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original article

J. Stomat. Occ. Med. (2009) 2: 191–204
DOI 10.1007/s12548-009-0032-x
Printed in Austria
© Springer-Verlag 2009

Three-dimensional CT analysis of vomer bone
in the architecture of craniofacial structures in caucasic
human skulls
Cristian Basili1;2 , Takero Otsuka3 , Mitsuyoshi Kubota4 , Rudolf Slavicek5 , Sadao Sato6
1

Postgraduate Research Fellow, Department of Craniofacial Growth and Development Dentistry, Division of Orthodontics,
Kanagawa Dental College, Yokosuka, Japan
2
Department of Pediatric and Preventive Dentistry, Universidad de Valparaiso, Valparaiso, Chile
3
Post-Doctoral Researcher, Department of Craniofacial Growth and Development Dentistry, Division of Orthodontics,
Kanagawa Dental College, Yokosuka, Japan
4
Department of Craniofacial Growth and Development Dentistry, Division of Orthodontics, Kanagawa Dental College,
Yokosuka, Japan
5
Course Director of Dental Science, Danube-University, Krems, Austria
6
Department of Craniofacial Growth and Development Dentistry, Research Institute of Occlusion Medicine,
Research Center of Brain and Oral Science – Division of Orthodontics, Kanagawa Dental College, Yokosuka, Japan
Received July 7, 2009; Accepted September 28, 2009

Introduction: The craniofacial architecture is the result of a
very complex interrelation. The nasal septum and specially
vomer bone, because of its strategic spatial location between
the cranial base and the mid-face, influence the growth of this
area of the facial skeleton, thus playing a major role in the
organization of the craniofacial architecture. The purpose was
to analyze the influence of vomer bone on the morphology of
the craniofacial architecture, evaluate its correlation with
different structures, and compare the spatial position and
dimensions between dentoskeletal frames.
Method: 3D cephalometric measurements were analyzed and correlated in 302 digitally reconstructed skulls by
3D CBCT of a caucasic European adult population.
Results: Changes in the inclination and the dimensions of
vomer bone were strongly correlated with other craniofacial
structures. There were significant variations in vomer bone
between the different dentoskeletal frames.
Conclusions: Vomer bone seems to play an important
role in the interrelation of the craniofacial architecture.
Keywords: Vomer, cranial base, maxilla, occlusal plane,
posterior occlusal plane, skull, 3D CBCT

Introduction
The craniofacial architecture is the result of a very complex
interrelation between different structures, which varies
among individuals. Some theories have been developed to
Correspondence: Cristian Basili, Department of Craniofacial Growth
and Development Dentistry, Division of Orthodontics, Kanagawa Dental
College, 82 Inaoka-cho, Yokosuka 238-8580, Japan.
E-mail: cristianbasili@gmail.com

J. Stomat. Occ. Med.  Springer-Verlag

represent these dynamic relations emphasizing on the articular mobility of the cranium and the interaction between the
different craniofacial structures. Among these theories, Dr.
Sadao Sato emphasizes the importance of synchondroses
between the bones, which allows them to be situated within
a flexible or moving structure when pressure or tension is
exerted on craniofacial structures. These synchondroses permit slight relative movements called articular mobility of the
cranium [30]. This mobility between the structures is important during growth and development of the mid-face, because
of the varying relation between different bone structures,
muscles, and functional influences that modulate the expression of the morphological skeletal patterns. In this interrelation, the nasal septum especially vomer bone, because of its
spatial location between the cranial base and the mid-face,
shape and the anatomical relation to important structures,
serves as an important structure that influences the growth of
this area of the facial skeleton. Therefore, it could play a major
role in the organization of the craniofacial architecture.
Some researchers have partially described the role of
vomer bone in the development of the maxillary complex as a
possible influencing factor in the lowering of the hard palate or
in the distribution of masticatory forces to the cranial base. At
the same time, some approaches for the development of the
anterior portion of the maxilla [3, 7, 11, 14, 21], and some
influence on the evolution of patients with cleft palate have
been described [8, 10, 17]. However, its influence on the
morphology of the craniofacial architecture still remains
unclear.
Most of the information from previous studies about
craniofacial interrelations was obtained from 2D cephalometric images, with limitation in the identification of this structure. Nowadays, the development of the Cone beam
Three-dimensional CT analysis of vomer bone

4/2009

191

Left canine. . 6. 1: Definition of anatomic landmarks for 3-dimensional computed tomography Landmark Abbreviation Definition on CT image Nasion N Nasofrontal structure in the midline Sella S Center of the pituitary fossa Basion Ba Anterior-inferior margin of the foramen magnum Upper vomer UV The most anterior point of the vomer bone base Lower vomer LV The midpoint in the posterior surface of the vomer bone base Anterior nasal spine ANS Central point of the anterior nasal spine Posterior nasal spine PNS The most posterior point of the palate in the medial plane A point A The deepest point of the midline maxillar frontal surface Right tuberosity TubR The midpoint of the junction between right sphenoid pterigoid processus and maxilla tuberosity Left tuberosity TubL The midpoint of the junction between left sphenoid pterigoid processus and maxilla tuberosity Tuberosity medial TubMed Computerized 3D middle point between tuberosity left and right landmarks Right canine 3R Tip of the cusp of the right canine Left canine 3L Tip of the cusp of the left canine Right 2nd premolar 5R Tip of the bucal cusp of the second right premolar Left 2nd premolar 5L Tip of the bucal cusp of the second left premolar 2nd premolar mean Premed Computerized 3D mean point between right and left second premolars Right 1st molar 6R Bucal area of the contact point between right first molar and right second premolar Left 1st molar 6L Bucal area of the contact point between left first molar and left second premolar Right 2nd molar 7R Tip of the disto-bucal cusp of the right second molar Left 2nd molar 7L Tip of the disto-bucal cusp of the left second molar B point B The deepest point of the mid mandibular frontal surface Menton Me The lowest border of the mid mandibular suture Tangent gonion right TGoR The lowest point in the distal right portion of the mandible Tangent gonion left TGoL The lowest point in the distal left portion of the mandible Upper interincisor point UII The most incisal point between the two upper central Incisors Fig. Right 2nd molar. 3.original article Tab. 16. Basion. 11. 22. 1: 3D Landmarks. 25. Left 2nd molar. 9. 13. Menton. Anterior nasal spine. 15. 20. Tuberosity medial. Median second premolar 192 4/2009 Three-dimensional CT analysis of vomer bone  Springer-Verlag J. Right canine. Right 2nd premolar. Nasion. 10. Stomat. 17. Lower vomer. Left 1st molar. 4. 14. 7. Upper vomer. 5. 18. Right tuberosity. Right 1st molar. Tangent gonion left. 24. 23. Occ. 1. 19. Sella. 8. Frontal and lateral images of the 3D virtual model of the skull with the cephalometric landmarks. Tangent gonion right. Left 2nd premolar. Interincisor point. 12. B point. 2. Med. 21. Left tuberosity. Posterior nasal spine. A point.

Germany) in DICOM multifile format and imported into MAXILIM software version 2. Germany) at 220 V.2. Sagital plane (SP) Three-dimensional CT analysis of vomer bone 4/2009 193 . left and right second molar Mandibular plane MP Plane defined by 3 landmarks: menton. Available Sella Landmark. the presence of a stable and reproducible mandible position. Palatal plane (PP). 8. 33]. Computerized generation of eight 3D Planes was defined (Table 2. 6. 2. Sella nasion plane (SN). who were killed or died circa 1870. The Conebeam angle is collimated to approximately 24 and has an orbital angle of 204 . randomly selected from the Weissbach Collection of the Natural History Museum Vienna. exposure parameters were controlled by automatic exposure control. Since the samples did not have a soft-tissue component. Stomat. evaluate its correlation with different structures. The samples included 322 caucasic European adult dry skulls. 2. Vertical plane (VP). Fig. ranges from 19 to 50 years.  Springer-Verlag Fig. Med. and compare the spatial position and dimensions between dentoskeletal frames in 3D digitally reconstructed skulls of a caucasic European adult population. 24. Reference planes are represented in blue. A silicone plaster was placed in the joint space to fill the area between glenoid fossa and the condylar head. 5. The purpose of this study was to analyze the influence of vomer bone on the morphology of the craniofacial architecture. These 3D reconstructed skulls models were re-analyzed on the basis of the following criteria 1. and 3. The cephalometric landmarks were located and marked on Tab. Donau University and Kanagawa Dental College Research Committee. Although no complete documentation about demographic information is available.0 (MEDICIM. because of the unavailable welldefined Nasion (19 skulls) or Sella (1 skull) landmarks. 3D measurements were undertaken in stages. Belgium). perpendicular to sagital plane Anterior occlusal plane AOP Plane defined by 3 landmarks: upper Interincisor point. Augustine Weissbach was a physician in charge of a military hospital in Constantinople and he foresaw the benefits of preserving the skulls of soldiers in the Imperial Army. and 3. 2: Graphic representation of the 3D planes. 4. There were about 850 skulls in the original collection donated in 1885 to the anthropology division of the Natural History Museum of Vienna. with the mandible in maximun intercuspation. right and left second premolar Posterior occlusal plane POP Plane defined by 3 landmarks: medial second premolar. The 3D cephaloJ. Cone Beam Computerized Tomography (CBCT) scans were acquired with the Galileo Compact (Sirona Dental System GmbH. Fig. frequency of 50/60 Hz with a total filtration of X-ray tube assembly >2. metric analysis was designed with 25 different landmarks (Table 1. Horizontal plane (HP). A custom plastic head holder was constructed to support the skulls during imaging and was placed with a laser marker. Mechelen. no evident cranial deformity 2. Mandibular plane (MP). 1. The scanning time was approximately 14 seconds and 200 single exposures were performed for each skull with a field of view of 15 cm diameter15 cm height. complete skull bone structure.5 Al. Available Nasion Landmark. perpendicular to sagital plane Palatal plane PP Plane through ANS-PNS line. 2: Definition of 3D planes used in the analysis Plane Abbreviation Definition Horizontal plane HP Automatically computed plane 6 below SN along the horizontal direction of the natural head position Vertical plane VP Plane through sella and perpendicular to the horizontal plane and sagital plane Sagital plane SP Plane through sella and nasion and perpendicular to the horizontal plane Sella nasion plane SN Plane through S-N line. 1) on the skulls. The models were obtained and reevaluated by a singlecalibrated operator (CB). 3. Presence of Skeletal basic structures. Constructed 3D planes are shown in red.original article computed tomography systems and its applications in craniofacial diagnosis provide new alternatives to evaluate the morphology of the craniofacial skeleton in a three-dimensional way with great accuracy [1. the skulls are mainly of males. The sample was selected on the basis of the following criteria: 1. Posterior occlusal plane (POP). The CBCT data were exported from the SIDEXIS XG software (Sirona Dental System GmbH. 20. 7. and the age at the time of death. 19. 2) and established. Occ. 20 skulls were eliminated from the sample. Anterior occlusal plane (AOP). right and left tangent gonion Material and methods This Research Protocol was approved by the Natural History Museum Vienna. 23. to improve the stability of the lower jaw. A group of orthodontists checked the occlusion to confirm the stability and reproducibility.

USA). Vomer bone and cranial base In the sample group. 3: Definition of the 3D angular measurements in the analysis Angular measurement Abbreviation Definition Cranial base Cr Base Angle between landmarks N-S-Ba AOP-POP AOP-POP 3D angle between AOP and POP AOP-SN AOP-SN 3D angle between AOP and SN plane POP-SN POP-SN 3D angle between SN plane and POP Vomer diagonal-SN Dvo-SN Angle between the line LV-ANS and the SN plane SN-PP SN-PP Angle between the line S-N and the palatal plane MP-AB MP-AB Angle between the line A-B and the mandibular plane PP-AB PP-AB Angle between the line A-B and the palatal plane S-Me-SP S-Me-SP Angle between the line S-Me and the sagital plane SN-MP SN-MP Angle between the line S-N and the mandibular plane Vomer Base-SN Bvo-SN Angle between the line UV-LV and the SN plane Vomer Post-SN Pvo-SN Angle between the line LV-PNS and the SN plane Vomer Sup-SN Svo-SN Angle between the line UV-ANS and the SN plane ANB ANB Angle between three landmarks: A.99. B. Stomat. which showed values between 0. Bonferroni tests) were performed for multiple group comparison to determine which group significantly differed. and 4. No systematic errors were detected. The abbreviations used in this study are listed in Tables 1.37  3. . The samples were classified according to the dentoskeletal frame groups. 3.. post-hoc analyses (Tukey. following this criteria: Class II < 81. The statistically significant levels were predetermined at P < 0.79 (Class I) < Class III. Class II.01. Excel files were exported to SPSS software version 15 for the statistic analysis. and paired samples t-test between first and second angular and linear measurements. were developed by a single-calibrated operator. Med. After this stage. and Class III based in the antero-posterior dysplasia indicator (APDI) [16]. 2. A SNB SNB Angle between three landmarks: S. Results 3D data obtained from the analysis of correlations between vomer bone and different structures and measurements of the skulls are presented. S. 3 and 4) previously designed were obtained in the Maxilim Software. Finally. Table 7 presents the correlations of linear measurements of vomer bone. the Pearson product moment correlation coefficients were calculated to estimate the relationship between vomer bone and the skeletal parameters. Figs. To determine intra-observer reliability and assess cephalometric method error. Table 6 shows the correlations between angular measurements and different parameters of the skull. the relation between the cranial base and the inclination of vomer bone in the angular measurements  Springer-Verlag J. USA). In addition to standard descriptive statistic calculations (means and standard deviations). duplicate 3D tracing and measurements of 25 randomly selected skulls were performed by the same investigator (CB) after 1 month. N.original article Tab. B the skulls using an optical mouse in a 69 cm (27 inch) LCD Display Monitor (Dell. therefore all the angular and linear 3D cephalometric measurement data were exported with the original skull identification number. Table 5 presents descriptive data of angular and linear measurements. ANOVA test was used to evaluate differences among the skeletal frames. Me N-S-Me NSMe Angle between three landmarks: N. Occ. Random and standard errors were calculated by correlation.80 and 0. correlations were determined by their relation to different structures. Statistical analysis Statistical analysis was performed with a standard statistical software package SPSS version 15 for Windows (SPSS Inc. Additionally. Figure 5 shows the lateral representation of a constructed vomer bone. into Class I. All the cephalometric images of the 302 skulls. S. Chicago. The Maxilim Software can export the measurement data to Excel files. When ANOVA yielded 194 4/2009 Three-dimensional CT analysis of vomer bone significant results indicating that at least one group was significantly different from the others. N ANS-S-Me ANS-SMe Angle between three landmarks: ANS. 24 angular (Table 3) and 37 linear 3D cephalometric measurements (Table 4. For the analysis. N.05 and P < 0. Me SNA SNA Angle between three landmarks: S. regarding the influence of vomer bone on the morphology of the craniofacial architecture.

original article Tab. Post Rt on PP Average tuberosity-A on PP Aver Tub-A on PP Average between TubLt-A on PP and TubRt-A on PP (Dvo-SN. Svo-SN. we noted a negative correlation of the anterior and posterior cranial base dimensions with the N-Ba distance. This shows that a bigger dimension of the Three-dimensional CT analysis of vomer bone 4/2009 195 . which means that extension of the cranial base is correlated to a downward inclination of vomer bone.  Springer-Verlag ments of the cranial base and most of the measurements of the inclination of vomer bone.01). Occ. in the analysis of the linear measureJ. Med. Stomat. 4: Definition of the 3D linear measurements in the analysis Linear measurement Abbreviation Definition ANS-PNS ANS-PNS Distance between landmarks ANS and PNS N-Ba N-Ba Distance between landmarks N and Ba S-Me S-Me Distance between landmarks S and Me Anterior cranial base Ant Cr Base Distance between landmarks S and N Sagital maxilla Max Dist Distance between landmarks ANS and TubMed Lower anterior facial height Fv (L) Distance between landmarks ANS and Me Upper anterior facial height Fv (S) Distance between landmarks N and ANS Total facial height Fv (T) Distance between landmarks N and Me Posterior cranial base Post Cr Base Distance between landmarks Ba and S Vomer diagonal distance Vo Diag Distance between landmarks LV and ANS Vomer posterior distance Vo Post Distance between landmarks LV and PNS Vomer superior distance Vo Sup Distance between landmarks UV and ANS Media second premolar-SN 5-SN Distance from landmark Premed to SN plane A-VP A-VP Distance from landmark A point to vertical Plane ANS-VP ANS-VP Distance from landmark ANS to vertical Plane B-VP B-VP Distance from landmark B point to vertical plane Me-VP Me-VP Distance from landmark Me to vertical plane N-VP N-VP Distance from landmark N to vertical plane Inter second molar Int 7 on PP Distance between projections of landmarks 7R and 7L on the palatal plane Inter second premolar Int 5 on PP Distance between projections of landmarks 5R and 5L on the palatal plane Intertuberosity Int Tub Distance between projections of landmarks TubR and TubL on the palatal plane UV-ANS Up Vo-ANS on VP Distance between projections of landmarks UV and ANS on the vertical plane UV-PNS Up Vo-PNS on VP Distance between projections of landmarks UV and PNS on the vertical plane Left anterior maxilla A-6 Lt on PP Distance between projections of landmarks A and 6L on the palatal plane Right anterior maxilla A-6 Rt on PP Distance between projections of landmarks A and 6R on the palatal plane Inter first molar Int 6 on PP Distance between projections of landmarks 6R and 6L on the palatal plane Intercanine Int 3 on PP Distance between projections of landmarks 3R and 3L on the palatal plane Left posterior maxilla Max Post Lt on PP Distance between projections of landmarks 6L and TubL on the palatal plane Right posterior maxilla Max Post Rt on PP Distance between projections of landmarks 6R and TubR on the palatal plane Left tuberosity-A on PP Tub Lt-A on PP Distance between projections of landmarks A and TubL on the palatal plane Right tuberosity-A on PP Tub Rt-A on PP Distance between projections of landmarks A and TubR on the palatal plane Posterior lower height of vomer bone Vo Post Lo on VP Distance between projections of landmarks LV and PNS on the vertical plane Postero-superior vomer bone Vo Post Up on HP Distance between projections of landmarks LV and UV on the horizontal plane Posterior upper height of vomer bone Vo Post Up on VP Distance between projections of landmarks UV and LV on the vertical plane Antero-superior vomer bone Vo Ant Up on HP Distance between projections of landmarks UV and ANS on the horizontal plane Average anterior maxilla Aver A-6 on PP Average between A-6Lt on PP and A-6Rt on PP Average posterior maxilla Aver Max Post on PP Average between Max Post Lt on PP and Max. At the same time. and Bvo-SN) showed a significant positive correlation (p < 0.

4. 1. 22. Up Vo-ANS on VP. Max Dist. Int 3 on PP. a negative correlation with SNA and SNB was shown. Anterior left maxilla (A-6 Lt on PP). Inter canine (Int 3 on PP). N-Ba. A-VP. At the same time. Only the base of the vomer (BvoSN) showed different results having only significant negative correlation with the posterior cranial base length. The angle of the posterior vomer (Pvo-SN) showed a positive correlation with the sagittal maxilla dimension (ANS-PNS) that indicates changes in the shape of the posterior part of the bone in relation to the maxilla changes. 4: Image of the 3D linear transversal measurements between landmarks. a significant negative correlation was found between some transversal dimensions of the maxilla (Int 7 on PP. 11. Vo post. If there is a class II tendency. Palatal plane (PP). 7. which means that a higher inclination of vomer bone is correlated with posterior position of the jaws. analyzing the proportions in the maxilla and the inclination of vomer bone (Dvo-SN). 6. Int 6 on PP) and the inclination of vomer bone (Dvo-SN). B-VP. 17. Vo Post Up on HP. Horizontal (HP) or SN Planes. 23. 5. 9. there was no correlation with the diagonal length (Vo Diag) and the cranial base angle. 8. Lower vomer landmark (LV). we observed a negative correlation with the anterior dimension of the maxilla (Aver A-6 on PP). vomer bone is bigger. Anterior nasal spine (ANS). 4. The difference in the anterior extension with the anatomical vomer bone has to be considered in the analysis of the results. and the same happens with the dimension of the maxilla. 12. Anterior right maxilla (A-6 Rt on PP). Vo Ant Up on HP Fig. However a negative tendency in all the other transversal measurements is appreciated (Int 5 on PP. 24. 1. Vo Post Lo on VP. 16. There was a positive relation with ANB. as a portion of the maxilla is included. 19. 6. Stomat. 8. Int Tub). Right tuberosityA point (Tub Rt-A on PP). 2. the projected measurements of the height of vomer bone in the vertical plane. Posterior left maxilla (Max post Lt on PP). 11. Inter second molars (Int 7 on PP). Inter tuberosity (Int Tub). and the posterior dimension of vomer bone (Vo Post) showed negative correlation. 2. 5. The posterior vomer dimension (Vo Post) showed a negative correlation with the palatal plane. or a retrusive position tendency. Vomer base (Bvo). 6. . Vo sup. had a significant negative correlation with the sagittal measurement of the maxilla (Max Dist). 5: Lateral representation of the constructed vomer bone. when it is more inclined the posterior dimension is smaller. UV-ANS on VP show a positive correlation and UV-PNS on VP a negative correlation with cranial base. Vo Post Up on VP. in vomer bone dimensions. 3. 10. Upper vomer landmark (UV). 2. 14. Superior vomer (Svo). 5-SN. Ant Cr Base. 20. and no correlation with the posterior (Aver Max Post on PP). At the same time. Posterior right maxilla (Max post Rt on PP). projected on the Palatal Plane (red color) to avoid vertical variations. 7. Med. 9. 15. 9.original article Fig. SvoSN. Inter first molars (Int 6 on PP). S-Me. Up Vo-PNS on VP. The diagonal length of the vomer showed a negative correlation with the angular inclinations. 3: Lateral image of virtual skull representing 3D linear sagital and vertical measurements. Diagonal vomer (Dvo) Vomer bone and maxilla Fig. although there is a negative tendency. On the other hand. 10. At the same  Springer-Verlag J. Fv(T). Fv(L). Vo diag. ANS-PNS. Inter second premolars (Int 5 on PP). The inclination of vomer bone measured by Dvo-SN. 7. ANS-VP. anterior and posterior lines. this could be related to the correlation with the sagital size of the maxilla. and Bvo-SN. 18. Posterior vomer (Pvo). At the same time. Left tuberosity-A point (Tub Lt-A on PP) anterior or posterior cranial base length is correlated with less inclination of vomer bone. 4. 3. Me-VP. calculating the distance from the different landmarks to the Vertical (VP). Occ. as the Palatal Plane presents a positive correlation. On the other hand. Posterior nasal spine (PNS). 5. Post Cr Base. Fv(S). 1. 13. 8. 196 4/2009 Three-dimensional CT analysis of vomer bone The inclination of vomer bone (Dvo-SN) is directly related to a similar rotation of the maxilla. 3. N-VP. 21.

6 25.5 78.1 Int 5 on PP 136 51.4 47.5 173.8 PP-AB 302 82.1 MP-AB 302 75.2 41.1 3.9 77.2 63 Fv(L) 302 66.1 Bvo-SN 302 158.5 80.7 55.7 43.5 3.5 56.original article Tab.5 SN-MP 302 27. Occ.2 3.1 4.9 4.1 57.4 Int 7 on PP 239 62.5 5.5 3.5 34.1 9.6 3.5 126.6 15.0 14.9 Max Dist 302 52.9 S-Me 302 121.0 3.2 6.6 Pvo-SN 302 57.2 4.3 47.1 3.5 2.7 38.0 5.9 N-Ba 302 101.7 (Continued) J.0 1.5 77.8 60.7 Fv(S) 302 50. 302 131.7 11.7 89.0 34.5 4.9 55.4 89. Stomat.0 5.5 NSMe 302 68.7 140.3 60.8 77.1 90.1 6.9 Fv(T) 302 115.8 Int Tub 302 43.6 49.3 3.8 6.1 25 POP-SN 138 19.5 79.4 79.8 92.2 Me-VP 302 56.9 Ant Cr Base 302 67.8 A-VP 302 66.1 6.9 51 Vo Diag 302 70.4 Angular measurements CrBase AOP-POP 101 7.9 4. Max.0 17.2 3.2 4.9 3. Min.1 ANS-S-Me 302 30.2 92.7 7.5 70.9 ANB 302 3.8 30. Med.9 5.1 112.5 Vo Post 302 25.0 20.1 81.7 ANS-PNS 302 51.6 B-VP 302 61.8 35.1 40.6 5.1 72.0 2.9 45.6 57.9 79.2 77.5 42.7 5-SN 137 72.9 Linear measurements 103 134.  Springer-Verlag Three-dimensional CT analysis of vomer bone 4/2009 197 .7 SNB 302 80.4 3.2 SN-PP 302 7. 5: Descriptive statistic of the different parameters Measurements N Mean S.0 2.9 3.6 79 ANS-VP 302 69.6 5.4 50.5 58.2 107.4 55.5 4.6 4.9 Dvo-SN 302 23.3 78 SNA 302 83.0 6.9 N-VP 302 67.7 4.8 Svo-SN 302 38.2 18.2 2.3 5.4 115 147.7 52.D.6 29.8 39.3 3.6 65.6 70.5 40.4 Post Cr Base 302 43.7 Vo Sup 302 56.6 3.5 32.1 3.4 AOP-SN 113 12.0 3.8 46.7 59.

017 0.572 0.001 0. Co.8 Vo Post Up on HP 302 19.276 0.182  0.413  0.000 0.1 19.082 NS 0.316  0.000 0.4 40.504  0.115  0.000 0.000 0.2 2.153 NS 0. 5: Continued Measurements N Mean S.004 Bvo-SN 302 0.001 0.944 PP-AB 302 0.000  0.199  0.239  0.013 0.260  ANSPNS 302 0.778  0.55 Aver Tub-A on PP 302 54.000 Dvo-SN 302 – 0.095 NS 0. Co.000 0.012 0.001 0.2 17.8 47.017 NS 0.5 52.279  0.7 Int 6 on PP 245 53.000 0.114  0.654 – 0.202  0.000 0.191  0.184  0.9 27.572 Pvo-SN 302 0.000 NS 0.000 0.513 0.010 NS 0.275  0.326  0.050 0.000 0.166  0.654 0.4 3.098 NS 0. Min.012  0.033 NS 0. Stomat. Co.000 0.145 Ant Cr Base 302 0.3 17.026 NS 0.000 0.000 0.000 MP-AB 302 0.345  0.8 Vo Ant Up on HP 302 48.3 3.0 2. Max.402 0.045 0.427 ANB 302 0.235  0.127 NS 0.431  0.218  0.6 2.000 Max Dist 302 0.000 SN-PP 302 0.000 0.004 NS 0.000 0.6 11.000 0.345  0.466 0.000 Svo-SN 302 0. Signif.000 0.296  0.102 0.011 NS S-Me 302 0.026 NS 0.3 Up Vo-PNS on VP 302 29.6 27.001 0.127 0.000 POP-SN 168 0.333  0.376  0.191  0.201  0.143  0.360  0.9 38.5 60.143  0.844 0.0 3.614 0.379 0.269  0.000 Fv(L) 302 0.260  0.200  0.262  0. Signif.000 0.211  0.205  0. Co.6 2. CrBase 302 0.423  0.611 0.004 SN-MP 302 0.391  0. Up Vo-ANS on VP 302 30.65 41.000 0.272  0.003 SNB 302 0.309  0.1 2.8 Tab.527 0.063 NS 0.000 0.145  0.000 0.016 0.778  0.545  0.921 0.153  0.2 3.8 35.325 SNA 302 0.038 NS 0.440  0.023 NS 0.000 0.047 0.1 2.000 0.514  0.000 0. Pvo-SN Cor.8 63.0 2.692 0.078 NS 0.504  0.3 Vo Post Up on VP 302 10.820 0.696 0.328  0.006 NS 0.8 25.177 0.001  0.033 NS 0.207 AOP-SN 122 0.072 NS 0.9 20.327  0.090 0.037 NS 0.251  0.051 NS 0.000 0.2 5.051 NS 0.427  0.2 27.000 (Continued) 198 4/2009 Three-dimensional CT analysis of vomer bone  Springer-Verlag J. Cor.239  0.000 0.7 42 Vo Post Lo on VP 302 19.6 Aver A-6 on PP 288 34.000 0.052 NS N-Ba 302 0.051 NSMe 302 0. Occ. Signif. .008 0.137 ANS-Sme 302 0.171  0.000 AOP-POP 110 0.000 0.000 0.037 NS 0.000 0. Med. Svo-SN Cor. 6: Correlation of craniofacial morphology between vomer angular measurements and the different parameters Measurement N Dvo-SN Bvo-SN Cor.D.000 0.167  0.366 0.029 NS 0.3 62.000 0.6 Int 3 on PP 152 36.000 – 0.original article Tab.365  0.155 0.164 NS 0.9 Aver Max Post on PP 288 29.099 0.8 11.1 37.351  0. Signif.381 0.607  0.000 –  0.

193 0.000 ANS-VP 302 0.035 0.083 NS 0.267 0.362  0.000 0.990 0.118 NS 0. Signif.002 0.05. Vomer bone and face height In relation to facial height dimension and the inclination of vomer bone (Dvo-SN). ANS.059 0.002 0.002 Vo Post Up on HP 302 0.147 Vo Ant Up on HP 302 0.000 0.001 Int 3 on PP 161 0. Signif. Pvo-SN Cor.446 0. and Bvo-SN).129  0.728  0.000 0.221  0.017 Aver Max Post on PP 288 0.142 0.000 Cor.287  0. At the same time.084 NS 0.175  0. and no correlation with the base or posterior vomer.018 NS 0.127  0.000 0.347  0.000 0.001 Aver Tub -A on PP 302 0.056 0. Despite these influences.474  0.395  0.656 A-VP 302 0.432 0.000 0.  Statistical significance at level 0.000 0.086 NS 0. Svo-SN Cor.004 0.038 NS 0.345  0. it is associated specially with an increase in the upper height of the face. SvoSN.003 NS 0.000 0.160 NS 0.447  0.204  0.057 0.224  0.271  0.230  0. 302 0.000 0.136 0.002 0.200 0.000 Vo Post Lo on VP 302 0. As vomer bone rotates downward.123 NS 0.164  0.200 Fv(S) Int Tub 302 0.166  0.507 0.039 NS 0. and Me to the vertical plane.000 0.121  0.168 0. Vomer bone and occlusal planes The downward inclination of vomer bone (Dvo-SN) is related to a similar inclination of the Posterior and Anterior Occlusal Plane (POP-SN and AOP-SN).917 0.255  0.000 0. Pvo-SN.000 0.000 0.561  0. this represents that a downward inclination.000 0. Occ.000 0.417  0.014 Int 5 on PP 154 0.001 0.000 Fv(T) 302 0.087 NS 0.000 0.237  0.567  0. Co.050 NS 0. Co.487  0. B.095 NS 0.000 0.286  0.035 NS 0.236  0. which can be understood as the inclination of the complete maxillary Three-dimensional CT analysis of vomer bone 4/2009 199 .420  0.547  0.001 0.038 NS 0.110  0.553 0. This influence seems to be higher in the maxilla than in the lower structures.111 NS 0.  Statistical significance at level 0.  Springer-Verlag The angle ANS-S-Me had a negative correlation with Dvo-SN and Svo-SN.002 0.258  0.041 0.631  0.078 NS 0.004 0.002 0.000 0.000 0. but the anterior height (UV-ANS on VP) showed a positive one.261  0.000 0.517 0.210  0.694  0.471  0.064 NS 0. All facial sagital dimensions had negative correlation with the inclination of vomer bone (Dvo-SN).106 NS 0.179  0.027 0.188 0.516  0.002 0.01 time.001 0.215  0.312  0.000 0.360  0.347 0.000 0. which makes the ANS point to also rotate downwards.407  0.061 NS 0.000 5-SN 154 0.001 NS 0.206  0.737 0.201  0. in relation to the spatial and structural variation.812  0.000 0.046 0.975 0.441  0.000 0.000 Up Vo-PNS on VP 302 0.037 NS 0. 6: Continued Measurement N Dvo-SN Bvo-SN Cor. N.000 B-VP 302 0.220  0.099 Up Vo-ANS on VP 302 0. shows smaller dimensions of A.000 Int 6 on PP 252 0.319  0.191  0.009 NS 0. it showed a decrease in the lower dimension. J.470  0.073 0.423  0.000 N-VP 302 0.219  0.000 Vo Post Up on VP 302 0.368  0.000 0.036 NS 0.085 NS 0.158  0.000 0.000 0.191  0.210  0.000 0.515  0. NS not significant.002 Int 7 on PP 240 0.000 0.191  0.000 Me-VP 302 0. there was a negative correlation with the lower dimension (Fv(L) and a positive with the upper height (Fv(S)) in the 4 measurements (Dvo-SN.368  0.368 0.199  0.000 0.836 0. Cor.177  0.119  0.000 Vo Post 302 0.000 Vo Diag 302 0.172 0.185  0.158 0.045 NS 0.742  0.261  0.436  0. Signif.000 0.386 Post Cr Base 302 0.109 NS 0. Med. this is related to the rotation of the maxilla.000 0.000 0. Co.118  0. Co.001 0. the posterior height (UV-PNS on VP) showed a significant negative correlation.174  0.262  0.426  0.354  0.193  0. there was no correlation between vomer inclination and the total face height.039 Vo Sup 302 0. Stomat.000 Aver A-6 on PP 288 0. this means that if we have a higher inclination of vomer bone.original article Tab.000 0.019 NS 0.239  0.225 0.000 0.112 NS 0.000 0.217  0. Signif. Co Correlation Coefficient.105 NS 0.

037 NS 0.135  Fv(T) 302 0.225  0.016 0.021 NS 0.404 DVoSN 302 0.153  0.000 0.083 NS 0.395  0.000 0.086 NS 0.000 0.027 0.360 0.000 0. .060 NS 0.410  0.000 0.000 0.096 0.514  0. Signif.732  0.372  0.480 Bvo-SN 302 0.447  0.000 0.623 0.300  0.233  0.714 SNB 302 0.004 NS 0.299  0.178  0.000 0.000 Pvo-SN 302 0.103 NS 0.683  0. Co.939 0.294  0.886 0.190  0. Cor.072 NS 0.149  0.161  0.000 0.020 NS 0.000 0.025 PP-AB 302 0.163 0.239  0.376 0.052 ANS-VP 302 0.000 Svo-SN 302 0.087 NS 0.433 0.028 NS 0.122  0.191  0.042 0.130 NS 0.062 N-Ba 302 0.224  0.003 B-VP 302 0.003 ANS-Sme 302 0.295 0.775  0.247  0.012 0.265  0.001 N-VP 302 0.362  0.006 NS 0.135  0.000 0.027 NS 0.296  0.122  0.000 0.003 0.000 0.198 NSMe 302 0.554  0.029 0.072 NS 0.000 0.037 NS 0.539  0.008 0.210  0.812  0.338  0.107 Vo Post 302 0.000 0.085 0.612  0.002 0.220  0.192  0.185  0.279  0.126 NS 0.041 0.023 SN-MP 302 0. Co.259  0.163 0.240  0.150 0.112 0.124  Int 7 on PP 240 0.438  0.262  0.487 0.169  0.104 0.169  0. UV-ANS on VP Signif.000 0.000 0.118  0.224  0.301  0.003 0.055 NS 0.001 0.053 NS 0.345  0. 7: Correlation of craniofacial morphology between vomer Linear Measures and the different parameters Measurement N Vo Diag Vo Post Vo Sup Cor.000 0.000 0.000 0.094 0.05 0.287  0.001 0.037 NS 0.000 0.263  0.447  0.168  0.034 0.000 0.000 – 0.000 0.028 NS 0.000 Ant Cr Base 302 0.000 0.253  0.000 0.939 Vo Diag 302 – 0.363  0.008 NS 0.033 Max Dist 302 0.306 AOP-SN 122 0.642  0.322  0. Med.000 Vo Sup 302 0.001 0.210  0.330  0.252  0.123  0.127  0.759  0.000 0.002 0.065 NS 0.520 0.000 5-SN 154 0.330  0.242  0.329  0.198  0.218  0.180  0.355  0.122  0.901 Int Tub 302 0.664  0.000 0.317  0.169  0. UV-PNS on VP Signif.000 0.000 0.411  0.194 0.006 A-VP 302 0.260  0.032 NS 0.699 POP-SN 168 0.000 – 0.000 0.642 0.262 0.000 0.237  0.403 0.032 NS 0. Cor.000 0.120 NS 0.000 0.002 0.130  0.041 0.130 0.001 0.131  0.367 0.210  0.071 NS 0.608  0.043 0.353  0.271  0.097 NS 0.000 0.162  0.775  0.127  0.101 NS 0.064 NS 0.000 0.216 UV-ANS on VP 302 0.051 NS 0.091 0.109 NS 0.157  0.001 0.000 0.000 0.201  0.000 0.414  0.220  0.154  0.028 0.000 0.023 NS 0.515  0.401 0.000 0.000 0.454  0.093 NS 0.097 NS 0.194  0.034 Fv(L) 302 0. Cr Base 302 0.000 0.584 0.000 0.089 NS 0.045 NS 0.482  0.000 0.247 0.005 0.421  0.040 NS 0.000 0.000 ANSPNS 302 0.000 0.000 0.007 0.248  0.028 NS 0.159  0.145  0.242  0.520 0.079 0.711 S-Me 302 0.000 0.004 0.438  0.019 0.006 AOP-POP 110 0.092 NS 0.037 NS 0.380 0. Co.019 0.163  0.193  0.000 0.074 NS 0.021 NS 0.075 NS 0.014 NS 0.052 0.914 0.331  0.582 0.329  0.201  0.000 0.000 0.416  0.011 NS 0.099 NS 0.239  0.000 0.000 0.803 0.028 0.000 0.414  0.010 0.266 0. Signif.001 0.024 0.original article Tab.142 MP-AB 302 0.039 0.006 0.262  0.369  0.000 0.005 0.000 0.056 NS 0.001 0.112 NS 0.001 0.119  0.010 NS 0. Occ.193  0.117  0.000 0.078 NS 0.116  0.000 ANB 302 0.000 0.000 0.145  SN-PP 302 0.000 0.817 0.733 0.000 0.137 SNA 302 0.000 0. Cor.126  0.086 NS 0.000 – 0. Signif.172  0.094 NS 0.000 0.152  0.206  0.489  0.000 Post Cr Base 302 0.000 0.009 0.664 Int 5 on PP 154 0.333 0.703  0.041 NS 0.513  0.019 0. Stomat.441  0.423  0.008 Fv(S) 302 0.059 0. Co.048 0. Cor.728  0.197  0.000 0. Co.549 0.011 0.127  0.000 0.129  0.142 NS 0.139  0.081 NS 0.000 0.252  0.031 (Continued) 200 4/2009 Three-dimensional CT analysis of vomer bone  Springer-Verlag J.001 Me-VP 302 0.085 NS 0.433  0.365 0.517 0.035 NS 0.000 0.000 0.034 0.

000 0. 6). UV-ANS on VP Signif.712  0.000 0.000 0.336  0.165  0.093 NS 0. Vertical plane.000 – Aver A-6 on PP 288 0. there was no significant correlation between the height of the occlusal plane to SN plane. 2.025 NS 0. Signif. Vo Ant Up on HP (Svo-SN) of the vomer. 6. Co.078 NS 0. UV-PNS on VP 302 0.417 0.012 NS 0. and also with the length of the anterior portion of vomer bone in the projection to the horizontal plane. Vo Post Lo on VP. The spatial measurement of vomer bone in relation to horizontal and vertical plane was correlated with a bodily rotation of the bone itself.053 NS 0.732  0.595  0.751  0.377  0. Cor.294  0.000 0. the ANB angle showed a corresponding negative correlation with the same three measures. Cor. Vo Post Up on HP.107 0. On the other hand. Co.020 0.433  0.372 0.005 0. On the other hand.000 0.021 NS 0. Co.  Statistical significance at level 0. Signif. and Bvo) were positively correlated with the mandibular plane inclination.137 0.327  0.000 0.000 0. Co.000 0.000 0.000 0. and the inclination of vomer bone.663 0. Svo. In the horizontal plane (HP).  Springer-Verlag Fig. Vomer bone All the angles of vomer bone had a positive correlation between them. both statistically significant. In the vertical plane. There was a positive correlation between PP-AB and the anterior height of the vomer (UV-ANS on VP) and negative correlation with the posterior height.459 Vo Post Lo on VP 302 0.031 Cor.048 NS 0.539  0.086 NS 0.851 Int 3 on PP 161 0. Cor.876  0.154  0. ANB angle showed positive correlation with the length of the diagonal (Vo Diag) and superior dimension of vomer bone (Vo Sup). which reflects a bodily rotation.117  0.009 Int 6 on PP 252 0.000 0. Vo Post Up on Vp.444  0.131  Aver Tub-A on PP 302 0. Horizontal plane. 6: Representation of the projection of vomer bone in the reference planes. there is no correlation between the MP-AB and the inclination of vomer bone.177 Vo Post Up on VP 302 0. Med. Three-dimensional CT analysis of vomer bone 4/2009 201 . In the horizontal plane.000 0.367  0.066 NS 0.026 0.000 0. NS not significant.124  0. The inclination of vomer bone (Dvo-SN) had a negative correlation with the diagonal length of itself (Vo Diag).115  0. Cor.000 0.225  0.000 0.137  0. landmarks are projected to measure upper and lower dimensions of vomer bone. this is clearer with the negative correlation of the anterior dimension of vomer bone (Vo Ant Up on HP) and the inclination of the bone (Dvo-SN) (Fig.757  0.050 0.068 NS 0.645 0.349  0.499  0.220  0.05.043 0.793 0.038 NS 0. the inclination of vomer bone (Dvo-SN) showed a positive correlation with the projected lower height (Vo Post Lo on Vp) and a decrease in the upper one (Vo Post Up on VP).420 Aver Max Post on PP 288 0. 3. 1. Occ. Co Correlation coefficient. Vomer bone and mandibular plane Three of the angular measurements (Dvo. 7: Continued Measurement N Vo Diag Vo Post Vo Sup Cor.218  0.286 0.218  0.160  0.000 0.055 NS 0.001 NS 0.  Statistical significance at level 0.000 Vo Post Up on HP 302 0.277  0.250  0. 4.original article Tab.329  0. There is a positive correlation with the vertical dimension of the vomer height to ANS (UV-ANS on VP) as the inclination of the vomer is increasing and positive or no correlation with the height to PNS (UV-PNS on VP) with the different variables.004 0.000 0. Interjaw relation There was a positive correlation of APDI (PP-AB) and the inclination of the diagonal (Dvo-SN) and the superior lines J. In the vertical plane (VP).000 0. only the base of the vomer had a slightly different or less correlation. Signif.000 0.000 0.984 0. UV-PNS on VP Signif.241  0. landmarks are projected to measure anterior and posterior dimensions.000 0.998 0.000 0.043 NS 0. But this inclination of vomer bone was not correlated with the angle between the two occlusal planes (AOPPOP).01 bone.392 0. 5. Stomat. The Base (Bvo-SN) showed no correlation and the posterior vomer showed negative correlation.000 NS 0.231  0.000 Vo Ant Up on HP 302 0.414  0.000 0. Co. On the other hand.

The distance to the posterior nasal spine.86 55.38    Vo Diag 69. 24.3 3.84 3.49 2. The distance from the upper vomer to anterior or posterior nasal spine (UV-ANS on VP. Even though these angular differences existed.87 28. The application of the three-dimensional Computerized Tomography. with great accuracy [1. Mean S. like the one used in this study.95 2. the constructed vomer bone was extended forward to the ANS point.02 2.78 57. Occ. Med.7 69. 6) showed no significant difference with the skeletal frames.55 19. 6).98 6.14 2. because of the difficulties in identifying it in a two-dimensional X-ray. allowing us to compare the data with other study results. The reason for this was to obtain clear landmarks and excellent reproducibility in positioning them.07 2. The definition of the constructed vomer bone slightly differs from that of a real vomer bone.34 6. The projection of vomer bone on the horizontal plane (Vo Post Up on HP.3 NS NS NS Vo Ant Up on HP 48. On the other hand. which was significantly different from the other two groups. and the possibility of creating 3D volumetric digital skull reconstruction provided us the opportunity to analyze the skull.85 47.26 2.05 Comparison between dentoskeletal frames In Table 8. this could be interpreted as a vertical growth tendency in this group. no difference was seen in the projected upper portion of vomer 202 4/2009 Three-dimensional CT analysis of vomer bone bone. UV-PNS on VP) showed some interesting differences between the groups.05).55 NS NS NS Vo Post Up on VP 9.19 10.72 4. There was a difference in the inclination of the diagonal vomer line between the groups. and posterior dimensions. III Dvo-SN 22. and some of them redefined to a three-dimensional environment.8 1. This bone usually remains hidden from our cephalometric analysis.19 2.11 5.64 3.36  NS  UV-PNS on VP 29.06 2. This must be considered in the interpretation of the results. and the posterior vomer line tendency increased from Class III to class II.46 56. was not significant. reflecting some verticalization tendency of the posterior area.18 3.82 NS NS NS Pvo-SN 58.66  NS  5.71 NS NS  Bvo-SN 158.61 4.9 3. On the other hand.85 23.01 6. as the values also reflect the inclination of the palatal plane.96 NS NS NS ANB Vo Sup 56. 33] and reproducibility [23].18 NS NS NS Vo Post Lo on VP 20.55 3.47 2. showing a tendency for the angle to increase from Class II to Class III.84 3. I vs.06 47.09 3.  Springer-Verlag J.69 3. Mean S. Discussion The results of this study show that vomer bone has very interesting interrelations within craniofacial architecture.97 2. In this way. Stomat.79 NS NS NS ANOVA.25 3. There was a significant difference between the two groups with lower vertical projection of vomer bone in the vertical plane (Vo Post Lo on VP) (Fig. no statistical significance was found between the groups in the linear measurements of vomer bone in the superior. III II vs.52 3 31. Class II showed the highest value and class III the smallest.78 2.28 3.63 29. with a statistically significant difference between these two groups (p < 0. The superior vomer angle (Svo) also showed that the smaller value is found in the Class II group being significantly different with the other two groups.29 10.D.76 18. diagonal.37 56. although there was a slight tendency to decrease towards Class III.78 2.13 2. the distance to the anterior nasal spine shows the smallest value in the Class II.D.05 25. II I vs.44 3. This result seems to be related to the inclination of the maxilla.41 5.79 19.43 3. by applying a different computerbased software.61 NS NS NS UV-ANS on VP 29. Especially with the Class III.86 69.51 30.08 2.87 3.original article Tab. which showed a higher value.99 23. NS not significant. The analysis of the structures was developed by defining landmarks and planes.59 NS NS  Vo Post Up on HP 19. although the measurement of the anterior portion of vomer bone tended to be reduced towards Class III.26 2. Vo Ant Up on HP) (Fig.87 25. These were extracted initially from the traditional 2D cephalometric analysis.  Statistical significance at level 0. Mean S.91 2.28 158.43 1. 20.27 2. in order to be able to correlate anatomical structures.82 39.9 158. 8: Comparison of vomer bone between different skeletal frames Class II Class I Class III Signif.D.1 38. . No difference was observed in the vomer base inclination between the groups.52 2.18 3.65 19. a comparison between vomer bone and the different skeletal frames is presented.13 2.69 NS NS  Svo-SN 37.39 NS NS NS Vo Post 25.

J. ANS. a description of the increase in the dimension of vomer bone was established. 32]. positive with UV-ANS on VP and negative with UV-PNS on VP.original article Some authors have mentioned the potential role of vomer bone on the development of malocclusions. the sagital dimension of the maxilla shows a smaller dimension. Squier [31] indicated that trauma to the vomer may impair anterior–posterior growth of the premaxilla and maxilla. 30]. variation in the inclination of vomer bone (Dvo-SN) seemed to be correlated with differences in the cranial base angle. This interrelation is presented in the angular measurements of the lines of the constructed vomer bone to SN Plane (Dvo-SN. All facial sagital dimensions had negative correlation with the inclination of vomer bone (Dvo-SN). 4. and no correlation with the posterior (Aver Max Post on PP). extension of the cranial base seems to be associated to a higher inclination of the vomer bone. sphenoid. This could represent a more vertical or retruded distribution of the face in a higher inclination of vomer bone. or motion in any of the structures can influence the entire complex and the related structures [5. Another remarkable finding was that variations in the position and rotation of vomer bone appear to be correlated with the spatial position and dimension of the maxilla. Svo-SN. According to Kimes [17]. This inclination of the occlusal planes could be one important factor determining the relation between vomer bone and the mandibular plane. and Svo-SN). which allow some degree of dynamic interrelation known as articular mobility of the cranium. shows a significant negative correlation with the sagital measurement of the maxilla. and Me to the vertical plane. which can be interpreted as a bodily rotation of the maxilla. the angle between the two occlusal planes (AOP-POP) was not correlated. there could be a relation not only on the position but also in the transversal and sagital dimensions of the maxilla. 6. 27–29. The role of vomer bone in the transmission of the masticatory forces was also described by Hilloowala [11]. POP-SN). This could be interpreted as a larger influence of vomer bone inclination on the anterior portion of the maxilla. These differences were expressed on the inclinations of the complete bone. Interestingly the analysis of this last correlation (UV-PNS on VP). 25. B. which became more retruded and smaller in the sagital dimension as the inclination increased. 15. there is a functional complex involving the occipital. which have shown contradictory results [2. Another finding was the correlation between vomer bone and the occlusal planes. N. In this study. was observed. as is evident from ANS-PNS. Int 3 on PP. The vomer showed significant differences between the different skeletal frames. as we can see from the corresponding positive correlation between the size of the diagonal vomer and the SNA and SNB angles. and also in the changes of shape and consequent variation in the relation with the other structures. a negative tendency in all the transversal measurements is appreciated (Int 7 on PP. Friede H [8] reported that the maxillary complex was displaced forwarddownwards in relation to the vomer. Stomat. This is a very interesting finding as previous studies had focused mainly on the influence of the cranial base and the interrelation between the jaws. Both correlations. Friede [7] reported that alteration in the vomero-maxillary suture is likely to be an important factor in the etiology of the midfacial retrusion that is sometimes seen in patients with unilateral cleft lip and palate. Although the author did not find a reason to believe in the importance of the septal cartilage in the growth of the maxillary complex. 13. 34]. maxilla. this can be interpreted that a downward inclination shows smaller dimensions of A. as it has been described previously that vertical dimension of dentoalveolar structures and variation in the cant of the posterior oclusal planes influence the position of the mandible [9. Occ. From the results of this study. who reported a comparison of the human skull and a gothic cathedral. Jerolimov [14] also indicated transmission of the masticatory forces through the vomer to the sphenoid bone. the period when most of the facial development takes place. Max Dist. At the same time. Three-dimensional CT analysis of vomer bone 4/2009 203 . which are also coincident with the projection in the Vertical Plane of the anterior and posterior height measurements of the vomer bone. In histological analysis of the postnatal development of the nasal septum. Bvo-SN. while flexion is related to less inclination of it. 12. In the analysis of the internal proportions in the maxilla and the inclination of vomer bone (Dvo-SN). and TUB-A measurements. the inclination of vomer bone (Dvo-SN) and the related rotation of the maxilla could influence the inclination of the anterior or posterior occlusal planes (AOP-SN. and vomer. Apposition in the anterior surface was found during the first 12 years. it was described that some cartilaginous structure could increase the ability of the septum to transfer forces from the incisor region to the sphenoid bone [22]. and apposition in the posterior margins and in the superior surface (base of the vomer) was reported as a continuous process until 17 years in men and 15 years in woman. This makes us assume that vomer bone could be an important connecting structure between the cranial base and maxilla. This complex is connected through sutures. Med. Other authors have described the importance of vomer bone in the growth of the maxilla. 26. More longitudinal evaluation studies in growing patients should be conducted in order to complement the understanding of its role in the craniofacial architecture. in the analysis of the transversal dimension of the maxilla. According to Sato and Slavicek [30]. These results show that in this sample.  Springer-Verlag and the negative correlation of the posterior length (Vo Post) with the cranial base angle. make us suppose that differences in the shape of the bone could also be presented. could be also expressing the rotation of the vomer bone. a negative correlation with the anterior dimension of the maxilla (Aver A-6 on PP). Int 6 on PP. and not the relation of this anatomically related structure. On the other hand. In this study. “unrestricted” growth of the nasal septum was related to abnormal midfacial osseous changes. 18. instead of some different inclination between one or another occlusal plane. Transmission of forces from the occlusion. and Bvo-SN. the results were consistent with the correlation found in this study. This could be interpreted as if the vomer is rotated downwards. Growth retardation was reported in the upper jaw in dogs with artificial cleft palate and extirpation of the vomer [21]. Int Tub). Int 5 on PP. The inclination of vomer bone measured by Dvo-SN.

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