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Introduction Orthodontic diagnosis and treatment planning encounter distinctive complexities when dealing with cleft lip and palate anomalies. This research endeavors to thoroughly examine skeletal and dental characteristics through cephalometric analyses among individuals with bilateral cleft lip and palate (BCLP) within the central Indian population. Due to anatomical variations and growth constraints, traditional cephalometric mean values derived from standard population studies are often inadequate for these cases. Advanced technology, such as NemoCeph (Nemotech, Madrid, Spain) software, enhances measurement accuracy. Methods Fifty patients, including 25 with BCLP and 25 without BCLP, aged 10 to 18, were selected for this cross-sectional study. Lateral cephalograms were traced and analyzed using NemoCeph software. Skeletal and dental parameters were measured, and a comparison was made between BCLP patients and the general population. Statistical analysis was conducted using the Student's unpaired t-test. Both SPSS Statistics Version 24.0 (IBM Corp., Armonk, NY, USA) and GraphPad Prism Version 7.0 (GraphPad Software, San Diego, CA, USA) were used for data analysis. Results The investigation revealed significant disparities across several parameters, including sella-nasion-A point angle (SNA), sella-nasion-B point angle (SNB), A point-nasion-B point angle (ANB), the inter-incisal angle (the angle between the long axes of the upper and lower incisors), and UP 1 to A-pog (a specific vertical measurement between anatomical markers labeled "upper 1" and "A point to pogonion"), with associated p-values for the skeletal and dental parameters of 0.310, 0.259, 0.195, 0.0001, and 0.0001, respectively. A comparison between manual tracing and digital methods indicated a reduction in errors and an improvement in measurement precision. Notably, patients diagnosed with BCLP exhibited distinctive skeletal and dental traits, highlighting the necessity for tailored treatment approaches. Conclusion This study emphasizes the importance of personalized cephalometric evaluations for patients with BCLP. Standard mean values may not be applicable due to unique anatomical considerations in these cases. Advanced technology and patient-specific assessments are crucial for accurate diagnosis, treatment planning, and orthognathic procedures in individuals with cleft lip and palate conditions. Embracing digital tools and tailored approaches can enhance patient care quality and lead to better clinical outcomes.

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Aim: To evaluate cephalometric parameters of orthodontic population in an urban setup in Odisha using Steiner's, Tweed's and Rakosi's analysis and compare it with the established Caucasian norms. Methodology: Pre-treatment patient records from a dental hospital were collected. Lateral cephalograms of the normal and supernormal sample were traced. Cephalometric features relating to various facial hard tissue that determine balance and harmony were measured using Steiner's, Tweed's and Rakosi's analysis. The values obtained were compared with the established Caucasian norms. Comparison of mean values were done via independent sample t test and ANOVA. Subsequently post hoc Tukey's was used to establish the significance of the mean difference of all the variables used. Results: Significant differences were obtained for lower incisor to NB, mandibular plane angle, FMA, FMIA, articular angle, basal plane angle, inclination angle, Rakosi Jarabak ratio and interincisal angle. Conclusion: Fundamental variations were seen in various parameters. Perception of lay persons can be of aid to the clinician in assembling commendations for alternative treatment plans.

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Maxillo-mandibular advancement MMA is considered an efficacious treatment for patients affected by severe obstructive sleep apnoea syndrome (OSAS). Even though OSAS improvement is the main goal of MMA, excessive maxillo-mandibular protrusion should be avoided to guarantee pleasant postoperative facial aesthetics. In order to attain such a result, the amount of MMA should be planned preoperatively by both aesthetic and cephalometric analyses. Steiner and Delaire cephalometric analyses are commonly used in the preoperative planning of orthognatic surgery for dentofacial deformities, however controversies still exist about the basis and postoperative aesthetic results of such cephalometric analyses in OSAS patients candidate for MMA. Forty-eight patients affected by severe OSAS were submitted to MMA. Pre- and post-operative Steiner and Delaire cephalometric tracings were assessed in each subject. For Steiner analysis, the variation in the SNA and SNB angles was measured, while for Delaire tracings the variation in the C3/FM-CPA and C3/FM-Me angles was assessed. Mean MMA was 6.9 + 3.8 mm for the maxilla and 13.6 + 5 mm for the mandible. After surgery, an improvement of the apnoea-hypopnoea index was recorded (40.47 + 7.64 preoperative vs. 12.56 + 5.78 postoperative). In all patients, both cephalometric analyses showed presurgical bimaxillary retrusion. After surgery, the mean value of Steiner's SNA angle increased from 78.18° to 85.58° (p < 0.001), while mean Delaire's C3/FM-CPA angle increased from 81.19° to 89.71° (p < 0.001). The mean value of Steiner's SNB angle increased from 74.33° to 80.73° (p < 0.001), while Delaire's C3/FM-Me angle increased from 80.10° to 87.29° (p < 0.001). Postoperatively, both the maxilla and mandible were in a more protrusive position (p < 0.001) according to Steiner analysis compared with Delaire tracing. Basing MMA on Delaire cephalometric analysis leads to an increased advancement of the maxillo-mandibular complex than Steiner tracing. The consequences of this aspect on facial aesthetics should be considered during surgical planning and preoperative informed consent in OSAS patients candidate for MMA.

Asunto(s)

Cefalometría , Humanos , Mandíbula/cirugía , Avance Mandibular , Maxilar/cirugía , Apnea Obstructiva del Sueño/cirugía

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A thorough background in craniofacial growth and development is necessary for every dentist. An important concept in the study of growth and development is variability. Cephalometrics is an important part of morphological diagnostic procedures to assess craniofacial growth and development. The aim of this study was to obtain cephalometric norms for Mewari children of Rajasthan by Steiner analysis and compare with Caucasian norms. The method involved clinical examination, collection and analysis of 100 lateral cephalometric radiographs of Mewari children (50 males and 50 females, between 11 and 13 years of age). All cephalometric landmarks were located and determined and subsequently tracing was done according to Steiner analysis. The mean value and standard deviation of each measurement were calculated. Statistical comparison was done using Student t-test. The result of this study showed that the Mewari children had retrusion of mandible relative to cranial base, proclined maxillary and mandibular teeth, with greater convexity of face. They also showed anteriorly placed occlusal plane to cranium and Less prominent chin. In conclusion, these ethnic differences should be considered during orthodontic treatment. How to cite this article: Rathore AS, Dhar V, Arora R, Diwanji A. Cephalometric Norms for Mewari Children using Steiner's Analysis. Int J Clin Pediatr Dent 2012;5(3):173-177.