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    Genetic Infuence On Dental Arch Form in Orthodontic Patients

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    Genetic influence on dental arch form in orthodontic patients Kevin M. Cassidy, DDS, MS; Edward F. Harris, PhD; Elizabeth A. Tolley, PhD; Robert G. Keim, DDS. tom ares tat are revel shor ond sue waters tae late een peed Be toed seen alt pletogesiy be pate Inacio" chr subsegueay a sats anroposteor and Burd and Lilie ine ine when he den ocho toon sown seal pst orarh o {gation.” While some authors have suggested that the shape of human arches approximates a cat- enary curve,**" other researchers have fit other geometric forms, such as an ellipse, a trifocal el- lipse, conic sections, a parabola, and polynomial equations.” Of note, there has been no critical evaluation of the goodness-of-fit of these com- peting models, (Once arch form is defined in the fetus, variabil- ity in eruptive paths of the teeth, growth of the supporting bones," and movement of the tect after emergence due to habits and unbalanced. muscular pressures” all contribute to variation in arch size and shape. The purpose of the present study was to inves- Original Article Abstract Human arch form varies considerably. This study analyzed the size and shape of the maxillary and mandibular dental arches of 320 adolescents from 155 sibships. A broad battery of measurements (k = 48) was computer-generated from Cartesian coordinates of cusp tips and line angles of the permanent teeth, and heritabilty estimates were generated from. intraclass correlations, controlling for sex and age where indicated. Arch size has a modest genetic component, on he order ‘of 50%, although this estimate may contain shared environmental influences. Tooth rotations have low h? estimates, most of them indistinguishable from zero. Arch shape, assessed as length-width ratios, also has a modest transmissible ‘component, suggesting that arch length and width growth factors are largely independent. Highest heritability estimates, as ‘@ group, were for transverse arch widths, which averaged about 60%. Several measures of left-right asymmetry also were analyzed (k = 31), and, while the arches are systematically asymmetric (generally with left > right), there is only weak ‘evidence of a transmissible component for directional asymmetry and essentially none for fluctuating asymmetry. nll, arch size and shape are seen to be more subject to environmental influences than to heredity. These findings direct attention toward the need to better understand what extrinsic factors modulate arch size and shape during development. Key Words Arch form + Palate + Jaw form * Family analysis * Heritability + Craniometry ‘Submitted: May 1997 Revised and accepted: December 1997 ‘Angle Orthod 1998;68(5):445-454, The Angle Orthodontist Vol. 68 No. 5 1998 445 Cassidy; Harris; Tolley; Keim Figure 1 ‘Schematle showing how the buccal seg- ‘ment relationship was ‘measured. The value was negative when the buccal groove of the ‘mandibular first molar was distal of the me- slobuccal cusp of the maxillary molar Classi molar relation- ship). Figure 2 ‘Schematics of themax- ilary and mandibular dentalarches showing locations of the two land’ fon each tooth, either cusp tips or line angles. A me- ‘ial and distal point was located on the ‘midpalatal raphe. ‘The Angle Orthodontist Figure 1 tigate the role heredity plays in determining arch ize and shape. The sample consisted entirely of boys and girls who subsequently received com- prehensive orthodontic care. This omitted the segment ofthe population with ideal occlusions, but, since they are the minority” and are sel ddom encountered by the specialist, there is less interest in development of their arch forms Moreover, since it appears that malocclusion, defined as tooth displacement and malrelationships, is an acquired rather than an inherited condition there should not be any striking difference in heritability estimates. On the other hand, exclusion of sibs not requiring treatment could inflate estimates of genetic in fluence since it may decrease within-sibship vari- The full-sib genetic model was used," and we began with the observation thatthe phenotypic variation can be partitioned into genetic and en- vironmental components, Vp = Vg + Ve, where “"V" isthe statistical variance. It would be desir- able ifthe “genetic” component were due just to the additive effects ofthe indefinitely large num- ‘ber of genes that collectively affect arch size (and ‘other skeletodental dimensions?) The genetic component actually may be confounded by two potentially relevant sources, one genetic and one environmental. Vg can be rewritten as Vo = Va + Vp + Veo, where A is the additive genetic ef fect, Dis due to dominance of some alleles over ‘others, and EC is the common environment of siblings, which enhances their phenotypic simi- larity beyond that due to the fact that full sibs (and other first-degree relatives) share an aver- age of 50% of their genes in common by descent. It-can be shown that the correlation for a trait between full sibs is due to 1 4 p¥at qo+ Veo (This equation ignores epistatic and genotype- environment interactions.) This confounding of Va with Vp and Vgc is not dissimilar to that en- countered when using monozygotic and dizy- Vol. 68 No.5 1998 gotic twins, although the assumptions of the twin ‘model seldom are made explicit in the clinical literature Shared environmental effects may be signifi- cant, but rather little is known about what spe- cifically in the environment influences dentoskeletal growth. There are obvious ex- amples, such as trauma, infectious disease, star- vation, chronic mouthbreathing, and digit habits, but, even collectively, these do not account for much of the observed frequency of malocclu- sion.” Shared environmental effects, such as location, diet, morbidity patterns, home lifestyle, and having the same parents, will, to a greater or lesser extent, cause the growth and develop- ‘ment of siblings to converge. This confounding, is why the term “transmissibility” generally is preferable to heritability, since it takes note of the nongenetic, cultural sources of sibling similari- ties.” Materials and methods The sample consisted of 155 sibships, 145 of them with two members and 10 with three. All individuals were American white adolescents. All had intact permanent dentitions, although the last teeth (excluding third molars, which were not measured), were not completely ‘erupted in a few of the youngest individuals, ac-~ counting for the variable sample sizes in the tables. Sibships were collected from several pri- vate orthodontic practices. The pretreatment orthodontic dental casts were analyzed; none had received prior treatment. All children sub- sequently received full-banded treatment, but no child with a craniofacial anomaly, genetic dis- ease, or premature loss of deciduous teeth was used. It was taken at face value that the siblings ‘were first-degree relatives as avowed by the par- ents. No serological or other test was used to con: firm consanguinity. Pretreatment record ages ranged from 10.0 to 19.0 years with a mean of 185 years (SD = 1.69 yrs) Data collection ‘Buccal segment relationship and incisor over jet were measured with the teeth held in maxi- ‘mum intercuspation according to the methods of Lundstrom! Figute 1) Two landmarks were located on each of the 14 teeth in each arch (Figure 2). These were the cusp tip ofthe protocone and paracone of the molars, the buccal and lingual cusps of the premolars, the protocone and tuberculum dentae ofthe ea- nine, and the mesial and distal line angles ofthe incisors. On the maxillary casts the axis of the ridpalatal raphe was defined by a line connect- ing a point marked on the raphe anterior of the incisive foramen and a second marked posterior on the raphe at the depth of the second molars (Figure2). Marking the dental landmarks before digitizing or photocopying was advocated by Takada et al: and Ho and Kerr® asa method of increasing accuracy. Each cast was photocopied at 1X by lacing the occlusal surface face down on a Kodak 2110 pho- tocopie in its photographic mode. A cardboard zask covered with millimetric graph paper was used to cover the active surface of the photo- copier. A small rectangle was cut into the mask to provide space for maxillary and mandibular casts, Tests were made to assess the accuracy of the method. When cusp tips were positioned in the occlusal plane, there was no measurable dis- tortion. When teeth were apical to the occlusal plane, as in cases with a deep curve of Spee, there ‘as some reduction in size, such that at 10 mm (which exceeded any curve of Spee in this study) reduction was 1% Landmarks on the photocopies were digitized a5 Cartesian coordinates, and linear and angu- lar measurements were computer-generated Us ing custom software. The arch size variables can be categorized into five groupings: (1) tooth angulations, (2) arch widths, @) arch depths, (4) arch chords, and (5) arch interrelationships. The angle formed by each maxillary tooth to the ‘midpalatal raphe was calculated (Figure 3A). A similar, albeit manual, approach was used by Lamons and Holmes. Arch widths in the up- perarch were measured orthogonal tothe raphe, and the left and right measurements were summed for each tooth type (Figure 38). In the mandible, arch width was,calculated as the straight-line distance between homologous cusp tips. Arch depths (Figure 3C) were measured parallel with the miapalatal raphe; five depths were defined to quantify various mesial and dis- tal segments ofthe arch plus the whole arch, & different procedure, attributable to DeKock,® Sibling analys of dental arch size ‘mph Figure 4 Figure 34-D Diagram showing the kinds of linear and angular measurements assessed from each set of dental study models. ‘A: Distolateral angle at the intersection of lines formed by a tooth’s. landmarks and the midpalatal raphe was measured for each tooth (except the incisors, where the mesiobuceal angles were calculated). B: Maxillary arch widths were measured from each tooth (excluding ‘central incisors) orthogonal to the midpalatal raphe. C: Five maxillary depths were calculated parallel withthe raphe: 1. incisor ‘depth, 2. premolar depth, 3. molar depth, 4. buecal depth, and 8. arch depth. D: Mandibular arch widths were the straight-line distances between homologous buccal cusp tips. Figure 4 Sketch of a mandibular dental arch illustrating arch chord distances. In this instance, lines AC and BC are the left and right chords for the second, molars. Analogous arch chords were calculated for the other five tooth types. Arch depth (D), shown here for the second molars, was calculated ‘from the formula below the figure. The Angle Orthodontist Vol. 68 No.5 1998 47 Cassidy; Harris; Tolley; Keim Tablet Descriptive statistics and ANCOVA tests for sexual dimorphism and influence of age on trait size’ Wales ‘Females ‘Sex Age ‘Standard confidence imite Variable pe fo fpratio, ahtle tleioremen etme Tooth intarelationships (mm) Buccal segment elation -11 2.48 091.9904 25 OSG 2082079 Incisor overiet Ol ee ot Maxillary angular relationships (degrees) Tangle PA Bangle Gees 10-725 11912) 11108 e224) 2209). = 016 = oldie 0.19151 0) Cangle 43 735 «(477 «657 «26 001.7022. Pr angie s02 805797 7.25 «(036 RMON O14 Od P2 angie 749° 861 742 «94108 S194 090d. M1 angle 584 667 «570668342 OSTY OZ 0287S M2 angle 601 688 590 752 21 16 004 016 034 027 Transverse maxilary arch widths (mm) I2 distance poeuee tise odes 100 ii0". 202) 106gceol2 es (0.aue Oss C distance 169 118 «160 119-365" «13, OSG" «OZ 0.32 0.79 Pt distance 200 153=««19.1 128 B13" 02 eat OT 0480.8 P2 distance 227 172 7145 BLT! 0? ONTO Mi distance: 253 163 243-146 331" 0.3 O7* ONT 0.80.80 M2 distance 280 «159270145 st BEY ONT O54 097 Maxilary arch chords (mm) 2.chord 198 089 131 «093 368" 04082" 013005088 C chord 185 114 «175-120-504 «0901300809 Pt chord (257, 27 1100], oval 2ri00! ee 4b es Olen Ou e012) = 024s 074) P2 chord 321 208 306 182 470" 04 048 012023072 Mi chord 385-219 388-200-823" 00 ta* ONS. 8. M2 chord 493 243-472-219 B18" 00S O46" OB O2O70 Maxillary arch depths (mm) Incisor depth 91 200 87 180 37 95 08st 013 0.08 0.59 Premolar depth 45 1380 «(13m et GAS OO BOOLES Molar depth Qe OesHe ile «Orr. c2ibu. s0e) t0Mne izes (O2al 072 Buccal depth 324 306 «174 «S04 17 Ot OO OB. Arch depth at 303-256 381" 4 * OTT 0.62. Maxillary arch form Upper width ratio 060 004 069 004 «34 Odo 0... Upper deptn ratio 022 004 022 004 00 121 oz 014 003 056 Upper shape ratio 068 006 0690.08 1.1 = 534BY OB ORO Mandibular arch chords (mm) l2.chord CO 03 mo Ml oP aN Oe C chord NGS N26 i7Ste. 198. 447s 206) 2020) geeO1dan OOlt O89 Pt chord e59 = 2g), 24s) e872 chan e 0Se 048y 201s. = (0292 073) P2 chord 825 223 809-212 B7a* 1 ta* 031908. Mi chord 385 «28271220 480" 03.88". Me chord 495 251 475-289 B4a* 0S. ‘Transverse mandibular arch wiaths (mm) 2 arch width NG 2ieeco! 07, tai. 87s 130 00a 01s 008. 08) Carch widin Py iy fr re et er Pt arch width ou 20 co 1290: oh7 2 0281 O98) =0tc = 02a: O77 2 arch width 386 279 «870-289 BOT 14 OT™ ONS. 0.22 O72 Mt arch width 438 263 «423,251 28S" 03ST. 08S. M2 arch width 493 288477 -24B St 39 OSS. OB. Manalbular arch depths (me) Pt aren depth NOCntcOU 0s fro eta 100 Oem Ol2 Oc 076 P2 arch depth A7oeeteGH ei06: = 1702 1i.0u cette) ee 0ST Ole 00s 108i Mi arch depth 240 204 «= 22185 wat OST O27 OTS M2 arch depth 353 284 «837 20R BOB" OH OAS O18 OB Mandibular arch form Lower width ratio Oy (or ey Lower depth ratio (Oa) 004 020) (008 [cost | 2!. oMoe iets O20 0.73 Lower shape index 140120 «1410116 B+ 03002 OS. "All measurements except overt are averages of ff and right sides obtained by computing ho statistics onthe otsight average of oach case. Tooth codes ae: incisors (0), canines (C), premolars (P). and molars (W); teeth wit a morphogenetic ed are numbered mesilly to distally *p2001 448 The Angle Orthodontist Vol. 68 No.5 1998 was used for mandibular arch depths. First the loft and right arch chords were calculated from the mesial line angle of the central incisor in a quadrant to each tooth except the central incisor. This was done for the left and right quadrants, then the arch widths and chords were used to calculate the arch depths (Figure 4). Arch chords also were calculated for maxillary teeth (Figure 30). ‘Total measurement error determined by double determinations" was 4%. This was the cumula- tive random error of cusp tip identification, pho- tocopying, and digitization of the landmarks ‘This compares favorably with published deter- ‘minations from other methods Asymmetry Most variables were calculated separately for left and right sides, which permitted assessments ‘of bilateral differences, both directional asymme- tay (DA) and fluctuating asymmetry (FA). Directional asymmetry occurs when one struc- ture preferentially outgrows the homologous structure on the contralateral side, Schultz” documented numerous directional asymmetries induced by preferential use ofthe right arm and Jegin higher primates, including humans, where the right limb bones typically are longer and ‘more robust than their antimeres ** Most indie viduals are right-handed,* and preferential side use during growth results in limb bone di _mensions that are somewhat larger on the right The presence of directional asymmetry was tested using a two-tailed, one-sample t-test of whether d= 0, where d is the average left-mi- rus-right difference in the sample, and mis the number of individuals: = _3(L-R) DA ===) Fluctuating asymmetry is assumed to result from inability ofthe organism to grow identical, bilaterally homologous structures. FA is present invitually all dentoskeletal dimensions inal dividuals providing the measurements are of sufficient resolution. Fluctuating asymmetry is without side-preference, however, so the distri ‘bution ought to be normal and the mean side di ference, d = E(L-R), will nt depart significantly from zero. The measure of fhictuating asymame- try used here is ML—R)— Xl 7 Ss ‘which is essentially that used by Otremski et al. ‘The effect of directional asymmetry in this equa- tion was removed from each subject's left-right FA=5, Sibling analysis of dental arch size difference. The absolute value was obtained since itis the amount of variability free from random left- and right-side differences that is desired, “The denominator scales the asymmetry to mean size ofthe variable so comparisons can be made among measurements." FA, by this formula, is the proportion of the dimension that is due to left-right asymmetry, and this can be described as.a percentage of trait size. Statistical design ‘The presence of statistically significant sex and/or age effects in each variable was tested with a general linear model.” Two runs were performed." The first tested whether any vari- able exhibited a significant sex-by-age interaction ‘effect. Since none did, the second run assumed a common slopes model. Heritability estimates were obtained by fitting mixed model ANOVAs with a random effect of sibship, and sex and age were included as cofac- tors where indicated. The intraclass correlation (1) then was estimated for each trait as the ratio cof among’sibship variance to the total variance, where total variance is the stum of the within- and among-sibship variances.” Heritability (h®) is twice the intraclass correlation in the full-sib model The formula for the standard error of by was from Swiger etal All inferential statis- tics were evaluated as two-tailed tests Results Sex and age effects Variables measured on the left and right sides were averaged for analysis in this section for brevity. There were 47 resulting variables; they are dealt with here in groups to avoid redun- dancy (Table 1), [Arch size, demarcated by the permanent dlen- tition, was significantly larger in males than in females. Indeed, 32 of the 33 linear arch size vari ables exhibited a significant sex difference, which is consistent with prior studies“ Dimensions were 3% to 5% larger in males, witha consistent degree of sexual dimorphism among arch width, depth, and chord measurements Only three dimensions changed systematically with age. In each case (i.e., maxillary incisor depth, upper depth ratio, and lower width ra- tio) the “age” effect was caused by children with more tapered arch forms and more protrusive incisor segments presenting at chronologically earlier ages. These “age” effects probably are unique to orthodontic samples where those chil dren with obvious malocclusions tend to be brought to the specialist at younger ages. There ‘were no statistically significant age effects forthe The Angle Orthodontist Vol. 68 No, 5 1998 449 Cassidy; Harris; Tolley; Keim 450 ‘The Angle Orthodontist other variables in Table 1. This may be due in patt tothe cross-sectional nature ofthe data, Lon gitudinal studies!” have reported slight in- creases in arch width and decreases in arch depth during adolescence, but the changes are too subile to be detected without serial data Asymmetry Most (22/31) measures of asymmetry exhibited statistically significant directionality (Table 2) All ofthe left-minus-right means were positive (except for some lower arch chords), showing, thatthe left side of the arch is slightly but sys- tematically larger than the right. This trend in- cluded buccal segment relationship (BSR), where these children were significantly more Class IL on the right side than the left (perhaps because the left side of the mandible was slightly longer than the right). Several tooth angulations also showed significant directional asymmetry, with the buccal aspects of the left teeth being rotated ‘more tothe distal than their right counterparts, a difference of about 4Y, on average. While the mean left-right differences may seem trivial, sev- eral individuals possessed matked asymmetries. Heritability estimates ‘Data from the Fll-sibling analysis ate listed in Table 1. Buccal segment relationship—the sagi tal relationship of the maxilla and mandible at the first molar—had a significant? estimate of 56%, implying that about half the total variation in BSR is due to the genetic influence of siblings sharing half their genes in common by descent from their parents, Puta different way, it means that adolescent sibtings tend to be much more alike as regards BSR than biologically unrelated adolescents. In contrast, there was no detectable familial component for overjet. In fact, though most of the variables (42/47) had a measurable genetic component («= 0.05; Table 1), the level of influence varied among the types of arch variables. The highest I estimates, were for arch widths; the mean h estimate ofthe collection of 12 maxillary and mandibular widths ‘was 57%, which is significantly higher than for the other 28 variables (Z = 37; p < 0.01). This leaves little doubt that arch size is under appre= ciable genetic control—which is in concert with prior analysis of arch size*” and with the other craniofacial complexes? "7? Results forthe tooth angulation variables were different (Table 1). Just three of the seven achieved statistical significance, and ranks for h? ofthese seven variables were significantly lower than for the other arch dimensions (Z = 29: p = 0.008) Vol. 68 No.5 1998 ‘Asymmetry ‘The sibling analysis produced litle evidence for genetic control of asymmetry (Table 2). Positive findings would mean that siblings share the same direction and/or magnitude of left-right asymmetry. Infact, though, just three of the 31 variables had an h estimate significantly above zero, and these three were small and scattered across the dataset rather than clustering within a type of measurement, which would imply a ‘meaningful pattern ‘There was even less evidence that the magni- tude of asymmetry ((e, fluctuating asymmetry) 4s clustered familaly. Just 2of the 31 estimates ‘were statistically significant, which is about what tone would expect due to Type If rors with this ‘many univariate tests” The largest h? estimate either for DA or FA was 0.43 for fluctuating asymmetry of M2 buccal chord distance. This implies that the degree of asymmetry (but not the direction) is significantly more similar within sibships than among them. Again, though, the paucity of significant results makes this isolated finding suspect. Discussion ‘Size and form of the dental arches generally are defined by positions of the teethy""""* but one certainly can have a measurable arch even in the absence of some or all of the teeth, whether the teeth are congenitally absent or lost postnatally. It seems that there are combined roles of the teeth. themselves and the supporting bone in determin- ing arch size and shape. The purpose of the present analysis was to assess the relative impor- tance of genetics in defining the dental arches in adolescents who have achieved virtually all of their adult arch size" Forty-seven vari- ables were computer-generated from each adolescent's dental study casts, but several of these were redundant because each of the seven. tooth-types typically was tested within each ‘measurement category. The battery of measure- ments can be reduced to five categories: (1) tooth interrelationships, 2) tooth angulations, (3) arch ‘widths, (4) arch depths and chords, and (8) size ratios, Of these five categories, all but tooth interrela- tionships contained enough variables to warrant tests among them. Tested with Kruskal-Wallis ‘one-way analysis of variance,* there was a sig nificant difference (p < 0.001), with the descend ing strengths of the h* estimates being arch widths > (depths and chords and ratios) > tooth angulations, The relatively high values for arch ‘widths agree with results by Harris and Smith,” Sibling analys of dental arch size Table 2 Descriptive st 3nd heritability estimates for directional and fluctuating asymmetries of dental arch form variables Directional asymmetry _ Fluctuating asymmetry Variable fee. cDeeetedeatimece | xp cON@enuaeseaeg te Bucoalseg. 920 082 170 3a 024 0.17 058 010 125 116 000 0.15 031 029 Maxillary angular relationships Ivangle 319 347 9.48 653" 008 015 021 037 0.07 008 0.35 0.19 -0.71 002 Wangle S18 469 1448 577" 008 O15 021 037 008 008 012 016 -0.44 0.20 Candle 2882.85 1044 463" O11 017 -022 043 018 015 018 0.16 -0.14 050 Prange 319 472 10.37 8.13 022 O17 058 012 010 009 -014 O17 -046 0.19 P2ange 320 332 1214 489" 008 015 021 087 012 0.12 O29" 013 003 055 Miangle 320 046 867 095 032 013 006 058 012 O10 014 O14 -014 042 M2angio 319-051 958 096 0.10 015 0.18 039 012 010 009 015 -020 038 Transverse maxillary arch widths ledistance 319° 012 121 173 022 0.14 049 0.08 0.08 0.00 0.18 -030 0.30 Coistance 317 013 123 191 -003 0.16 028 0.06 0.05 0.01 018 -0.82 029 Pidistance 319 040 193 533 008 015 037 0.05 0.04 0.10 016 -0.42 022 P2distance $20 0.65 147 7.90" 0.04 0.15 034 0.05 0.04 0.04 0.15 -025 0.34 Midistance $20 0.95 1.58 1071 -012 0.16 020 0.05 0.04 0.45 O14 -013 043 M2distance $20 082 1.74 951" 023 0.17 O11 0.05 0.08 0.26 018 -0.61 0.08 Maxilary arch depths Incisor —$17,—«O34 1.67 3.66" O18 0.14 046 0.16 0.15 007 0.48 -0.23 0.36 Premolar 318 O17 132 251° 027 O14 054 0.07 0.07 001 O16 -032 029 Molar 820015 0.86 303" 028 013 055 0.05 005 O11 015 -017 0.40 Buccal 818-013-153 145 033" 0.13 089 © 004 0.04 012 O18 -0.17 040 Arch 319 021 194 195 0.18 0.18 048 © 004-003. 012 0.18 -0.17 0.40 Maxilary arch chords W2chord $160.07 O84 147 -O.14 O17 -047 0.19 0.05 0.04 0.04 0.16 -095 027 Cchord 315007 120 098 001 016 -029 032 0.05 0.05 0.28 O14 0.00 058 Pichord 318 047 173 484° 0.13 015 -0.16 042 0.05 005 007 0.15 -023 0.36 P2Chord 317 068 183 6.45" 0.08 0.15 -021 037 0.04 0.04 -005 016 -036 026 Michord 317 0.73 181 721" 0.18 014 -010 046 004 004 0.11 O15 -0.18 040 M2chord 317 056 160 624" O11 015 -017 040 003 002 001 0.16 -032 029 Mandibular arch chords IBchord 3160.11 O71 270" -O10 0.16 -042 022 0.06 0.05 -008 O16 -0.40 0.24 Cchord 319 «O18 131 260" O13 014 -016 041 0.07 0.08 0.04 015 025 0.34 Pichord 319-013 178 127 023 O14 -004 050 007 007 O14 O14 014 042 P2chord 317 036 162 391" 019 O14 -009 047 0.05 0.05 002 015 -029 032 Michord 318-037 1.63 4.08" O31" 013 0.05 058 0.04 004 026 O14 -003 051 M2 chord 319-052 1.65 560" 0.30" 013 0.04 056 0.03 0.03 043" 013 0.18 0.68 ‘all variables, except angles, were measured in milimetors. Codes are: numberof ndviguals(n), sample mean (3), standard deviation (0), Hosts for directional asymmetry (Hy: = 0), hentabilty estimate (h), standard erorofh (SE), and 95% confidence limits of (LL). "9 <005, who analyzed family similarities within and be- ing bone rather than on positions of the teeth tween generations, which allowed them to con- themselves. Prior studies" found that bone- clude that their hé estimates for arch size are not _ based skeletodental variables have higher hi es- substantially confounded by environmental co- _timates than tooth-based variables such as tooth variance. The low genetic contribution for tooth rotations, displacements, and axial inclinations, angulations (Figure 3A) was the most divergent where estimates generally are indistinguishable from among the types of variables measured. It from h? = 0. The present results are consistent is noteworthy that tooth angulations are ana- with prior findings in that the orientations of the tomically different than the rest of the variables, teeth (rather than their locations in supporting, which depend on size and shape of the support- bone) are found to be affected primarily by the The Angle Orthodontist Vol. 68 No.5 1998 451 Cassidy; Harris; Tolley; Keim 452 ‘The Angle Orthodontist environment. Its speculated that local environ- ‘mental factors control tooth angulations, but spe- cific influences remain elusive? Six arch form ratios were calculated, three for each arch. One was a ratio of arch widths, one a ratio of arch depths, and the third a ratio of arch width to depth. These sorts of “shape” variables have been used in prior research'™" and the intent was to test the familial influence on shape ofthe dental arches. Estimated heritabilities were lower than average, with a mean of 38%, so the majority of the variability in arch shape is ac- quired environmentally. Heritability of 0.39 in- dicates thatthe intraclass correlation was about 0.20, s0 the coefficient of determination would be 4%, In other words, virtually none of the shape in one adolescent's dental arch in this sample could be predicted fom examination of a sibling's arch shape. Brown et al reported low, nonsignificant correlations between arch ‘growth in the mesiodistal and transverse dimen- sions, concluding that “breadth and depth were largely independent of one another, probably affected by different development processes,” ‘Tests for significant left-right asymmetry showed that the left quadrants were larger than the right, and this sidedness was generalized, covering most lengths and widths as well as tooth angulations. Woo™ and others have docu- ‘mented similar results for the calvaria and some facial structures. They found the right side of the calvaria to be larger, which conventionally has been attributed to greater size ofthe right hemi- sphere of the brain with accommodating and compensating growth of the calvarial bones. Incontrast, Woo found that the malas and max- illae (including the palate) exhibited the oppo- site directionality, left > right, perhaps in compensation for side differences elsewhere or because of acquired lateralites, such as chewing side preference. The finding in the present study thatthe lft side ofthe arch is characteristically larger is, then, in keeping with the rest ofthe fa- cial plan. It is noteworthy that, in spite of the pervasiveness of asymmetry in the arch dimen- sions, the bulk of the tests for directional (28/ 31) and fluctuating (29/31) asymmetry had no discernible transmissible influence (h’ = 0), ‘which agrees with other studies that have tested for a genetic basis for developmental asymme- tries The scattering of significant results was only as common as expected from chance. Vol. 68 No.5 1998 It is interesting that sagittal molar relationship exhibited significant directional asymmetry since it may be related to the anecdotal findings that it takes more effort to move one side of a Patient’s dentition into a Class I molar relation- ship than the other. Statistically, this sample was less Class II dentally on the left side, so the av- ‘erage case required more sagittal correction on the right. "Assessment of the relative importance of genet- ics in defining size and shape of the arches is more than an academic exercise. It directs atten- tion to the nature of the developmental problem. If arch form were modulated predominately by the genotype, then treatment is destined to be palliative. If, in contrast, heritability is low(as shown here), with the environment playing a more important role, then research ought to fo- cus on elucidating those factors detrimental 10 development of the occlusion, with the ultimate aim of prevention, ‘Summary Little is known of the factors controlling den- tal arch size and shape. The present familial analysis suggests some interpretations, Arch di- mensions are significantly larger in boys, both ‘mediolaterally and anteroposteriorly, than in girls, a sex difference largely established prior to onset of the adolescent growth spurt, Most aberations of tooth position (e.g., rotations, dis- placements) have nonsignificant h estimates, implying that most of the variation is due to en- vironmentally induced, acquired factors. In con trast, arch dimensions have h? estimates significantly different from zero, but the magni- tude varies: h? estimates were highest for arch ‘widths, chords, and depths, with a mean trans- missibility of 50%, So, while there are significant familial similarities in arch size, at least half of the phenotypic variation in this sample is due to environmental differences, ‘Author Address Dr. Edward Harris College of Dentistry Department of Orthodontics University of Tennessee Memphis, TN 38163 E-mail: eharris@utmem! utmem.edu 10, 1. 2 13. 14 ro 1 16, 1, , 2 Sibling analysis of dental arch size References 24 ‘Shave JCM. The teeth, the bony palate and the mar ible in Bantu races of South Africa, Landon: John Bale, Sons and Danielsson, Ltd, 193) Woo TL. A biometrical study ofthe human malar ‘bone. Biometrika 1988,2%113-123, Pepe SH. Polynomial and catenary curve fits to human dental arches. J Dent Res 1975541124. a2, Jacobson A. The dentition of the South African Negro. Anniston, Ala: Higginbothan, 1982. Ferrario VF, C Sforza, A Miani Je, G Tartaglia, Hu rman dental arch shape evaluated by Euclidean- dlistance matrix analysis. Am J Phys Anthropol 1995-0445-153, Freiband B. Growth ofthe palate in the human fe- tus. Dent Res 193716103148, Burd AR, LillieJH. A catenary analysis of the max: illary dental arch curing human embryogenesis. ‘Anat Rec 1966;154:15-20 Burdi AR Morphogenesis of mandibular dental arch shape in human embryos. J Dent Res 196847:50-58 ‘MacConaill MA, Scher EA. The ideal form of the Juman dental arcade with some prosthetic appl cation. Dent Ree 1949;69:285-302, Scott JH. The shape ofthe dental arches, J Dent Res 195736:996-1008, Musich DR, Ackerman JL. The catenometer: Ar liable device for estimating dental arch perimeter, ‘Am J Orthod! 1973:63:366-375 Lu KH. An orthogonal analysis of the form, sym- metry ond asymmetry of the dental arch, Arch (Oral Biol 196617:1057-1069, Cartier JH. A computerized geometric analysis of bpuman dental arch form. Am j Orthod 196856168 17, Biggerstaf€ RH, Three variations in dental arch form estimated by aquadratic equation, | Dent Res 1972511509, Brader AC. Dental arch form related with intraoral forces: PREC, Am J Orthod 1972:61:541-561, Hchter, FJ. Symmetry and dental arch form of corthodontically treated patients. J Canad Dent ‘Asso 1978, 4:173-184, Sampson PD. Dental arch shape: A statistical analysis using conic sections. Am J Orthod 1981,79:535-548 Cohen JT. Growth and development of the dental arches in children. ] Am Dent Assoc 1940;27:1250 11260. Henriques AC. The growth of the palate and ‘growth of the face during the period of the chang- ing dentition. Am J Orthod 1953;39:836-85. Bjirk A, Skieler V, Growth in width of the maxe ila studied by the implant method. Scand J Plast Reconstr Surg 197482623. Linder-Aronson$, Adenoids: Their effecton mode fof breathing and nasal airflow and thelr velaion- Ship to characteristics of the facial skeleton and dentition. Acta Otolaryng Scand 1970; supplement 265. Proffit WR, Fields HW, Nixon RM. Occlusal forces in normal and long face adults, | Dent Res 1983 62:566.571. Proffit WR. On the aetiology of malocclusion. Br J Orthod 1986.13.11, 2. » 31 2 a. 39, 40. 41 2 Solow B, Siersbaek-Nielsen S, Greve E. Airway adequacy, head posture and craniofacial morpho!- ‘ogy Am J Orthod 1984;86.214-223. 3. Vargervik K, Miller AJ, Chierci G, Harvold E, ‘Tomer BS. Morphologic response to changes in neuromuscular patterns experimentally induced by altered modes of respiration. Am J Orthod 198485.115-124 Kelly JE, Harvey CR, An assessment of the occlu sion of youths 1217 years. United States Public Health Service, 1977 (Vital and Health Statistic, seties 11, no. 162), ‘MeLean JB, Profft WR. Oral health status in the United States: Prevalence of malocclusion, J Dent ed 1985;49.386.397. ‘Corruccin RS, Potter RY, Genetic analysis of oc-

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