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5005/jp-journals-10021-1113
ORIGINAL ARTICLE
Amit Kumar Khera et al

Relationship between Dental Arch Dimensions


and Vertical Facial Morphology in
Class I Subjects
1
Amit Kumar Khera, 2Gulshan K Singh, 3Vijay P Sharma, 4Alka Singh

ABSTRACT

Introduction: A well-balanced face has its good proportions in all three dimensions of space, i.e. transverse, sagittal and vertical. The vertical
proportions of the face are important in determining the esthetics and harmony of the face. The objectives of this study were to evaluate the
relationship between dental arch dimensions and the vertical facial pattern determined by the Jarabak ratio, and to examine the differences in dental
arch dimensions between male and female untreated adults.
Materials and methods: Lateral cephalograms and study models were obtained from 90 untreated subjects (45 males, 45 females) between 17
and 24 years of age with no crossbite, no/minimal crowding and spacing. The Jarabak ratio (posterior facial height/anterior facial height) was
measured on cephalograms of each patient. Study models were used to obtain comprehensive dental measurements, including maxillary and
mandibular cumulative mesiodistal width, intercanine, first interpremolar and first intermolar widths as well as arch perimeter, arch length, overbite,
palatal height and curve of Spee.
Results: The results showed that, for both males and females, there was a trend that as vertical facial height increased, arch width, arch perimeter
and overbite decreased but palatal height and curve of Spee increased and males have significantly larger arch dimensions than those of females.
Conclusion: It was concluded that dental arch dimensions were associated with facial vertical morphology and gender. Thus, using individualized
archwires according to each patient’s pretreatment arch form and width is suggested during orthodontic treatment.
Keywords: Normodivergent, Hypodivergent, Hyperdivergent, Arch dimensions.

How to cite this article: Khera AK, Singh GK, Sharma VP, Singh A. Relationship between Dental Arch Dimensions and Vertical Facial
Morphology in Class I Subjects. J Ind Orthod Soc 2012;46(4):316-324.

INTRODUCTION as kind of flexible ribbons, adapted to varying jaw relationships


to maintain normal relationship between dental arches for
An individual’s facial pattern may be considered as one of the
esthetic and function.
key determinants of treatment selection because facial type
The two extremes of vertical facial dysplasia have been
influences the anchorage system, growth prediction of
described as hypodivergent and hyperdivergent by Schudy2 or
maxillofacial structures and goal of orthodontic treatment.
short face syndrome (SFS) and the long face syndrome (LFS)
Knowledge of arch forms is important for an orthodontist, by Opdebeeck.3 Hypodivergent subjects are characterized by
as it is related to future growth and treatment outcome. a forward rotating mandible due to relatively large vertical
However traditionally, change in the arch form has been condylar growth and small amount of vertical growth of
analyzed in terms of the behavior of various linear dimensions, alveolar process and/or anterior facial sutures. Hyperdivergent
such as arch width, length and perimeter. Arch form has been subjects are characterized by backward rotating mandible due
defined as a linear formulation by Penrose1 as ‘form = size + to the opposite differential growth pattern. It is generally
shape’. The upper and lower dental arches can be considered accepted among orthodontists that a relationship exists
between dental arch width and vertical facial morphology. A
long face (leptoprosopic) individual usually has narrower arch
1
Senior Resident, 2Associate Professor, 3Former Head and Professor, dimensions and a short face individual (euryprosopic) has
4
Assistant Professor
1-4
wider arch dimensions according to Rickets et al.4
Department of Orthodontics and Dentofacial Orthopedics, Faculty
of Dental Sciences, CSMMU (Upgraded KGMC), Lucknow Nowadays, preformed archwires are routinely used by
Uttar Pradesh, India many orthodontists regardless of the facial type, facial
Corresponding Author: Amit Kumar Khera, Senior Resident, proportions and gender of the patients. However, using
Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dental individualized archwires according to each patient’s pre-
Sciences, CSMMU (Upgraded KGMC), Lucknow, Uttar Pradesh treatment arch form and width is suggested during orthodontic
India, e-mail: dr_amitkhera@rediffmail.com
treatment.
The present study was carried out in order to evaluate the
Received on: 21/1/12 relationship between dental arch dimensions and vertical facial
Accepted after Revision: 8/5/12 pattern.

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Relationship between Dental Arch Dimensions and Vertical Facial Morphology in Class I Subjects

The objectives of present study were as follows: Subjects were divided into two groups according to sex as
1. To evaluate the dental arch dimensions in different follows:
vertical-facial pattern. • Group I male (n = 45)
2. To evaluate the correlation between dental arch • Group II female (n = 45)
dimensions and different vertical facial pattern. On the basis of Jarabak ratio (Table 1), group I male
3. To evaluate the differences in dental arch dimensions subjects were further subdivided into three subgroups, i.e.
between male and female subjects. subgroup Ia (hypodivergent male), subgroup Ib (neutral/
normodivergent male) and subgroup Ic (hyperdivergent male).
MATERIALS AND METHODS Similarly, group II female subjects were subdivided into three
Sample subgroups, i.e. subgroup IIa (hypodivergent female), subgroup
The present study was conducted on 90 subjects comprising IIb (neutral/normodivergent female) and subgroup IIc
of 45 males (ranging from 18-24 years) and 45 females (hyperdivergent female).
(ranging from 17-21 years) with a mean age of 20.53 ± 1.23 Measurements
and 19.63 ± 1.06 years for males and females respectively.
The lateral cephalograms and study models for the purpose of High quality orthodontic impressions for study models were
study were obtained from the records of patients visiting the taken with alginate impression material using rim lock
outpatient department of the Department of Orthodontics and impression trays. The lateral cephalograms of the selected
Dentofacial Orthopedics, Faculty of Dental Sciences, CSM subjects were taken using the standard technique employed in
Medical University, Lucknow (UP), India. the Department of Orthodontics and Dentofacial Orthopedics,
The subjects were selected on the basis of following CSM Medical University (Erstwhile KGMC). The lateral
inclusion and exclusion criteria: cephalograms were traced on acetate tracing sheets, 0.5
micron in thickness using a sharp 4H pencil on a view box
Inclusion Criteria using transilluminated light in a dark room.
1. All permanent teeth should be present in each arch (3rd For each subject, Jarabak ratio (Siriwat and Jarabak 1985)5
molar may or may not be present) and sufficiently erupted was measured. The posterior facial height was drawn from sella
to permit measurement of mesiodistal crown dimensions. to gonion (Go) and anterior facial height was drawn from
2. Subjects with skeletal Class I pattern and Angle’s Class I nasion to menton (Me).
molar relation having minimum/no crowding, spacing, Study model measurements were performed using a
rotation were selected. Korkhaus three-dimensions caliper (Dentaurum) and digital
3. No history of previous orthodontic treatment. caliper. The following maxillary and mandibular dimensions
4. There should be no gross carious lesions or any proximal were measured (Figs 1 to 4):
restoration, which can change the mesiodistal dimensions 1. Cumulative mesiodistal crown width [mesiodistal width
of arch. of the crown at the greatest mesiodistal diameter of each
tooth (Fig. 1)].
Exclusion Criteria 2. Intercanine width [from buccal cusp tip (Fig. 2)].
1. Subjects with craniofacial anomalies like cleft lip and 3. First interpremolar width [from buccal cusp tip (Fig. 2)].
palate and syndromes were not included in study. 4. First intermolar width [from buccal, and lingual surface,
2. Subjects with deleterious oral habits, like mouth-breathing, (Fig. 2)]: The average of buccal and palatal/lingual widths
tongue thrusting and thumb sucking, were excluded. were taken.
3. Subjects with anterior and posterior crossbite were also 5. Arch length: From the contact point between the
excluded. permanent central incisors to the line joining the distal
4. No history of trauma to dentofacial region. surface of the permanent first molar (Fig. 2).
5. Individuals with marked jaw asymmetries and temporo- 6. Palatal height: From the connecting line between the
mandibular joint (TMJ) abnormality were excluded from midpoint of the fissures of both upper first molars to the
the study. surface of the palate (see Fig. 2).
Table 1: Distribution of subjects

Groups Subgroups
Hypodivergent Normodivergent Hyperdivergent
(n = 40) (n = 30) (n = 20)
Jarabak ratio Jarabak ratio Jarabak ratio
(64-80%) (59-63%) (54-58%)

Group I Subgroup Ia (n = 20) Subgroup Ib (n = 15) Subgroup Ic (n = 10)


Male (n = 45)
Group II Subgroup IIa (n = 20) Subgroup IIb (n = 15) Subgroup IIc (n = 10)
Female (n = 45)

The Journal of Indian Orthodontic Society, October-December 2012;46(4):316-324 317


Amit Kumar Khera et al

Fig. 1: Mesiodistal width measurement by digital caliper Fig. 4: Measurement of curve of Spee

9. Overbite: Vertical distance between the incisal tips of


maxillary and mandibular central incisors (Fig. 3).
10. Curve of Spee: Perpendicular distance between the
deepest buccal cusp tips and a scale that was laid on the
top of the mandibular dental cast (Fig. 4).
Korkhaus three-dimensional caliper was used to measure
the parameters: Arch length, intercanine width, first
interpremolar width, first intermolar width and palatal height,
while the mesiodistal crown width was measured with digital
caliper and overjet, overbite and curve of Spee were measured
with scale and divider.

STATISTICAL ANALYSIS
Arch dimensions were evaluated using 16 linear parameters.
Fig. 2: Arch length, arch width and palatal height measurement by Six maxillary, six mandibular and four other parameters were
Korkhaus caliper
measured over the maxillary and mandibular study models. The
data so obtained was subjected to the statistical analysis using
statistical package program STATA version 10.2. Descriptive
statistics, including the mean and standard deviation values,
were calculated for all the parameters in each group. Student
t-test was used to determine the significant differences
between the mean and standard deviations of various
parameters in the male and female groups. Subgroups of both
groups were compared using one way analysis of variance
(ANOVA) followed by Bonferroni post-hoc test.

RESULTS
The arch dimension measurements of hypodivergent,
normodivergent and hyperdivergent subgroups of male and
female were shown in Table 2 (Figs 5A to C) and Table 3
(Figs 6A to C) respectively.
Fig. 3: Measurement of overbite and overjet The hypodivergent subgroup had larger arch dimensions
than hyperdivergent subgroup for most of measurements except
2 2 for palatal height and curve of Spee which were larger in
7. Arch perimeter: Using formula 2
Y  (4 x /3) given by hyperdivergent subgroup.
Mills and Hamilton (1965).6 The mean of maxillary and mandibular first interpremolar
8. Overjet: From the labial surface of the lower incisor to width, first intermolar width, arch perimeter and overbite were
the incisal edge of the upper incisor (Fig. 3). decreased from hypodivergent to hyperdivergent but palatal

318 JAYPEE
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Relationship between Dental Arch Dimensions and Vertical Facial Morphology in Class I Subjects

Table 2: Comparison of arch dimension measurements between hypodivergent (subgroup Ia),


normodivergent (subgroup Ib) and hyperdivergent (subgroup Ic) of Group I (male)

Parameters Subgroup Ia Subgroup Ib Subgroup Ic ANOVA p-value


(n = 20) (n = 15) (n = 10) p-value
Ia vs Ib Ia vs Ic Ib vs Ic
Mean ± SD Mean ± SD Mean ± SD

Maxillary parameters
1. Cumulative mesiodistal 90.34 + 5.63 89.6 + 3.60 90.27 + 3.75 0.915 1.00 1.00 1.00
crown width (TTM)
2. Intercanine width 37.13 + 2.53 35.31 + 1.60 34.89 + 1.76 0.002** 0.045* 0.038* 1.00
3. First interpremolar width 44.60 + 2.50 42.38 + 1.80 41.56 + 3.05 0.005** 0.044* 0.010** 1.00
4. First intermolar width 49.23 + 2.30 47.19 + 1.36 46.84 + 1.93 0.003** 0.019* 0.014* 1.00
5. Arch length 37.02 + 2.23 35.88 + 2.06 37.7 + 1.79 0.110 0.403 1.00 0.131
6. Arch perimeter 65.20 + 2.79 63.00 + 2.38 61.43 + 2.09 0.002** 0.058 0.002** 0.601
Mandibular parameters
1. Cumulative mesiodistal 82.19 + 4.59 83.59 + 2.40 82.41 + 3.01 0.562 0.893 1.00 1.00
crown width (TTM)
2. Intercanine width 27.43 + 1.84 25.31 + 1.83 25.14 + 1.59 0.004** 0.05* 0.010** 0.082
3. First interpremolar width 36.17 + 1.88 34.65 + 1.91 33.72 + 2.46 0.009** 0.123 0.013* 0.883
4. First intermolar width 45.60 + 1.58 43.81 + 2.36 42.54 + 2.69 0.002** 0.064 0.002** 0.519
5. Arch length 32.52 + 2.29 31.77 + 2.39 33.56 + 1.24 0.102 0.403 1.000 0.131
6. Arch perimeter 59.03 + 2.28 57.07 + 2.62 56.6 + 2.60 0.022* 0.092 0.050* 1.000
Other parameters
1. Overjet 2.20 + 0.92 2.12 + 1.08 1.89 + 0.89 0.272 1.00 1.00 1.00
2. Overbite 2.82 + 1.06 2.35 + 1.07 1.78 + 0.51 0.033* 0.526 0.032* 0.558
3. Palatal height 21.10 + 3.06 22.00 + 2.55 24.33 + 2.45 0.022* 1.000 0.019* 0.183
4. Curve of Spee 1.91 + 0.61 2.04 + 0.72 2.59 + 0.22 0.022* 1.00 0.020* 0.115

p-value: > 0.05 nonsignificant; *:<0.05 just significant; **: <0.01 moderately significant

Table 3: Comparison of arch dimension measurements between hypodivergent (subgroup IIa),


normodivergent (subgroup IIb) and hyperdivergent (subgroup IIc) of Group II (female)

Parameters Subgroup IIa Subgroup IIb Subgroup IIc ANOVA p-value


(n = 20) (n = 15) (n = 10) p-value
Mean ± SD Mean ± SD Mean ± SD IIa vs IIb IIa vs IIc IIb vs IIc

Maxillary parameters
1. Cumulative mesiodistal 87.94 + 3.71 89.9 + 3.32 88.73 + 5.77 0.704 1.00 1.00 1.00
crown width (TTM)
2. Intercanine width 34.60 + 1.83 34.40 + 1.68 34.05 + 1.83 0.728 1.00 1.000 1.000
3. First interpremolar width 42.4 + 2.51 42.7 + 2.40 40.00 + 2.40 0.024* 1.00 0.041* 0.028*
4. First intermolar width 46.6 + 2.86 45.5 + 1.30 44.50 + 1.53 0.048* 0.442 0.050* 0.803
5. Arch length 36.48 + 2.72 36.53 + 2.56 35.30 + 3.50 0.508 1.000 0.883 0.889
6. Arch perimeter 62.86 + 2.20 62.97 + 3.32 60.08 + 2.91 0.024* 1.000 0.039* 0.043*

Mandibular parameters
1. Cumulative mesiodistal 80.03 + 3.44 81.98 + 2.68 80.60 + 4.54 0.265 0.325 1.000 1.000
crown width (TTM)
2. Intercanine width 25.7 + 1.71 25.7 + 1.67 25.2 + 2.00 0.600 1.000 1.000 1.000
3. First interpremolar width 34.70 + 1.94 34.6 + 1.23 34.05 + 2.06 0.625 1.000 1.000 1.000
4. First intermolar width 43.77 + 2.14 42.97 + 1.88 41.75 + 1.34 0.030* 0.664 0.027* 0.376
5. Arch length 32.6 + 2.40 32.67 + 1.99 31.50 + 2.92 0.402 1.000 0.637 0.719
6. Arch perimeter 57.47 + 3.22 57.17 + 2.05 55.55 + 1.73 0.046* 1.000 0.047* 0.154

Other parameters
1. Overjet 2.70 + 1.17 1.93 + 0.70 2.55 + 1.21 0.103 0.116 1.000 0.474
2. Overbite 3.48 + 0.94 2.47 + 1.30 2.10 + 1.13 0.004** 0.033* 0.008** 1.000
3. Palatal height 20.05 + 2.24 21.73 + 2.81 23.05 + 3.00 0.0143* 0.201 0.015* 0.675
4. Curve of Spee 1.85 + 0.80 2.0 + 0.82 3.15 + 0.80 0.001*** 1.000 0.000*** 0.003**

p-value: > 0.05 nonsignificant; *: <0.05 just significant; **: <0.01 moderately significant; ***: <0.001 highly significant

height and curve of Spee increased from hypodivergent to DISCUSSION


hyperdivergent (see Tables 2 and 3). The facial growth pattern differs from individual to individual
Table 4 (Figs 7A to C) shows that dental arch dimension and the variations in the dentofacial patterns are quite high.
measurements of male and female subjects. It was clearly The assessment of relationship of dental arch dimensions with
demonstrated that males had larger arch dimensions than females. the vertical dentofacial pattern is essential to understand the

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Amit Kumar Khera et al

Figs 5A to C: Comparison of variables in different subgroups (Ia, Ib,Ic) of Group I (male)

variation in size and shape of dental arches. Research has segregated according to sex to maintain the homogeneity of
established the importance of vertical dimension. It has been the sample. Jarabak and Siriwat (1985),5 Bishara and Jakobsen
suggested that a subject with a high MP-SN angle tends to (1985)12 had also found a sexual dimorphism to exist among
have a longer face and narrower arch dimensions and one with various facial types.
a low MP-SN angle often has a shorter face and wider arch In the present study, subjects were divided into subgroups:
dimensions (Ricketts et al 19824, Enlow and Hans 19967). A Hypodivergent, normodivergent and hyperdivergent on the
well-established sexual dimorphism in the arch dimensions basis of Jarabak ratio (Table 1) because it is a reliable
has been found to exist in the vertical plane [Wei (1970),8 measurement, constructed from anatomic landmarks (Bishara
Christie (1977), 9 Eroz et al (2000) 10 and Forster et al and Jakobsen, 198512) and the chance of human error is also
(2008)11]. They found that males had sufficiently larger arch minimized by using a ratio instead of linear parameter. Only
widths as compared with females. Therefore, the subjects were skeletal Class I subjects were selected because considerable

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Table 4: Comparison of arch dimension between Group I (male) and Group II (female)

Parameters (in mm) Group I (n = 45) Group II (n = 45) p-value


Mean ± SD Mean ± SD

Maxillary parameters
1. Cumulative mesiodistal crown width (TTM) 90.11 + 3.62 88.50 + 3.07 0.086
2. Intercanine width 36.08 + 2.31 34.41 + 1.75 0.001**
3. First interpremolar width 43.26 + 2.72 42.00 + 2.60 0.030*
4. First intermolar width 48.31 + 2.24 45.97 + 2.75 0.001**
5. Arch length 36.83 + 2.16 36.23 + 2.84 0.272
6. Arch perimeter 64.31 + 2.66 62.28 + 2.96 0.001**
Mandibular parameters
1. Cumulative mesiodistal crown width (TTM) 82.67 + 3.69 80.80 + 3.52 0.017*
2. Intercanine width 26.87 + 1.83 25.95 + 1.74 0.067
3. First interpremolar width 35.18 + 2.22 34.32 + 1.74 0.047*
4. First intermolar width 44.69 + 2.23 42.92 + 2.22 0.004**
5. Arch length 32.51 + 2.19 32.41 + 2.39 0.838
6. Arch perimeter 58.32 + 2.55 57.11 + 2.69 0.034*
Other parameters
1. Overjet 2.11 + 0.95 2.41 + 1.00 0.199
2. Overbite 2.17 + 0.97 3.06 + 1.17 0.001**
3. Palatal height 23.02 + 2.85 20.69 + 2.67 0.001**
4. Curve of Spee 2.06 + 0.59 2.14 + 0.77 0.567

p-value: NS > 0.05 nonsignificant; *: <0.05 just significant; **: <0.01 moderately significant

natural dentoalveolar compensation is expected in skeletal tension increases, which in turn causes the maxillary arch to
Class II or Class III subjects, which might obscure the be constricted. Conversely, the low MP-SN growth pattern
relationship between vertical facial morphology and arch has less facial height tending to permit maxillary teeth to move
dimensions. When intragroup comparisons were done between toward buccoversion. Nasby et al (1972)13 also reported that
hypodivergent, normodivergent and hyperdivergent subgroups backward rotating mandible (hyperdivergent pattern) were
of both male and female groups (see Tables 2 and 3), the mean associated with narrower intermolar widths. Musculature has
value of cumulative mesiodistal crown width did not show any been considered as a possible link in this close relationship
statistically significant difference (p > 0.05) suggesting that between the transverse dimension and vertical facial
the tooth size appear to be a variable independent of the vertical morphology.
growth pattern. This finding was also supported by studies done The present study also suggests that maxillary and
by Nasby et al (1972).13 mandibular arch lengths are similar in hypodivergent,
For maxillary arch, there was a statistically significant inverse normodivergent and hyperdivergent subgroups, whereas the
relationship between vertical facial morphology and dental arch arch perimeter was greater in hypodivergent than hyper-
width at maxillary canine, first premolar and first molar region in divergent sujects. Similar findings were reported by Nasby
males and only between first molar widths in females. For et al (1972).13 No significant difference was found for overjet
mandibular arch, it was found that males had statistically in hypodivergent, normodivergent and hyperdivergent
significant correlation between vertical facial morphology and subgroups for both the sexes, but overbite was found to
mandibular intercanine, first interpremolar and first intermolar decrease with increase in vertical dimension. So, the overbite
widths but, in females, only first intermolar width was was more in hypodivergent and less in hyperdivergent subjects
significant. These findings were supported by Nasby et al for both the groups. Nasby et al (1972)13 also reported that
(1972),13 while they were in contrast to Eroz et al (2000)9 hyperdivergent subjects were associated with longer anterior
and Forster et al (2008)10 who demonstrate that mandibular and posterior alveolar heights that will result the dental open
first intermolar width was similar in hypodivergent and bite or reduced overbite in these subjects. Palate was found to
hyperdivergent subjects, however, the present data did not be high in hyperdivergent subgroup and shallow in
support such a relationship. In the present study, it was also hypodivergent subgroup for both males and females. Curve of
observed that males had larger maxillary and mandibular first Spee was found to increase as the facial height increased. These
intermolar width than females. Similar findings have also been findings suggest that the depth of curve of Spee was more in
reported by the Eroz et al (2000)9 and Foster et al (2008).10 hyperdivergent as compare with hypodivergent male and
Isaacson et al (1971)14 reported that steep mandibular plane female subjects, because of decrease in arch perimeter in
individuals generally had narrower maxillary first intermolar hyperdivergent group, there may be compensatory increase in
width than flat mandibular plane individuals. They suggested curve of Spee to accommodate the tooth material. Schudy
that the backward rotation of mandible in high MP-SN cases (1968)15 explained the importance of dentoalveolar dimension
cause an increase in facial height which tends to lengthen the to establish the overbite. According to him, mandibular
musculature. As the muscles are elongated, the passive stretch incisors are the best compensator in preventing the open bite.

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Amit Kumar Khera et al

Figs 6A to C: Comparison of variables in different subgroups (IIa, IIb, IIc) of Group II (female)

Another possible explanation for the increased curve of Spee explain the gender differences found in our study, in the sense
in hyperdivergent subjects was that, because of vertical that females have a weaker genetic determination than males
skeletal dysplasias, the natural dentoalveolar compensation for the vertical craniofacial morphology.
in mandibular anterior region will take place to establish The results of present study provide normative data for
normal overbite (Anwar et al 2009).16 the arch dimensions of hypodivergent, normodivergent and
A possible explanation to our findings regarding the hyperdivergent male and female subjects. The study also
different influence of the vertical facial pattern on arch provides a comparative evaluation of arch dimension in
dimensions for both the sexes can be attributed to the different different vertical-facial pattern which is an important adjunct
impact of genetic factors on males and females. A genetic for selection of treatment plan.
study of cephalometric variables performed in twins showed Many authors have acknowledged that there is variability
that the genetic determination for vertical variables was 77.3% in size and shape of human archforms. People from different
for boys and 72.8% for girls (Carels C 2001).17 This could ethnic groups present with different physiologic conditions,

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Relationship between Dental Arch Dimensions and Vertical Facial Morphology in Class I Subjects

Figs 7A to C: Comparison of variables in male and female groups

and clinician should anticipate the difference in size and form tend to exhibit wider transverse head dimensions (Hannam and
rather than treating all cases to a single ideal. Wood, 1989,20 Kiliaridis and Kalebo 199121).
Little, 18 based on more than 35 years of research, This study can be made more exhaustive by observing the
recommended as a clinical guideline that patient’s pretreatment effect of the muscle activity (using ultrasonography) on arch
archform be used as a guide to posttreatment archshape. dimensions in different dentofacial patterns.
The limitations of present study must be acknowledged
because of the large individual variation encountered and dental CONCLUSION
arch dimensions are certainly a multifactorial phenomenon Following conclusions were drawn from present study:
(Schulhof et al, 1978). 19 The general consensus is that 1. Maxillary and mandibular first intermolar width, arch
individuals with strong or thick mandibular elevator muscles perimeter and maxillary first interpremolar width were

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Amit Kumar Khera et al

maximum in hypodivergent followed by normodivergent 6. Mills LF, Hamilton PH. Epidemiological studies of malalignment,
a method for computing dental arch circumference. Angle Orthod
and minimum in hyperdivergent in males as well as in
1965;35:244-48.
females. 7. Enlow DH, Hans MG. Essentials of facial growth. Philadelphia:
2. Maxillary intercanine width, mandibular intercanine width WB Saunders 1996.
and first interpremolar width were higher in the 8. Wei SH. Craniofacial width dimensions. Angle Orthod 1970;40:141-47.
9. Christie TE. Cephalometric patterns of adults with normal
hypodivergent as compared with hyperdivergent in males.
occlusion. Angle Orthod 1977;47:128-35.
3. The overbite had a negative correlation with vertical facial 10. Eroz UB, Ceylan I, Aydemir S. An investigation of mandibular
height for both the sexes. This concludes that overbite was morphology in subjects with different vertical facial growth
more in hypodivergent as compared with hyperdivergent patterns. Aus Orthod J 2000;16:16-22.
11. Forster CM, Chung CH. Relationship between dental arch width
subjects.
and vertical facial morphology in untreated adults. Eur J Orthod
4. The palate height was more in hyperdivergent and shallow 2008;30:288-97.
in hypodivergent in males as well as in females. 12. Bishara SE, Jakobsen JR. Longitudinal changes in three normal
5. Curve of Spee was high in hyperdivergent as compared facial types. Am J Orthod 1985;88:466-502.
13. Nasby JA, Isaacson RJ, Worms FW. Orthodontic extractions and
with hypodivergent in males as well as in females.
facial skeletal pattern. Angle Orthod 1972;42:116-22.
6. Maxillary and mandibular first interpremolar width, first 14. Isaacson JR, Isaacson RJ, Speidel TM, Worms FW. Extreme
intermolar width and arch perimeter were greater in males variation in vertical facial growth and associated variation in skeletal
as compared with females. and dental variations. Angle Orthod 1971;41:219-30.
15. Schudy FF. The control of vertical overbite in clinical orthodontics.
7. Maxillary intercanine width and palatal height were more
Angle Orthod 1968;38:19-39.
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more in females. clinical application. Eur J Orthod 2009;31:516-22.
17. Carels C, Van Cauwenberghe N, Savoye I, et al. A quantitative
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