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Fulltext Comparison of popular sagittal cephalometric analyses for validity and reliability

Qamaruddin I, Alam MK, Shahid F, Tanveer S, Umer M, Amin E

Saudi Dent J, 2018 Jan;30(1):43-46.
PMID: 30166870 DOI: 10.1016/j.sdentj.2017.10.002

Background: The analysis of skeletal relationships of jaws in the sagittal plane is of utmost importance in orthodontic diagnosis for which numerous lateral cephalometric analyses have emerged. None of the analyses is without flaws. Current study compares ANB, Wits appraisal, Beta angle, Yen angle and W angle for their validity and reliability in diagnosis of skeletal classes.
Methods: Pretreatment cephalograph of 209 orthodontic patients comprised of 92 males and 117 females were selected from orthodontic archives. Radiographs were traced for ANB, Wits appraisal, Beta angle, W angle and Yen angle measurements. Patients were divided into three skeletal classes i.e. class I, II and III based on measurements and incisor classification and profile recorded from their files. ANOVA was applied to check the validity of performed analyses and Cramer's correlation was performed to find out the correlation between analyses and skeletal classes.
Results: All performed analyses showed statistically significant difference in the values for all three skeletal classes p

Matched MeSH terms: Cephalometry
Fulltext Growth charts based on longitudinal study of Malaysian children from birth to six years

Chen ST

Med J Malaysia, 1985 Jun;40(2):80-9.
PMID: 3834290

Percentile growth charts of weight, length and head circumference, from birth to six years of age, for boys and girls, are presented. These can be used to monitor the growth of Malaysian children.

Matched MeSH terms: Cephalometry
Geographical variation in skull morphology of gray-bellied squirrel Callosciurus caniceps

Hayashida A, Endo H, Sasaki M, Oshida T, Kimura J, Waengsothorn S, et al.

J Vet Med Sci, 2007 Feb;69(2):149-57.
PMID: 17339759

The geographical variation of the gray-bellied squirrel (Callosciurus caniceps) was examined using osteometry of skull in Southeast Asia. From the principal component analysis (PCA), the plots of the northern localities from Nan to Kanchanaburi and those of the southern localities from Narathiwat to Kuala Lumpur in male were completely separated. In female, the plots of the locality from Uttradit to Kanchanaburi and those of the locality from Pattani to Negri Sembilan were completely separated. We called these northern localities and southern localities which are distinguished by the PCA as N group and S group. The size and shape of the skulls of these squirrels indicated the differences between N group and S group from t-test and U-test. These results may be influenced by the two transitions of the phytogeography around the southernmost locality in N group and the northernmost locality in S group in the peninsular Thailand and Malay Peninsula. Localities which are located between N and S groups were called the Middle (M) group. From the PCA among N, S groups and each locality of M group, the plots of localities such as Prachuap Khiri Khan, Chumphon, Krabi, Nakhon Si Thammarat and Trang in both sexes of M group could not be separated from those of N and S groups. We suggest that the sympatric distribution of N and S groups and the hybrid of N and S populations may be seen in these localities of M group.

Matched MeSH terms: Cephalometry/methods; Cephalometry/veterinary
Secular trend of growth in Malaysian children

Chen ST

J Singapore Paediatr Soc, 1990;32(3-4):102-7.
PMID: 2133745

Over the past hundred years in industrialised countries and recently in some developing countries, children have been getting larger and growing to maturity more rapidly. This paper compares the growth of Malaysian children with similar socioeconomic backgrounds but born about twelve years apart. Data were obtained from records of 227 children born between 1968 and 1973 and 238 children born between 1980 and 1985. The children were followed-up regularly at the University Hospital Child Health Clinic in Kuala Lumpur for a variable period from birth to five years of age. Measurements for their weight, length and head circumference were taken at each visit. There is a directional indication that boys and girls of the 1980-1985 cohort are taller, heavier and have bigger head circumferences from birth to five years of age and the difference widens as the child grows older. This study clearly shows that a positive secular trend has taken place in the last decade, reflecting an improvement of living conditions with time. The factors involved in the positive secular trend are manifold and the most important is probably nutrition.

Matched MeSH terms: Cephalometry
Growth of head circumference of Malaysian infants and pre-school children

Chen ST

J Singapore Paediatr Soc, 1990;32(3-4):81-6.
PMID: 2133761

126 Malaysian children, 65 boys and 61 girls from higher income families were followed-up regularly from birth to six years of age in the University Hospital, Kuala Lumpur. The study confirms the observations of previous studies that growth velocity of head circumference is most rapid during the first few months of infancy and then decreases so that by the fifth year of life the increment is minimal. It also confirms the fact that boys have bigger head circumferences than girls. The paper also presents the head circumference distance and velocity percentile charts which can be used to monitor the head circumference of Malaysian children.

Matched MeSH terms: Cephalometry*
Regression methods to investigate the relationship between facial measurements and widths of the maxillary anterior teeth

Isa ZM, Tawfiq OF, Noor NM, Shamsudheen MI, Rijal OM

J Prosthet Dent, 2010 Mar;103(3):182-8.
PMID: 20188241 DOI: 10.1016/S0022-3913(10)60028-5

In rehabilitating edentulous patients, selecting appropriately sized teeth in the absence of preextraction records is problematic.

Matched MeSH terms: Cephalometry/methods
A self-grinding occlusal plane template to help modify an uneven occlusal plane before providing definitive restorations

Patil PG, Nimbalkar S

J Prosthet Dent, 2021 Mar;125(3):551-553.
PMID: 32418665 DOI: 10.1016/j.prosdent.2020.03.002
Matched MeSH terms: Cephalometry
The hyoid bone in malay infants with cleft lip and palate

Rajion ZA, Townsend GC, Netherway DJ, Anderson PJ, Hughes T, Shuaib IL, et al.

Cleft Palate Craniofac J, 2006 Sep;43(5):532-8.
PMID: 16986987

To compare morphological and positional variations of the hyoid bone in unoperated infants with cleft lip and palate (CL/P) with those in noncleft infants.

Matched MeSH terms: Cephalometry
A comparative morphological study on the craniofacial complex of irus monkeys from different habitats by means of roentgenographic cephalometrics

Kobayashi S, Inoue N, Ito G, Komatsu T, Ishibashi K

Bull. Tokyo Med. Dent. Univ., 1965 Mar;12(1):127-41.
PMID: 4953221
Matched MeSH terms: Cephalometry*
Three-dimensional quantitative evaluation of facial morphology in adults with unilateral cleft lip and palate, and patients without clefts

Othman SA, Ahmad R, Asi SM, Ismail NH, Rahman ZA

Br J Oral Maxillofac Surg, 2014 Mar;52(3):208-13.
PMID: 24342372 DOI: 10.1016/j.bjoms.2013.11.008

The aims of this study were to assess the quantitative values of measurements using proportion indices in the craniofacial region in patients with repaired, non-syndromic, complete unilateral cleft lip and palate (UCLP), and compare them with a control group who did not have clefts using the non-invasive systems of 3-dimensional technology. Three-dimensional measurements of the facial surfaces of 15 Malay patients who had UCLP repaired and 100 Malay control patients aged 18-25 years were analysed. The 3-dimensional images of the respondents' faces were captured using the VECTRA-3D Stereophotogrammetry System. Eleven craniofacial proportions were assessed using a combination of 18 linear measurements obtained from 21 anthropometric soft tissue landmarks. These measurements were used to produce proportion indices to find the differences in the morphological features between the groups, and assessed using the independent sample t test and z scores. There were significant differences between the groups in 7 out of 11 craniofacial proportion indices (p=0.001-0.044). Z scores of 2 indices were disproportionate. They were nasal index (which was severely supernormal) and upper lip index (which was moderately supernormal). Patients with UCLP had higher mean z scores, indicating that patients with UCLP tended to have larger faces than the control group. There were clinically important differences mainly in the nasolabial area, where the nose and the upper lip were wider, larger, or flatter in patients with UCLP.

Matched MeSH terms: Cephalometry/methods
Postnatal treatment factors affecting craniofacial morphology of unilateral cleft lip and palate (UCLP) patients in a Japanese population

Alam MK, Iida J, Sato Y, Kajii TS

Br J Oral Maxillofac Surg, 2013 Dec;51(8):e205-10.
PMID: 23099108 DOI: 10.1016/j.bjoms.2012.10.001

We have evaluated the craniofacial morphology of Japanese patients with unilateral cleft lip and palate (UCLP) and assessed the various postnatal factors that affect it. Lateral cephalograms of 140 subjects (mean (SD) aged 7 (2) years) with UCLP were taken before orthodontic treatment. Surgeons from Hokkaido University Hospital had done the primary operations. The craniofacial morphology was assessed by angular and linear cephalometric measurements. Cheiloplasty, palatoplasty, and preoperative orthopaedic treatment were chosen as postnatal factors. To compare the assessments of the postnatal factors, we made angular and linear cephalometric measurements for each subject and converted them into Z scores in relation to the mean (SD) of the two variables. Subjects treated by the modified Millard cheiloplasty had larger sella-nasion-point A (SNA) and nasion-point A-pogonion (NA-POG) measurements than subjects treated by the modified Millard with a vomer flap cheiloplasty. Two-stage palatoplasty showed consistently better craniofacial morphology than the other palatoplasty. Subjects who had preoperative orthopaedic treatment with a Hotz plate had significantly larger upper incisor/sella-nasion (U1-SN) measurements than who had no preoperative orthopaedic treatment or an active plate. We conclude that in subjects treated by a modified Millard type of cheiloplasty, a two-stage palatoplasty, and a Hotz plate there were fewer adverse effects on craniofacial morphology.

Matched MeSH terms: Cephalometry/methods*
Facial profile shape, malocclusion and palatal morphology in Malay obstructive sleep apnea patients

Banabilh SM, Samsudin AR, Suzina AH, Dinsuhaimi S

Angle Orthod, 2010 Jan;80(1):37-42.
PMID: 19852637 DOI: 10.2319/011509-26.1

To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA).

Matched MeSH terms: Cephalometry
Prevalence of snoring and craniofacial features in Malaysian children from hospital-based medical clinic population

Banabilh SM, Asha'ari ZA, Hamid SS

Sleep Breath, 2008 Aug;12(3):269-74.
PMID: 17978839 DOI: 10.1007/s11325-007-0154-6

Snoring is considered as the most common clinical symptom of obstructive sleep apnea-hypopnea syndrome. However, many snoring studies were done in western population, and data from around Asia is scarce. Therefore, the purposes of this study were to determine the prevalence of snoring among Malaysian children from hospital-based medical clinic population setting and to compare the craniofacial features of children with and without snoring using cephalometric analysis. A cross-sectional study among children aged 7-15 years were carried out in Hospital Kuala Terengganu. Sleep behavior questionnaire (Berlin questionnaire) was given to 500 children. The respondents were divided into snoring and non-snoring groups. Thirty children from each group were randomly selected to undergo a cephalometric X-ray. For each lateral cephalometric radiograph, 17 parameters consisting bony, soft tissue, and angular measurements were recorded using computer software VixWin2000. Independent t test was used to analyze the data. The results indicated that the whole questionnaire respondents were 317 (46 snoring and 271 non-snoring), hence, the prevalence of snoring in our survey population was 14.51%. The cephalometric X-ray showed that the snoring children manifested a significant different craniofacial features, such as narrow airway at the level of the soft palate and oropharynx (p < 0.05), more inferiorly positioned hyoid bone (p < 0.05), longer vertical airway length from posterior nasal spine to the base of epiglottis (p < 0.05), more protruding maxilla, and anterior-posterior discrepancy of maxilla and mandible (p < 0.05). In conclusion, our snorer children exhibit significant craniofacial differences compared to non-snorer groups.

Study site: ACC at Hospital Kuala Terengganu, MalaysiaThe ACC is a daycare center consisting of
various specialty clinics such as Pediatrics, Orthopedics,
Otorhinolaryngology, Dental, Oral-maxillofacial, General
Surgery, General Medical, Ophthalmology, Psychiatry, and
Obstetrics and Gynecology clinics.

Matched MeSH terms: Cephalometry
Fulltext Change in facial shape in two cohorts of Japanese adult female students twenty years apart

Hossain MG, Saw A, Ohtsuki F, Lestrel PE, Kamarul T

Singapore Med J, 2011 Nov;52(11):818-23.
PMID: 22173252

Secular changes in the head and body dimensions of the Japanese population were recorded during the last century, but studies on Japanese adult facial shape were poorly documented. This study aimed to document the secular changes in facial shape and their association with craniofacial measures of Japanese adult female students.

Matched MeSH terms: Cephalometry/methods*
Fulltext Multiple regression analysis of anthropometric measurements influencing the cephalic index of male Japanese university students

Hossain MG, Saw A, Alam R, Ohtsuki F, Kamarul T

Singapore Med J, 2013 Sep;54(9):516-20.
PMID: 24068061

INTRODUCTION: Cephalic index (CI), the ratio of head breadth to head length, is widely used to categorise human populations. The aim of this study was to access the impact of anthropometric measurements on the CI of male Japanese university students.

METHODS: This study included 1,215 male university students from Tokyo and Kyoto, selected using convenient sampling. Multiple regression analysis was used to determine the effect of anthropometric measurements on CI.

RESULTS: The variance inflation factor (VIF) showed no evidence of a multicollinearity problem among independent variables. The coefficients of the regression line demonstrated a significant positive relationship between CI and minimum frontal breadth (p < 0.01), bizygomatic breadth (p < 0.01) and head height (p < 0.05), and a negative relationship between CI and morphological facial height (p < 0.01) and head circumference (p < 0.01). Moreover, the coefficient and odds ratio of logistic regression analysis showed a greater likelihood for minimum frontal breadth (p < 0.01) and bizygomatic breadth (p < 0.01) to predict round-headedness, and morphological facial height (p < 0.05) and head circumference (p < 0.01) to predict long-headedness. Stepwise regression analysis revealed bizygomatic breadth, head circumference, minimum frontal breadth, head height and morphological facial height to be the best predictor craniofacial measurements with respect to CI.

CONCLUSION: The results suggest that most of the variables considered in this study appear to influence the CI of adult male Japanese students.

Matched MeSH terms: Cephalometry/methods*
Fulltext Craniofacial anthropometric norms of Malays

Ngeow WC, Aljunid ST

Singapore Med J, 2009 May;50(5):525-8.
PMID: 19495526

INTRODUCTION: This study was undertaken to establish the craniofacial anthropometric norms of young adult Malaysian Malays.
METHODS: The study group consisted of convenient samples of 100 healthy volunteers (aged 18-25 years), with an equal number of female and male subjects who had no history of mixed racial parentage. 22 linear measurements were taken twice from 22 landmarks over six craniofacial regions.
RESULTS: The Malays shared many similar sizes of measurements with the Singaporean Chinese. Their left eye fissure length and mouth width (ch-ch) were almost identical for both genders. However, Malay females had an upper lip height (sn-sto) (left) and ear width (pra-pa) similar to Singaporean Chinese females. Six other measurements, viz. the head width (eu-eu), head circumference (on-op), face height (n-gn), lower face height (sn-gn), (left) eye fissure height (ps-pi), cutaneous upper lip height (sn-ls) and cutaneous upper lip height (ls-sto), were 0.4-4.3 mm less in the Malays. Measurements for another four parameters, viz. the length of the head (g-op), biocular width (ex-ex), lower vermillion height (sto-li) and (left) ear length (sa-sba), were 0.5-3.6 mm higher in the Malays. Only three measurements were obviously different; the height of the head (v-n) and intercanthal width (en-en), were lower, and the protrusion of the nasal tip (sn-prn) was higher in the Malays.
CONCLUSION: These findings suggest that three features, i.e. the height of the head (v-n), intercanthal width (en-en) and protrusion of the nasal tip (sn-prn) may be useful in differentiating a Malay face from a Singaporean Chinese one.

Matched MeSH terms: Cephalometry
Fulltext Intrauterine growth of liveborn Malaysian infants between gestation of 28 to 42 weeks

Boo NY, Lye MS, Ong LC

Singapore Med J, 1994 Apr;35(2):163-6.
PMID: 7939812

A cross-sectional study was carried out on 8,478 consecutive normal singleton Malaysian neonates born in the Maternity Hospital, Kuala Lumpur. The objectives were to compare the mean birth-weights, crown-heel lengths and head circumferences of Malay, Chinese and Indian infants at gestation age from 28 to 42 weeks, and to construct the Malaysian growth charts. Above the gestation age of 34 weeks, the birthweights were significantly influenced by maternal gravida status (p < 0.03), ethnic origin (p < 0.001) and/or sex of the neonates (p < 0.026). Above this gestation age, neonates of multigravida mothers were significantly heavier than those of primigravida mothers; Indians were significantly lighter than Malays and Chinese; and males were significantly heavier than females. The head circumferences and body lengths of neonates were significantly influenced by ethnic origin, sex and/or maternal gravida status at gestation above 35 and 36 weeks respectively (p < 0.05). It was most likely due to the small sample size which explained our inability to detect statistically significant difference in all measurements (birthweight, length and head circumference) by sex, ethnicity and maternal gravida status at gestation below 35 weeks. Based on the measurements obtained in this study, percentile charts for the Malaysian population were constructed and made available for the first time. These charts will be useful for the assessment of Malaysian neonates during the perinatal period.

Matched MeSH terms: Cephalometry/statistics & numerical data
Fulltext Cephalometric and malocclusion analysis of Kadazan dusun ethnic orthodontic patients

Rohaya Megat Abdul Wahab, Hartini Idris, Habibah Yacob, Shahrul Hisham Zainal Ariffin

Sains Malaysiana, 2013;42(1):25-32.

The aims of this study were to assess the skeletal pattern and the malocclusion of Kadazan Dusun ethnic patients who seek for orthodontic treatment. Cephalometric radiographs (248) and 345 study models were collected from four orthodontic clinics in Sabah. The cephalometric mean values (SNA, SNB, ANB, MMA, SNMxP, UIMxP, LIMnP and ALFH) were measured and the study models were analysed for overjet, overbite, incisor and molar relationships. Some morphological or occlusal features such as shovel shape, Talon cusp, peg shape teeth, midline diastema, canine displacement and supernumerary tooth were also noted. The frequency and correlation of cephalometric mean values and prevalence of malocclusion were analysed using SPSS 18. Class I Skeletal pattern was the most common (48%) followed by Class II (33%) and Class III (18%). There was a strong correlation between SNA and SNB values (>0.70). Class II/1 incisor relationship has the highest frequency (41%) followed by Class III (32%), Class I (21%) and Class II/2 (6%). Class II Molar relationship of both right and left showed highest frequency (38%) followed by Class I (33%) and Class III (30%). Increased of overjet (44%) and reduced overbite (41%) and shovel-shaped incisor were the most common occlusal and dental features. The Kadazan Dusun patients who seek for orthodontic treatment in Sabah were mostly presented with Class I Skeletal pattern with high prevalence in Class II/1 incisor relationship, Class II molar relationship, increased overjet and reduced overbite. The orthodontic treatment pertaining to this ethnicity should be in line with the findings that will benefit patient specifically based on their common presented features.

Matched MeSH terms: Cephalometry
Fulltext Morphometric approach to 3D soft-tissue craniofacial analysis and classification of ethnicity, sex, and age

Agbolade O, Nazri A, Yaakob R, Ghani AA, Cheah YK

PLoS One, 2020;15(4):e0228402.
PMID: 32271782 DOI: 10.1371/journal.pone.0228402

BACKGROUND: The application of three-dimensional scan models offers a useful resource for studying craniofacial variation. The complex mathematical analysis for facial point acquisition in three-dimensional models has made many craniofacial assessments laborious.
METHOD: This study investigates three-dimensional (3D) soft-tissue craniofacial variation, with relation to ethnicity, sex and age variables in British and Irish white Europeans. This utilizes a geometric morphometric approach on a subsampled dataset comprising 292 scans, taken from a Liverpool-York Head Model database. Shape variation and analysis of each variable are tested using 20 anchor anatomical landmarks and 480 sliding semi-landmarks.
RESULTS: Significant ethnicity, sex, and age differences are observed for measurement covering major aspects of the craniofacial shape. The ethnicity shows subtle significant differences compared to sex and age; even though it presents the lowest classification accuracy. The magnitude of dimorphism in sex is revealed in the facial, nasal and crania measurement. Significant shape differences are also seen at each age group, with some distinct dimorphic features present in the age groups.
CONCLUSIONS: The patterns of shape variation show that white British individuals have a more rounded head shape, whereas white Irish individuals have a narrower head shape. White British persons also demonstrate higher classification accuracy. Regarding sex patterns, males are relatively larger than females, especially in the mouth and nasal regions. Females presented with higher classification accuracy than males. The differences in the chin, mouth, nose, crania, and forehead emerge from different growth rates between the groups. Classification accuracy is best for children and senior adult age groups.

Matched MeSH terms: Cephalometry*
Weight, volume and surface area of placenta of normal pregnant women and their relation to maternal and neonatal parameters in Malay, Chinese and Indian ethnic groups

Sivarao S, Vidyadaran MK, Jammal AB, Zainab S, Goh YM, Ramesh KN

Placenta, 2002 10 4;23(8-9):691-6.
PMID: 12361688

This study was conducted to determine the effect of ethnicity on maternal, placental and neonatal parameters. Maternal, placental, and the newborn parameters were corrected for gestational age. The male:female sex ratio was 1:1.03. One hundred and forty-four freshly delivered placentae from 55 Malaysian, 51 Chinese, and 38 Indian normal healthy patients were collected and standard stereological methods used to estimate the placental parameters. Pearson's correlation, Spearman's correlation and 1-way ANOVA were used to test significance of differences. Placental surface area, placental weight and placental volume of Indians were lower than Malays (P< 0.05). Placental weight correlated significantly with neonatal length (r=0.527), birthweight (r=0.665), head circumference (r=0.371) and booking weight (r=0.193) while placental volume correlated with neonatal length (r=0.588), birthweight (r=0.688), head circumference (r=0.384), parity (r=0.202) and booking weight (r=0.219) at P< 0.05. Indian babies weight and length were less than Chinese and Malay babies (P< 0.05) while booking weight of Indian mothers was less than those of Chinese mothers (P< 0.05). Even after being corrected for booking weight, placental parameters of Indian patients were still significantly less than Malays and Chinese (P< 0.05).

Matched MeSH terms: Cephalometry/ethics

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