|Year : 2021 | Volume
| Issue : 4 | Page : 98-102
Cephalometric evaluation based on Steiner's analysis in local population of Uttarakhand
Dhananjay Rathod1, Santosh Kumar2, Arya Priyadarshini3, Amrita Pritam3, Binita Venugopal3, Jyoti Kumari3
1 Reader, Department of Orthodontics and Dentofacial Orthopaedics, Vananchal Dental College, Garhwa, Jharkhand, India
2 Senior Lecturer, Department of Orthodontics and Dentofacial Orthopaedics, Vananchal Dental College, Garhwa, Jharkhand, India
3 Post Graduate Student, Department of Orthodontics and Dentofacial Orthopaedics, Vananchal Dental College, Garhwa, Jharkhand, India
|Date of Submission||12-Aug-2021|
|Date of Acceptance||27-Aug-2021|
|Date of Web Publication||23-Dec-2021|
Dr. Dhananjay Rathod
Department of Orthodontics and Dentofacial Orthopaedics, Vananchal Dental College, Garhwa, Jharkhand
Source of Support: None, Conflict of Interest: None
Objective: The purpose of the study was to evaluate and establish norms for the class I subjects of Uttarakhand population using the Steiners Analysis.
Aims and Objectives: 1. To Establish Cephalometric norms for population in Uttarakhand Using Anteroposterior and Vertical Dimensions. 2. To Compare the hard and soft Tissue Cephalometric Norms of Individuals of Uttarakhand by Steiners Analysis. 3. To Compare male and female cephalometric norms of individuals of Uttarakhand.
Materials and Method: The sample included pre-treatment lateral cephalograms of 60 subjects belongIng to Uttarakhand and possessing a skeletal class I malocclusion with pleasing profile (age 11-36 years).
Results: The Mean values obtained fro the male and female subjects were compared to that of caucasian Populations and statistical different obtained were used to create a new value for the Uttarakhand Population.
Conclusion: Beta angle is relatively a stable parameter in population with different ethnicities.
Keywords: Cephalometrics, steiners, Uttarakhand
|How to cite this article:|
Rathod D, Kumar S, Priyadarshini A, Pritam A, Venugopal B, Kumari J. Cephalometric evaluation based on Steiner's analysis in local population of Uttarakhand. Int J Prev Clin Dent Res 2021;8:98-102
|How to cite this URL:|
Rathod D, Kumar S, Priyadarshini A, Pritam A, Venugopal B, Kumari J. Cephalometric evaluation based on Steiner's analysis in local population of Uttarakhand. Int J Prev Clin Dent Res [serial online] 2021 [cited 2022 Jan 20];8:98-102. Available from: https://www.ijpcdr.org/text.asp?2021/8/4/98/333543
| Introduction|| |
Orthodontic treatment is best when the facial and cephalometric characteristics of the local population are considered. The orthodontic literature contains many studies involving cephalometric and profile standards of European-American, African-American, Japanese and Chinese populations,,,,,,, little for Arabs and Saudis in specific,,,, but very few in Indian population and none on the local population of Uttarakhand. The analysis of Steiner is considered to be the first modern cephalometric analysis. ANB angle, which indicates the skeletal discrepancy of the jaws, became one of the specific guides in treatment planning. The importance of cephalometric norms relevant to particular age and local population is well known. But as clinicians in this part of the country, we need to set up our own cephalometric norms for local population. As more and more individuals residing in Uttarakhand state are seeking orthodontic treatment, it becomes important for orthodontist in uttarakhand to know the cephalometric norms of this local population. This investigation is to study the skeletal, dental and soft tissue pattern which comprises people from uttarakhand and to relate the norms of this population with Caucasians.
Aims and objectives
- To establish cephalometric norms for population in Uttarakhand using anteroposterior and vertical dimensions
- To compare the hard and soft tissue cephalometric norms of individuals of Uttarakhand by Steiner cephalometric analysis
- To compare male and female cephalometric norms of individuals of Uttarakhand.
| Materials and Methods|| |
The present study was conducted in the department of orthodontics and dentofacial orthopedics which comprised of 60 subjects 16 males and 44 females between the age of 11–36 years residing in Uttarakhand. The individuals included in the study were selected by the data available in the department and those undergoing orthodontic treatment. All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval and clearance was obtained from the ethical committee of our institution. A written informed consent was obtained from each participant.
- The inclusion and exclusion criteria for the subjects to be included in subjects with
- Angle's Class I, Class II, Class III, dental malocclusion were selected
- Visiting Department of Orthodontics and Dentofacial orthopedics, who already visited for the treatment
- Full complement of teeth (except third molars).
- Subjects with gross facial asymmetry
- Subjects with pregnancy
- Subjects with any congenital abnormality and facial trauma
- Subjects below age group 11 and above age 36
- Subjects who were not willing to participate in study.
For this purpose, all the lateral cephalometric having similar orientation and magnification were taken from the standardized Planmeca Proline XC Dima x3 OPG machine with a Cephalostat (Dentsply Italia, Italy) on a standard Kodak C-MAT Green sensitive 8 × 10 inch film with an anode-to-midsubject distance of 5 feet. Subjects were asked to look straight in a long mirror which was placed in front of them, and plumb line was placed on the right side of the subject to obtain natural head position [Figure 1]. Thyroid shield and lead apron were worn by the subject to reduce radiation exposure. All the films were exposed with 80 KVp, 7.5 mA, and an exposure time of 2.5 s. All the radiographs were traced on a standard matte acetate tracing paper in a random order by a single operator to reduce bias. Each landmark and point were rechecked, and then, Steiner's analysis was done.
| Results|| |
The collected data were analyzed statistically using SPSS software (version 10 Inc., Chicago, IL, USA). The mean value of the male and female samples was compared to that of the Caucasian males and females [Table 1],[Table 2],[Table 3].
|Table 3: Comparison of values of Steiner's analysis between males and females in the present study|
Click here to view
Data obtained was compiled on an MS Office Excel Sheet (v 2010) and was subjected to statistical analysis using the Statistical package for the social sciences (SPSS v 21.0, IBM).
- Normality of data was determined using Kolmogorov–Smirnov test and it was found that data followed a normal curve, hence parametric tests were used
- Intergroup comparison of all variables (between 2 groups like males vs. females) was done using t-test
- Intergroup comparison of all variables (between >2 groups like Class) was done using one-way ANOVA test
- Intergroup comparison of all variables (between 2 groups like present study versus Caucasian STD) was done using one-sample t-test
- For all the statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and β error at 20%, thus giving a power to the study as 80%.
| Discussion|| |
This study was carried out to evaluate and compare the cephalometric parameters between the male and females in a local population of Uttarakhand and compare them with that of the Caucasian population. Certain variations in the dimensions of the present study were significantly different than those obtained by Steiner, although all selected individuals had a pleasant appearance and good facial harmony.
SNA angle: The mean value of SNA angle in the present study was slightly greater for males (84.25 ± 3.9) than females (83.65 ± 4.2) than those presented by Steiner (82 ± 2°), indicating maxillary protrusion relative to cranial base as compared to those given by Steiner.
SNB angle: The mean value of SNB angle in the present study was significantly less in Mewari children (77.15° ±2.52°) than those presented by Steiner (80 ± 2°), indicating mandibular retrusion relative to cranial base. The SNB angle found in the present study is in agreement with the studies done by Bishara SE (1982) (SNB – 78.5°) and Franchi L et al. (1989) (SNB – 78.52°) on North Indian and Aryo-Dravidians, respectively.
ANB angle: The mean value of ANB angles for Mewari (3.05 ± 1.38°) children was slightly more than those presented by Steiner (2°), indicating greater convexity. This is in agreement with the study done by bishara (1982) on North Indian children (ANB – 3.12°), Huang et al..(1990) on North Indian preschool children (4.95°) and mcnamara in (2001) on children of South Kanara (ANB – 3.2°). Significant difference of ANB angle in all these studies was found when compared with those presented by Steiner.
Occlusal plane angle: In the present study, the mean of occlusal plane angle for Mewari (19.73o ± 1.52o) children showed a significant difference than measurements given by Steiner (14°). This indicates more anteriorly placed occlusal plane as compared to those given by Steiner. This is in agreement with the study done by Huang et al..(1990) on North Indian preschool children (occlusal angle– 21.7°) which is greater than those presented by Steiner.
Mandibular plane angle suggests growth patterns in individuals, and the mean values of this angle for Mewari (30.36 ± 1.59°) children were slightly less than those presented by Steiner (32°). This finding is in agreement with the study done by Condo (1975) on dentofacial patterns of Gurkhas (mandibular plane angle–29.7°) and Davis et al..(1976) on Madras population (mandibular plane angle–31.0°), where mandibular plane angle was lesser than the value given by Steiner.
Maxillary incisor position represents the relative location and axial inclination of the upper incisors.
The upper incisor to N-A reading in degrees indicates the relative angular relationship of the upper incisor teeth to N-A line, and the mean value of maxillary incisor position in degrees in the present study for Mewari (23.98 ± 5.19°) children is significantly higher than those presented by Steiner indicating more labial inclination of maxillary teeth in Mewari children.
The upper incisors to N-A reading in millimeters provide information on the relative forward or backward positioning of the incisor teeth to N-A line, and the mean value in the present study for Mewari (5.11 ± 2.39 mm) children is significantly higher than those presented by Steiner indicating more forward positioning of maxillary teeth in Mewari and children.
This finding is in agreement with the study done by Hamdan (1975) on Indian population in which she had concluded that the teeth of people from India were more labially placed. This finding is also in agreement with the study done by Davis et al..(1976) on Madras population (Angular measurement – 23.5°, linear measurement – 4.2 mm) and also study done by Bishara (1982) on North Indian children (angular measurement – 24.9°, linear measurement – 4.9 mm) where both the angular and linear measurements were more as compared to those given by Steiner.
Mandibular incisor position represents the relative anteroposterior location and angulation of the lower incisor teeth.
The lower incisor to N-B line in degrees indicates relative angular relation. The mean value of mandibular incisor position in degrees in the present study for Mewari (28.36 ± 4.18°) children is significantly higher than those presented by Steiner indicating more labial inclination of mandibular teeth in Mewari children.
The lower incisors to N-B reading in millimeters provide information on the relative forward or backward positioning of the incisor teeth to N-B line, and the mean values in the present study for Mewari (5.34 ± 2.07 mm) children are significantly higher than those presented by Steiner, indicating more forward positioning of mandibular teeth in Mewari children.
This finding is in agreement with the study done by Huang (1975), mcnamara (1976) on Indian population in which she had concluded that the incisor teeth of people from India were more labially placed. This finding is also in agreement with the study done by Davis et al..(1976) on Madras population (angular measurement– 26°, linear measurement– 5.2 mm) and also in a study done by Bishara (1982) on North Indian children (angular measurement– 27.8° and linear measurement 6 mm) where both the angular and linear measurements were more as compared to that given by Steiner.
Interincisal angle relates the relative position of the upper incisor to that of the lower incisors. The mean value of interincisal angle in the present study for Mewari (123.63 ± 7.19°) children is significantly lower than those given by Steiner, indicating proclined maxillary and mandibular teeth.
This finding is in agreement with the study done by Sarban et al..(1969) on North Indians in which they had reported acute interincisal angle suggesting more vertical incisors in North Indians, Hamdan (1975) on Indian population (interincisal angle – 119°) in which she had concluded that the incisor teeth of people from India were more labially placed.
This finding is also in agreement with the study done by Al Jasser et al..(2000) in which it was found that interincisal angle was less for North Indians as compared to Caucasians and was concluded that North Indians have more proclined lower incisors as compared to Caucasians.
Lower incisor to chin indicates the prominence of chin when compared with lower incisors. The mean value of lower incisor to chin in the present study for Mewari (1.71 ± 1.38 mm) children is significantly lesser than those presented by Steiner (4 mm), indicating less prominence of chin to lower incisors for Mewari children as compared to those given by Steiner.
| Conclusions|| |
The findings of the present study have revealed that certain fundamental variation exists in the craniofacial structures of the so-called well-balanced faces of Uttarakhand population when compared with Steiner's norms. The following differences and similarities were demonstrated in the Uttarakhand samples as compared to the Caucasian samples.
- The anterior-posterior position of the apical base of the maxilla and mandible in relation to the anterior cranial base was more anteriorly placed or prognathic as compared to the Caucasian samples
- Uttarakhand male group had a more prognathic maxilla than the female group
- The angular relationship of the mandibular plane in relation to the cranial base plane (SN-Go-Gn angle) was average which was suggestive of an average growth pattern in the Uttarakhand's population
- The Uttarakhand population has a protrusive alveodental pattern when compared to the Caucasians. The labial inclination of the incisors was found to be more in the female Jharkhand subjects
- There was a wide divergence of the S-Line distance in the Uttarakhand population when compared to the Caucasians.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Downs WB. Analysis of the dentofacial profile. Angle Orthod 1956;26:191.
Riedel RA. The relation of maxillary structures to cranium in malocclusion and in normal occlusion. Angle Orthod. 1952;22:142-145.
Bishara SE. Longitudinal cephalometric standards from 5 years of age to adulthood. Am J Orthod 1981;79:35-44.
Franchi L, Baccetti T, McNamara JA Jr., Cephalometric floating norms for North American adults. Angle Orthod 1998;68:497-502.
Huang WJ, Taylor RW, Dasanayake AP. Determining cephalometric norms for caucasians and African Americans in Birmingham. Angle Orthod 1998;68:503-11.
Miyajima K, McNamara JA Jr, Kimura T, Murata S, Iizuka T. Craniofacial structure of Japanese and European-American adults with normal occlusions and well-balanced faces. Am J Orthod Dentofacial Orthop 1996;110:431-8.
Kondo S, Wakatsuki E, Shibagaki H. A somatometric study of the head and face in Japanese adolescents. Okajimas Folia Anat Jpn 1999;76:179-85.
So LL, Davis PJ, King NM. “Wits” appraisal in Southern Chinese children. Angle Orthod 1990;60:43-8.
Hamdan AM, Rock WP. Cephalometric norms in an Arabic population. J Orthod 2001;28:297-300.
Shalhoub SY, Sarhan OA, Shaikh HS. Adult cephalometric norms for Saudi Arabians with a comparison of values for Saudi and North American Caucasians. Br J Orthod 1987;14:273-9.
Sarhan OA, Nashashibi IA. A comparative study between two randomly selected samples from which to derive standards for craniofacial measurements. J Oral Rehabil 1988;15:251-5.
Al-Jasser NM. Cephalometric evaluation of craniofacial variation in normal Saudi population according to Steiner analysis. Saudi Med J 2000;21:746-50.
Ioi H, Nakata S, Nakasima A, Counts AL. Comparison of cephalometric norms between Japanese and Caucasian adults in antero-posterior and vertical dimension. Eur J Orthod 2007;29:493-9.
[Table 1], [Table 2], [Table 3]