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      The predictability of dentoskeletal factors for soft-tissue chin strain during lip closure

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          To investigate the dentoskeletal factors which may predict soft-tissue chin strain during lip closure.


          The pretreatment frontal and lateral facial photographs and lateral cephalograms of 209 women (aged 18-30 years) with Angle's Class I or II malocclusion were examined. The subjects were categorized by three examiners into the no-strain and strain groups according to the soft-tissue chin tension or deformation during lip closure. Relationships of the cephalometric measurements with the group classification were analyzed by logistic regression analysis, and a classification and regression tree (CART) model was used to define the predictive variables for the group classification.


          The lower the value of the overbite depth indicator (ODI) and the higher the values of upper incisor to Nasion-Pogonion (U1-NPog, mm), overjet, and upper incisor to upper lip (U1-upper lip, mm), the more likely was the subject to be classified into the strain group. The CART showed that U1-NPog was the most prominent predictor of soft-tissue chin strain (cut-off value of 14.2 mm), followed by overjet.


          To minimize strain of the soft-tissue chin, orthodontic treatment should be oriented toward increasing the ODI value while decreasing the U1-NPog, overjet, and U1 upper lip values.

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          Most cited references 22

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          Lip posture and its significance in treatment planning.

           C Burstone (1967)
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            A longitudinal study of soft tissue facial structures and their profile characteristics, defined in relation to underlying skeletal structures

             J.D. Subtelny (1959)
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              Determination of smoking and obesity as periodontitis risks using the classification and regression tree method.

              A model that focuses on personal risk factors associated with poor lifestyle has been proposed for the etiology of generalized periodontitis. Numerous investigations have linked individual lifestyle-related factors to periodontitis risk; however, a definite relationship among lifestyle-related factors remains unclear. The objective of this study was to determine which lifestyle-related factors demonstrated the greater impact on periodontitis risk. The association of lifestyle-related factors, such as smoking status and obesity, with periodontitis was assessed in 372 Japanese workers via a self-administered questionnaire. Smoking status and obesity were evaluated in terms of pack-years and body mass index (BMI), respectively. Clinical periodontal examination included probing depth (PD). The effective impact on periodontitis risk was analyzed by the classification and regression tree (CART) method and multiple logistic regression analysis. Simple logistic regression analyses revealed that factors such as age, gender, alcohol consumption, smoking status, BMI, and frequency of toothbrushing were associated with periodontitis. CART results demonstrated a significant correlation between periodontitis and pack-years, BMI, and age; in contrast, alcohol consumption, gender, and toothbrushing frequency were not correlated with periodontitis. The strongest factor for periodontitis risk was pack-years of smoking. Additionally, both pack-years and BMI exhibited clear dose-response relationships with periodontitis. These relationships were maintained despite adjustment for known confounding factors. Smoking displays the greatest impact on periodontitis among lifestyle-related factors. Both smoking and obesity are independent risk indicators for periodontitis; moreover, these parameters exhibit a dose-response relationship with respect to periodontitis risk.

                Author and article information

                Korean J Orthod
                Korean J Orthod
                Korean Journal of Orthodontics
                Korean Association of Orthodontists
                December 2013
                09 December 2013
                : 43
                : 6
                : 279-287
                Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Korea.
                Author notes
                Corresponding author: Yae-Jin Kim. Clinical Instructor, Department of Dentistry, Korea University Anam Hospital, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. Tel +82-2-920-6498, estelle7@ 123456korea.ac.kr
                © 2013 The Korean Association of Orthodontists.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Original Article


                soft-tissue chin, classification and regression tree, mentalis


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