Cephalometric Norms in an Omani Adult Population of Arab Descent
: Objectives: This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians. Methods: This cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman,...
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| Published in | Sultan Qaboos University medical journal Vol. 18; no. 2; pp. 182 - 189 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
Muscat - Oman
Sultan Qaboos University
01.05.2018
Sultan Qaboos University, College of Medicine and Health Sciences Sultan Qaboos University Medical Journal, College of Medicine & Health Sciences |
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| Online Access | Get full text |
| ISSN | 2075-051X 2075-0528 2075-0528 |
| DOI | 10.18295/squmj.2018.18.02.010 |
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| Abstract | : Objectives: This study aimed to establish cephalometric norms for an Omani population of Arab descent
and to compare these with established cephalometric values for Caucasians. Methods: This cross-sectional study
was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and
October 2016. A total of 150 Omani patients between 20–29 years old seeking orthodontic treatment were included.
All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal
overjet/overbite (<3 mm) and mild spacing/crowding of the teeth (≤3 mm). Lateral cephalography was performed
in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were
then compared with Eastman Standard norms. Results: The Omani subjects were found to have a slightly retrusive
maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison
to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal
angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more
protrusive and the nasolabial angle was more obtuse. Conclusion: In the Omani sample, increased proclination of the
incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be
considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study
may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent. |
|---|---|
| AbstractList | This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians.
This cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and October 2016. A total of 150 Omani patients between 20-29 years old seeking orthodontic treatment were included. All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal overjet/overbite (<3 mm) and mild spacing/crowding of the teeth (≤3 mm). Lateral cephalography was performed in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were then compared with Eastman Standard norms.
The Omani subjects were found to have a slightly retrusive
, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more protrusive and the nasolabial angle was more obtuse.
In the Omani sample, increased proclination of the incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent. : Objectives: This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians. Methods: This cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and October 2016. A total of 150 Omani patients between 20–29 years old seeking orthodontic treatment were included. All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal overjet/overbite (<3 mm) and mild spacing/crowding of the teeth (≤3 mm). Lateral cephalography was performed in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were then compared with Eastman Standard norms. Results: The Omani subjects were found to have a slightly retrusive maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more protrusive and the nasolabial angle was more obtuse. Conclusion: In the Omani sample, increased proclination of the incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent. Objectives: This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians. Methods: This cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and October 2016. A total of 150 Omani patients between 20–29 years old seeking orthodontic treatment were included. All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal overjet/overbite (<3 mm) and mild spacing/crowding of the teeth (≤3 mm). Lateral cephalography was performed in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were then compared with Eastman Standard norms. Results: The Omani subjects were found to have a slightly retrusive maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more protrusive and the nasolabial angle was more obtuse. Conclusion: In the Omani sample, increased proclination of the incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent. Keywords: Cephalometry, standards; Population Characteristics; Ethnic Groups; Arabs; Orthodontics; Oman. This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians.OBJECTIVESThis study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians.This cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and October 2016. A total of 150 Omani patients between 20-29 years old seeking orthodontic treatment were included. All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal overjet/overbite (<3 mm) and mild spacing/crowding of the teeth (≤3 mm). Lateral cephalography was performed in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were then compared with Eastman Standard norms.METHODSThis cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and October 2016. A total of 150 Omani patients between 20-29 years old seeking orthodontic treatment were included. All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal overjet/overbite (<3 mm) and mild spacing/crowding of the teeth (≤3 mm). Lateral cephalography was performed in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were then compared with Eastman Standard norms.The Omani subjects were found to have a slightly retrusive maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more protrusive and the nasolabial angle was more obtuse.RESULTSThe Omani subjects were found to have a slightly retrusive maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more protrusive and the nasolabial angle was more obtuse.In the Omani sample, increased proclination of the incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent.CONCLUSIONIn the Omani sample, increased proclination of the incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent. Knowledge of the way in which an individual’s cephalometric values differ from accepted norms will allow clinicians to conclude whether the anomaly is dento-alveolar or skeletal in origin and undertake corrective measures if necessary.4 In a comparison of cephalometric norms between Egyptian adolescents and those of a sample in Iowa, USA, Bishara et al. concluded that Egyptian boys tended to have bimaxillary dental protrusion and greater posterior facial heights (PFHs), whereas Egyptian girls had mandibular dental protrusion and more convex skeletal profiles.5 In a Jordanian population, Hamdan et al. concluded that, in comparison to a British sample, Jordanians had reduced lower facial heights and more proclined upper incisors (UIs) and lower incisors (LIs); this finding was substantiated by a reduced interincisal angle.3 Al-Awwad et al. compared the cephalometric norms of a sample of adult Kuwaitis with those of previously published Caucasian norms, reporting that the Kuwaiti subjects had more proclined incisors and significantly more obtuse nasolabial angles; moreover, females had more protrusive lower lips with more proclined LIs compared to males.6 Another study found that adolescent Kuwaitis had a steeper mandibular plane (MN) and a more convex profile, with reduced chin protrusion and more protrusive dentition compared to published norms.4 Shalhoub et al. established cephalometric radiographical norms for Saudi Arabian adults by comparing normal facial proportions with a North American sample; the Saudi subjects showed reasonably normal dental relationships, with no severe anteroposterior, vertical or transverse skeletal discrepancies.7 In western Saudi Arabia, previous findings have suggested that western Saudis have an increased A point/nasion/B point (ANB) angle due to the retrognathic nature of the mandible and bimaxillary dento-alveolar protrusion, with males having a steeper MN angle.2 Among Saudi Arabian students with acceptable profiles and occlusion, a craniofacial analysis indicated the students had a slightly protrusive maxilla, with a tendency towards class II facial patterns, high MN angles and procumbent maxillary and mandibular incisors in comparison to Caucasian subjects.8 In Oman, the native population has a unique culture and lineage, with a history of considerable ethnic diversity.9 Although previous studies have attempted to set normative standards in the Arabian Gulf region, none have so far focused on Omanis of Arab descent.2–4,7,8 Therefore, the present study aimed to establish cephalometric standards for an Omani population of Arab descent and compare these with Eastman Standard norms.10–27 Methods This cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, from May 2014 to October 2016. The sample size was calculated using nMaster software, Version 1.0 (Department of Biostatistics, Christian Medical College, Vellore, India) based on the following formulae: N=2Sp2[Z1-a2+Z1-B]2D2Sp-pooled SD=SD of males+SD of females2 Where Sp is the target population, Z is the confidence interval (1.96), a is the α error (assumed to be 1%), B is the β error (assumed to be 10% at a power of 90%), D is the effect size (i.e. the mean difference between males and females) and SD is the standard deviation. Table 1 Definition of various cephalometric parameters used in the current study Parameter Definition Skeletal SNA Position of the maxilla in relation to the skull base (i.e. the angle between the SN and NA planes) SNB Position of the mandible in relation to the skull base (i.e. the angle between the SN and NB planes) ANB Sagittal relationship between the maxilla and mandible (i.e. the angle between the NA and NB planes) SN-MP Vertical relationship between the maxilla and cranium (i.e. the angle between the SN and ANS and PNS planes) PPL-MN Angle between the PPL and MN LAFH Distance between the Me and MP (i.e. distance between the Me and ANS) UAFH Distance between the N and MP (i.e. distance between the N and ANS) LAFH/TAFH Ratio of LAFH to the TAFH (i.e. ratio of the N-ANS to the ANS-Me) LPFH Distance between the Go and MP (i.e. distance between the Go and PNS) UPFH Distance between the S and MP (i.e. distance between the S and PNS) PFH Distance between the S and Go Wits appraisal Extent to which the jaws are related to each other* Dental Overjet Horizontal overlap of the incisors from the labial aspect of the LI to the incisal edge of the UI Overbite Vertical overlap of the incisors from the incisal edge of the UI to the incisal edge of the LI UI-MP Angle between the UI axis and MP LI-MP Angle between the LI axis and MP UI-LI Angle between the UI and LI axes LI protrusion Distance between the incisal edge of the LI and the line joining point A to Po LI-FP Distance between the incisal edge of the LI and the line joining N to Po B-NPo Distance between point B and the line joining N to Po LDFH Distance between the tip of the LI and the MP Soft tissue UL-EP Distance between the UL and Ricketts’ E line† LL-EP Distance between the LL and Ricketts’ E line† NLA Angle between the Co and Sn of the UL Chin thickness Distance between the hard and soft tissue Po Open in a separate window SNA = sella (S)/nasion (N) point A; SNB = SN point B; ANB = A point/N/B point; MP = maxillary plane; ANS = anterior nasal spine; PNS = posterior nasal spine; PPL = palatal plane; MN = mandibular plane; LAFH = lower anterior facial height (AFH); Me = menton; UAFH = upper AFH; TAFH = total AFH; LPFH = lower posterior facial height (PFH); Go = gonion; UPFH = upper PFH; LI = lower incisor; UI = upper incisor; Po = pogonion; FP = facial plane; LDFH = lower dental facial height; UL = upper lips; EP = E plane; LL = lower lips; NLA = nasolabial angle; Col = columella; Sn = philtrum. *Measured by drawing perpendicular lines from points A and B on the maxilla and mandible, respectively, to the occlusal plane through the region of overlapping cusps of the first premolar and first molars. †Measured by drawing a line from the tip of the nose to the soft tissue Po. The Omani subjects had a significantly smaller SN point A (SNA) value (81.24 ± 4.40 degrees versus 82.01 ± 3.89 degrees; P = 0.036), suggesting a retro-positioned maxilla.12 In addition, the Omani subjects had slightly more divergent basal planes, as indicated by their significantly higher palatal-MP (26.84 ± 5.46 degrees versus 25 ± 6 degrees; P <0.001) and SN-MP (8.57 ± 3.87 degrees versus 7 ± 3 degrees; P <0.001) angles.12,13 In addition, the Omani subjects had significantly smaller anterior and PFHs (P <0.001 each).11,13–16 According to the Wits appraisal value, the SD value of jaw disharmony of the Omani population was just over 1 mm less than that of the Eastman Standard norms (−0.59 ± 3.25 mm versus 0.59 ± 1.84 mm; P <0.001).19 Both the overjet and overbite of the Omani subjects was significantly decreased in comparison to Eastman Standard norms (P <0.001 each), with the Omani subjects having more proclined incisors.20,21 With regards to soft tissue parameters, the upper and lower lips were significantly more protrusive in the Omani subjects and the nasolabial angle was significantly more obtuse (P <0.001 each) [Table 3].10–27 Table 3 Comparison of cephalometric norms in an adult Omani population (N = 150) with Eastman Standard norms10–27 Parameter Mean ± SD P value Arab Omanis (N = 150) Eastman Standard norms Skeletal SNA in degrees 81.24 ± 4.40 82.01 ± 3.8912 0.036 SNB in degrees 79.38 ± 4.28 79.77 ± 3.6912 0.272 ANB in degrees 1.90 ± 2.61 2.04 ± 1.8112 0.517 SN-MP in degrees 8.57 ± 3.87 7 ± 313 <0.001 PPL-MN in degrees 26.84 ± 5.46 25 ± 614 <0.001 LAFH in mm 59.35 ± 8.24 64.95 ± 3.5511 <0.001 UAFH in mm 49.79 ± 4.85 52.35 ± 2.815,16 <0.001 LAFH/TAFH ratio in % 36.92 ± 26.25 5517 <0.001 LPFH in mm 43.00 ± 34.50 43.0 ± 418 <0.001 UPFH in mm 39.89 ± 5.06 52.25 ± 1.9513 <0.001 PFH in mm 72.75 ± 7.89 79.0 ± 4.513 <0.001 Wits appraisal in mm −0.59 ± 3.25 0.59 ± 1.8419 <0.001 Dental Overjet in mm 2.56 ± 2.07 3.2 ± 0.520,21 <0.001 Overbite in mm 1.45 ± 1.80 3.2 ± 0.720,21 <0.001 UI-MP in degrees 115.93 ± 8.18 112 ± 613 <0.001 LI-MN in degrees 95.50 ± 7.86 91.4 ± 3.7810 <0.001 UI-LI in degrees 121.57 ± 10.98 135.4 ± 5.7610 <0.001 LI protrusion in mm 2.76 ± 2.62 1 ± 222 <0.001 LI-FP in mm 3.10 ± 2.93 1.6 ± 223 <0.001 B-NPo in mm −1.52 ± 1.46 −2 ± 227 <0.001 LDFH in mm 37.20 ± 4.14 40 ± 215,16 <0.001 Soft tissue UL-EP in mm 2.55 ± 3.21 −5.4 ± 222 <0.001 LL-EP in mm −0.82 ± 2.01 −2.0 ± 222 <0.001 NLA in degrees 105.57 ± 9.74 102.0 ± 424 <0.001 Chin thickness in mm 11.95 ± 2.52 12.65 ± 1.925,26 <0.001 Open in a separate window SD = standard deviation; SNA = sella (S)/nasion (N) point A; SNB = SN point B; ANB = A point/N/B point; MP = maxillary plane; PPL = palatal plane; MN = mandibular plane; LAFH = lower anterior facial height (AFH); UAFH = upper AFH; TAFH = total AFH; LPFH = lower posterior facial height (PFH); UPFH = upper PFH; UI = upper incisor; LI = lower incisor; FP = facial plane; B-NPo = point B/N/pogonion; LDFH = lower dental facial height; UL = upper lips; EP = E plane; LL = lower lips; NLA = nasolabial angle. |
| Author | Al-Busaidi , Ibrahim Govinakovi , Prashantha S Senguttuvan , Viswapurna |
| AuthorAffiliation | 3 Department of Orthodontics, Oman Dental College, Muscat, Oman 2 Department of Orthodontics, Military Dental Centre, Ministry of Defence, Muscat, Oman 1 Department of Orthodontics, M. S. Ramaiah University of Applied Sciences, Bangalore, India |
| AuthorAffiliation_xml | – name: 1 Department of Orthodontics, M. S. Ramaiah University of Applied Sciences, Bangalore, India – name: 3 Department of Orthodontics, Oman Dental College, Muscat, Oman – name: 2 Department of Orthodontics, Military Dental Centre, Ministry of Defence, Muscat, Oman |
| Author_xml | – fullname: Al-Busaidi , Ibrahim – fullname: Govinakovi , Prashantha S – fullname: Senguttuvan , Viswapurna |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30210848$$D View this record in MEDLINE/PubMed |
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| Copyright | Copyright Sultan Qaboos University May 2018 Copyright 2018, Sultan Qaboos University Medical Journal, All Rights Reserved 2018 |
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| PublicationPlace | Muscat - Oman |
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| PublicationTitle | Sultan Qaboos University medical journal |
| PublicationTitleAlternate | Sultan Qaboos Univ Med J |
| PublicationYear | 2018 |
| Publisher | Sultan Qaboos University Sultan Qaboos University, College of Medicine and Health Sciences Sultan Qaboos University Medical Journal, College of Medicine & Health Sciences |
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| Snippet | : Objectives: This study aimed to establish cephalometric norms for an Omani population of Arab descent
and to compare these with established cephalometric... This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for... Knowledge of the way in which an individual’s cephalometric values differ from accepted norms will allow clinicians to conclude whether the anomaly is... Objectives: This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric... |
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| SubjectTerms | Adult Adults Arabs Cephalometry - standards Clinical & Basic Research Cross-Sectional Studies Dental Occlusion, Centric Dentition, Permanent DIAGNOSIS Female HEAD Humans Lip - anatomy & histology Male Males Medical diagnosis Medical imaging OMAN ORTHODONTICS Patients Plastic surgery Reproducibility of Results SIZE MEASUREMENT TOMOGRAPHY Young Adult التشخيص التصوير الإشعاعي المقطعي الرأس تقويم الأسنان عمان قياس الحجم |
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| Title | Cephalometric Norms in an Omani Adult Population of Arab Descent |
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