in just 5 patients (16.12%). Only one patient (3.22%) showed combination of protrusion of UI and retrusion of LI and at the same time vertical growth pattern. |