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      Study of the influence of crossbite on the size of the apical area in a child population by analyzing panoramic X-ray

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          Abstract

          Background

          The apical area is the space in the maxillary bones that contains teeth during formation and is subsequently occupied by the apices of the permanent teeth. Its dimensions are easy to perceive and determine by observing a panoramic X-ray. Our objective was to analyze the influence of crossbite on the size of the anterior and mesial apical area in Caucasian children.

          Material and Methods

          Based on the ortopantomograph of 353 patients in mixed dentition and crossbite, the sizes of the apical areas of the four hemiarches were studied using the Tps Dig Version 2® computer program. These data were subjected to statistical analysis using the SPSS 22.0 for Windows program and applying the methods of descriptive statistics of quantitative variables, the Kolmogorov-Smirnov test, the non-parametric test Mann-Whitney-Wilcoxon test, and the paired Student t-test.

          Results

          In the group of boys, average values in the superior-mesial, superior-anterior, inferior-mesial and inferior-anterior apical areas of the crossbite were 173.43, 99.85, 180.32 and 87.56 respectively, with the lower values being in the hemiarch without malocclusion. In the group of girls, for the same apical areas, average values were 165.64, 94.24, 168.62 and 83.34 respectively, with all the highest values being in the hemiarch with crossbite, except for the inferior-mesial apical area. Statistically significant differences were found in the hemiarch with crossbite between both genders in the superior-anterior, inferior-anterior and inferior-mesial apical areas, with the significance being 0.001, 0.029 and 0.001 respectively, while in the hemiarch without malocclusion significance was observed in the superior-mesial, superior-anterior and inferior-mesial apical areas, with values of 0.004, 0.001 and 0.004, respectively.

          Conclusions

          Crossbite affects the size of the anterior apical area in both arches and in both genders. The mesial apical area is influenced by this malocclusion in the jaw in boys and in the maxilla girls.

          Key words:Apical area, ortopantomography, crossbite.

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          Most cited references14

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          Reproducibility of rotational panoramic radiography: mandibular linear dimensions and angles.

          D B Svanaes, T A Larheim (1986)
          The reproducibility of nine mandibular variables (linear dimensions and angles) assessed from panoramic radiographs with the Orthopantomograph 5 (Siemens) was investigated. Attention was given to the possible influence of recording the reference number of the head positioner with one or two radiographers. Two separate exposures of three groups of patients were made under different radiographic conditions, each group representing one method. Acceptable reproducibility was observed for the vertical and angular variables, the method variance being mostly within 3% of the total variance. Horizontal variables were clearly more unreliable. No statistically significant differences were observed between the reproducibility of the right and left sides. A negative correlation was found between the angular variables within two groups. For most variables, only small differences among the methods were found. The highest reliability was obtained when the same radiographer recorded the reference number of the head positioner and made both exposures. An accuracy study on five dried skulls showed an image magnification of approximately 18% to 21% for the vertical variables, whereas the gonial angle assessed from a panoramic film was almost identical to that measured on the dried mandible.
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            Accuracy of measurements of mandibular anatomy and prediction of asymmetry in panoramic radiographic images.

            Melanie Ludlow, W Laster, Clair H. Hershey … (2005)
            Measurements of ideally positioned and systematically mis-positioned skulls were used to evaluate errors in linear measurements and symmetry ratios made with panoramic X-ray images. Digital panoramic images of 30 skulls placed in ideal, shifted and rotated positions, were assessed by measuring distances between anatomic points and fiducial references. Differences between photographic measurements (control) and radiographic measurements were compared. Horizontal measurements included a 20 mm wire and the distance from gonion to mental foramen (G-MF). Vertical distances measured included a 40 mm wire, condyle to sigmoid notch length, and condyle to gonion (posterior mandibular height or PMH). A relative symmetry ratio comparing the difference between right and left PMH was also calculated. Distances measured in panoramic images were corrected using the left vertical wire distance or the panoramic unit's stated magnification factor (1.25x). Greatest differences were noted for horizontal measurements and shifted skull positions. Use of an arbitrary magnification correction was consistently less accurate than use of an internal calibration and resulted in general underestimation of actual dimensions. Measures of PMH varied significantly from expected values for each of the three skull positions (P<0.005). Panoramic accuracy for detecting asymmetry was 67% for ideal, 70% for rotated, and 47% for shifted skull positions when an internal reference was used. Panoramic radiographs should be used with caution in making absolute measurements or relative comparisons. Even when internal fiducial calibration for image distortion of anatomy is used, measurements such as those assessing posterior mandibular facial symmetry may be unreliable.
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              Accuracy of linear and angular measurements on panoramic radiographs taken at various positions in vitro.

              M Darendeliler, Joseph P Geenty, Steve Stramotas … (2002)
              The accuracy of measurement of tooth length and angulation on dental panoramic tomograms (DPTs) is thought to be highly dependent on head positioning technique. A model representing the dentition and the functional occlusal plane was designed using an acrylic framework and stainless steel wires. The aim was to investigate whether varying the position of the model affects the linear and angular measurements on DPTs. Four different positions were investigated: initial position representing natural head posture (NHP) (T1); lateral right cant of the occlusal plane (T2); lateral left cant of the occlusal plane (T3); and tilting the occlusal plane up anteriorly (T4). On each DPT, four sets of measurements were recorded: (1) Vertical linear measurements of the stainless steel pins and ratio calculations of the 'crown' and 'root' segments (represented by the wire above and below the occlusal plane, respectively); (2) angular measurements of the pins relative to the occlusal plane; (3) angular measurements of the pins relative to a constructed reference line; and (4) angular measurements of pins relative to each other in the same segment. The results showed a significant error (P < 0.05) in all measurements when the occlusal plane was tilted up anteriorly by 8 degrees. A lateral cant of the occlusal plane by less than 10 degrees without an upward anterior rotation showed no significant effect on the measurements. This would suggest that there is some tolerance of variation in head position.
              Article 0 comments Cited 24 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Exp Dent
                Journal ID (iso-abbrev): J Clin Exp Dent
                Journal ID (publisher-id): Medicina Oral S.L.
                Title: Journal of Clinical and Experimental Dentistry
                Publisher: Medicina Oral S.L.
                ISSN (Electronic): 1989-5488
                Publication date (Electronic): 1 August 2018
                Publication date Collection: August 2018
                Volume: 10
                Issue: 8
                Pages: e768-e771
                Affiliations
                [1 ]DMD, MS, PhD, Clinical Assistant Professor of Pediatric Dentistry, Department of Specialties Dental Clinics, Faculty of Dentistry, Complutense University of Madrid
                [2 ]DMD, MS, PhD, Associate Professor of Pediatric Dentistry, Department of Specialties Dental Clinics, Faculty of Dentistry, Complutense University of Madrid. Assistant Professor in the Dentistry Department. School of Biomedical Science. European University of Madrid
                [3 ]DMD, MS, PhD, Associate Professor of Pediatric Dentistry, Department of Specialties Dental Clinics, Faculty of Dentistry, Complutense University of Madrid
                [4 ]DMD, MS, PhD, Contract Doctor Professor of Pediatric Dentistry, Department of Specialties Dental Clinics, Faculty of Dentistry, Complutense University of Madrid
                Author notes
                Facultad de Odontología Universidad Complutense de Madrid Plaza de Ramón y Cajal, 3 28040 Madrid, España , E-mail: narodrig@ 123456ucm.es

                Conflict of interest statement: The authors have declared that no conflict of interest exist.

                Article
                Publisher ID: 54915
                DOI: 10.4317/jced.54915
                PMC ID: 6174011
                SO-VID: 616843f5-5724-4bd4-b3b4-3eb7aa67f7fa
                Copyright © Copyright: © 2018 Medicina Oral S.L.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date accepted : 5 July 2018
                Date received : 10 April 2018
                Categories
                Subject: Research
                Subject: Orthodontics

                Data availability:

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