A CEPHALOMETRIC STUDY
STRUCTURED ABSTRACT:
AIM: To describe and evaluate any deviation in the cervical vertebral morphology in different skeletal patterns.
OBJECTIVE: To describe the cervical vertebral morphology in patients with different skeletal patterns
BACKGROUND AND REASONS: Cervical vertebral analysis has been an aid to orthodontic diagnosis for several years. It helps in indicating the age changes which helps in early treatment of some types of malocclusion. Traditionally cervical vertebral anomalies are observed in patients with cleft lip and cleft palate. Some research has stated that normal patients with no syndromes also have cervical vertebral anomalies, particularly fusion of cervical vertebrae seen in skeletal class III patients. This study is undertaken to find the cervical vertebral morphological changes in class I Class II and Class III skeletal pattern
MATERIAL AND METHODS: A total of 105 lateral cephalograms were taken, With 35 in each skeletal pattern. With inclusion criteria of any age group from 22±6 years of age and both genders. Patients with a prior history of orthodontic treatment and patients with any craniofacial syndrome were excluded. The cervical vertebrae on all the 105 cephalograms were analyzed using a cephalometric software
STATISTICS: Mean, median and SD for three groups. To analyse the data one way ANOVA was done to evaluate if any deviation in the cervical vertebral column morphology in different skeletal pattern.
RESULTS: No significant differences were detected between the three groups in terms of sex , age and morphology *P = NS. A total of 105 lateral cephalograms were evaluated and was found that there were no statistically significant difference in the morphology of the cervical vertebral columns in different skeletal pattern in Chennai population
CONCLUSION: According to our study result there is no significant correlation exists between cervical vertebrae anomalies and skeletal malocclusions in Chennai population.
Introduction:
The cervical vertebra column supporting the head comprises seven vertebrae. The first vertebra (C1) or atlas and the second vertebra or axis together form the superior or sub occipital segment connecting the spine to the occiput and involving a complex chain of joints. Sub occipital muscles attached to this region determine head posture, controlling fine through complicated movements for compound flexion and extension, as well as lateral flexion with rotation.[1]
There are studies that have demonstrated the deviations in skeletal components such as the cranial base, mid-facial complex and mandible may be seen in patients with class III skeletal malocclusion.[1-3] Additionally, deviations in head and neck posture can also be associated with this type of malocclusion[4]
Studies are indicative of the relationship between orthopedic and orthodontic findings. Several of these studies have evaluated the correlation between head posture and cervical inclination. Festa and colleagues evaluated the relationship between mandibular length and cervical lordosis . D’Attilio noticed a significant relationship between the position and length of mandible and cervical. Lippold confirmed the correlation between the position of mandible and cervical vertebrae morphology. Sonnesen et al. evaluated the morphology of cervical column in class III skeletal malocclusion.[3]
This study sought to evaluate the correlation between class I, class II and class III skeletal malocclusion and cervical vertebrae anomalies such as vertebral fusion altered intervertebral space and spinal deviation in the Chennai population.
MATERIALS AND METHOD:
In this study, 105 patients with age group of 22±6 years were included who reported to various dental colleges in Chennai city and were divided into 3 groups ( 35 subjects in each group with class I as control group , class II and class III malocclusion as study group).
The inclusion criteria were:
- No history of previous orthodontic treatment or orthognathic surgery
- Patients with permanent teeth
- No history of any syndrome , neuromuscular disease or temporomandibular joint disorder.
- Lateral cephalogram with first 5 cervical vertebra visible
- No wound, burns, or scarring in the head and neck
The exclusion criteria were:
- A prior history of orthodontic treatment
- Any craniofacial anomaly
- Systemic muscle or joint disorder.
Lateral cephalograms with first 5 cervical vertebral units clearly visible were selected according to these inclusion criteria from patients who reported for orthodontic treatment to various dental institutes in Chennai city. The control group (Group 1) consisted of 35 subjects with 15 males(ages , 22±6 years; mean, 20.4) and 20 females(ages , 22±6 years; mean, 21.6) of class I skeletal pattern. Group 2 consisted of 35 subjects with class II malocclusion with 13 males and 22 females (ages, 22±6 years; mean, 23.5) and 20 females (ages , 22±6 years; mean, 21.2). Group 3 consisted of 35 subjects with 15 males (ages, 22±6 years; mean, 24.6) and 20 females (ages , 22±6 years; mean, 20.6) of class III skeletal pattern. (TABLE 1)
TABLE 1. Frequency distribution of patients with different skeletal pattern and control group.
A cephalometric software (FACAD) was used to measure the inter vertebral distance between the cervical vertebra c1-c2, c2-c3, c3-c4. The subjects with normal cervical vertebra had at least 1 mm and more intervertbral space which is radiolucent. Meibodi et al has identified fusion and posterior arch deficiency in his study. The lateral cephalograms with fusion will show absence of radiolucent space between the cervical vertebras.
STATISTICAL ANALYSIS:
Mean and standard deviation(TABLE 2) were calculated and One way ANOVA statistical test was performed to determine the morphology of the cervical column in different skeletal patterns. The results were considered not significant . The statistical analyses were performed with IBM SPSS software(version 20.00)