Evaluation of Skeletal, Dentoalveolar, and Sagittal Airway Changes Induced by the Mandibular Anterior Repositioning Appliance (MARA) in Class II Malocclusion: A Retrospective Controlled Study on Lateral Cephalograms
Abstract
:1. Introduction
2. Materials and Methods
2.1. Cephalometric Analysis
- SNA (°): angle between sella, nasion, and subspinale point A. It indicates the antero-posterior position of the maxilla relative to anterior cranial base (Figure 1, 1);
- SNB (°): angle between sella, nasion, and supramentale point B. It indicates the antero-posterior position of the mandible to anterior cranial base (Figure 1, 2);
- ANB (°): angle resulting from the difference between the SNA and SNB angles, which provide an indication of the sagittal skeletal relationships (Figure 1, 3);
- Wits (mm): is the measure of the segment Ao-Bo where Ao and Bo indicate respectively the projection of point A and point B on the occlusal plane (Figure 2, a);
- SN-Occlusal Plane (°): angle between the cranial base (SN) and the occlusal plane (Figure 1, 4);
- SN-Palatal Plane (°): angle between the cranial base (SN) and the palatal plane (Figure 1, 5);
- SN-Mandibular Plane (°): angle between the cranial base (SN) and the mandibular plane (Figure 1, 6);
- Palatal Plane-Mandibular Plane (°): angle between the bispinal plane and the mandibular plane, expressing intermaxillary divergence (Figure 1, 7);
- Co-Gn (mm): distance from condylion to anatomic gnathion, expressing total mandibular length (Figure 2, b);
- Co-Go (mm): distance from condylion to gonion, expressing the height of the mandibular ramus (Figure 2, c);
- Co-Go-Me (°): mandibular angle (Figure 1, 8);
- Overjet (mm): parameter indicating the measurement of the distance in the sagittal plane between the incisal margin of the upper incisors and the vestibular surface of the lower incisors (Figure 2, d);
- Overbite (mm): distance in the vertical plane between the incisal margin of the upper and lower central incisors (Figure 2, e);
- Molar relationship (mm): distance between the projections in the occlusal plane of the point of contact between the first permanent molars and the adjacent mesial tooth (second deciduous molar or second premolar) (Figure 2, f);
- Inc. Sup.-Pal. Pl. (°): angle expressing the inclination of the axis of the upper central incisor relative to the palatal plane (Figure 1, 9);
- Inc. Inf.-Mand. Pl. (°): angle expressing the inclination of the axis of the lower central incisor relative to the mandibular plane (Figure 1, 10);
- PNS-AD1 (mm): lower airway dimension; distance between the PNS and the nearest adenoid tissue measured through the PNS-Ba line (AD1) (Figure 3, g);
- AD1-Ba (mm): lower adenoid size; defined as the soft tissue thickness at the posterior nasopharynx wall through the PNS-Ba line (Figure 3, h);
- PNS-AD2 (mm): upper airway dimension; distance between the PNS and the nearest adenoid tissue measured through a perpendicular line to S-Ba from PNS (AD2) (Figure 3, i);
- AD2-H (mm): upper adenoid size; defined as the soft tissue thickness at the posterior nasopharynx wall through the PNS-H line (H, Hormion, point located at the intersection between the perpendicular line to S-Ba from PNS and the cranial base) (Figure 3, I);
- McNamara’s upper pharynx dimension (mm): the minimum distance between the upper soft palate and the nearest point on the posterior pharynx wall (Figure 3, m);
- McNamara’s lower pharynx dimension (mm): the minimum distance between the point where the posterior tongue contour crosses the mandible and the nearest point on the posterior pharynx wall (Figure 3, n).
2.2. Method Error
2.3. Statistical Analyses
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Variables | MARA Group (n = 24) | Control Group (n = 20) | Diff. | p-Value | ||
---|---|---|---|---|---|---|
Mean | SD | Mean | SD | |||
Age at T1 (years) | 13.8 | 2.0 | 13.8 | 1.8 | 0.0 | 0.902 |
Age at T2 (years) | 15.7 | 1.9 | 15.4 | 1.6 | 0.3 | 0.517 |
T1-T2 interval (years) | 1.9 | 0.4 | 1.6 | 0.5 | 0.3 | 0.071 |
CVM at T1 | CS1 = 4; CS2 = 3; CS3 = 2; CS4 = 6; CS5 = 6; CS6 = 2 | CS1 = 3; CS2 = 3; CS3 = 1; CS4 = 4; CS5 = 7; CS6 = 2 | 0.980 | |||
CVM at T2 | CS2 = 2; CS3 = 4; CS4 = 7; CS5 = 5; CS6 = 5 | CS2 = 1; CS3 = 4; CS4 = 5; CS5 = 7; CS6 = 3 | 0.862 |
Variables | MARA Group (n = 24) | Control Group (n = 20) | Diff. | p-Value | 95% CI of the Difference | |||
---|---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Lower | Upper | |||
Age (years) | 13.8 | 2.0 | 13.8 | 1.8 | 0.0 | 0.902 | −1.1 | 1.2 |
SNA (deg) | 80.3 | 4.2 | 81.1 | 3.2 | −0.8 | 0.517 | −3.0 | 1.5 |
SNB (deg) | 75.4 | 3.2 | 75.9 | 2.8 | −0.5 | 0.632 | −2.3 | 1.4 |
ANB (deg) | 4.9 | 2.4 | 5.2 | 1.6 | −0.3 | 0.638 | −1.6 | 1.0 |
Wits (mm) | 2.7 | 2.5 | 2.3 | 3.1 | 0.4 | 0.591 | −1.3 | 2.2 |
SN-Occ. Pl. (deg) | 17.2 | 3.6 | 17.8 | 3.8 | −0.6 | 0.551 | −2.9 | 1.6 |
SN-Pal. Pl. (deg) | 7.8 | 2.9 | 7.8 | 2.9 | 0.0 | 0.974 | −1.7 | 1.8 |
SN-Mand. Pl. (deg) | 31.8 | 6.1 | 30.5 | 4.7 | 1.3 | 0.424 | −2.0 | 4.7 |
Pal. Pl. to Mand. Pl. (deg) | 24.0 | 5.7 | 22.7 | 5.0 | 1.3 | 0.431 | −2.0 | 4.6 |
Co-Gn (mm) | 103.5 | 12.8 | 102.7 | 5.9 | 0.8 | 0.175 | ||
Co-Go (mm) | 52.6 | 7.6 | 52.2 | 4.5 | 0.4 | 0.465 | ||
Co-Go-Me (deg) | 121.6 | 6.2 | 121.5 | 5.4 | 0.1 | 0.948 | −3.5 | 3.7 |
Overjet (mm) | 4.9 | 2.0 | 4.9 | 1.3 | 0.0 | 0.936 | −1.1 | 1.0 |
Overbite (mm) | 2.9 | 1.8 | 4.1 | 2.2 | −1.2 | 0.062 | −2.4 | 0.1 |
Molar Relationship (mm) | −0.1 | 1.5 | −0.6 | 1.7 | 0.5 | 0.338 | −0.5 | 1.5 |
Upper Inc. to Pal. Pl. (deg) | 111.2 | 7.3 | 107.4 | 7.6 | 3.8 | 0.099 | −0.7 | 8.3 |
Lower Inc. to Mand. Pl. (deg) | 102.0 | 6.5 | 103.5 | 7.8 | −1.5 | 0.495 | −5.8 | 2.9 |
PNS-AD1 (mm) | 22.9 | 4.8 | 23.7 | 3.3 | −0.8 | 0.536 | −3.3 | 1.8 |
AD1-Ba (mm) | 20.6 | 4.3 | 18.5 | 4.3 | 2.1 | 0.115 | −0.5 | 4.7 |
PNS-AD2 (mm) | 18.1 | 3.9 | 18.7 | 4.1 | −0.6 | 0.649 | −3.0 | 1.9 |
AD2-H (mm) | 11.3 | 3.7 | 10.6 | 3.8 | 0.7 | 0.529 | −1.6 | 3.0 |
McNa Upper Pharinx (mm) | 12.4 | 3.9 | 12.6 | 3.4 | −0.2 | 0.809 | −2.5 | 2.0 |
McNa Lower Pharinx (mm) | 9.4 | 2.6 | 10.2 | 2.8 | −0.8 | 0.297 | −2.5 | 0.8 |
Variables | MARA Group (n = 24) | Control Group (n = 20) | Diff. | p-Value | 95% CI of the Difference | |||
---|---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Lower | Upper | |||
SNA (deg) | −0.3 | 1.1 | 0.0 | 1.2 | −0.3 | 0.301 | −1.1 | 0.3 |
SNB (deg) | 0.4 | 1.0 | 0.1 | 1.3 | 0.3 | 0.476 | −0.4 | 0.9 |
ANB (deg) | −0.7 | 1.0 | −0.1 | 0.9 | −0.6 | 0.038 | −1.2 | 0.0 |
Wits (mm) | −1.0 | 1.7 | 0.4 | 1.6 | −1.4 | 0.009 | −2.4 | −0.4 |
SN-Occ. Pl. (deg) | 0.3 | 2.9 | −0.7 | 2.6 | 1.0 | 0.251 | −0.7 | 2.7 |
SN-Pal. Pl. (deg) | 0.4 | 0.9 | 0.8 | 1.4 | −0.4 | 0.252 | −1.2 | 0.3 |
SN-Mand. Pl. (deg) | −1.3 | 3.3 | −0.5 | 1.6 | −0.8 | 0.532 | ||
Pal. Pl. to Mand. Pl. (deg) | −1.7 | 3.0 | −1.3 | 1.9 | −0.4 | 0.887 | ||
Co-Gn (mm) | 3.2 | 2.4 | 3.0 | 2.3 | 0.2 | 0.732 | ||
Co-Go (mm) | 2.3 | 1.7 | 2.2 | 1.7 | 0.1 | 0.785 | −0.9 | 1.2 |
Co-Go-Me (deg) | −1.1 | 2.4 | −1.5 | 1.7 | 0.4 | 0.570 | −0.9 | 1.6 |
Overjet (mm) | −2.2 | 2.2 | −0.3 | 0.9 | −1.9 | 0.001 | −3.0 | −0.8 |
Overbite (mm) | −1.4 | 1.9 | 0.1 | 1.0 | −1.5 | 0.005 | ||
Molar Relationship (mm) | 1.6 | 2.0 | −0.2 | 0.9 | 1.8 | 0.000 | 0.9 | 2.8 |
Upper Inc. to Pal. Pl. (deg) | −1.4 | 7.2 | 0.6 | 2.9 | −2.0 | 0.249 | −5.5 | 1.5 |
Lower Inc. to Mand. Pl. (deg) | 3.2 | 4.3 | 0.5 | 2.1 | 2.7 | 0.012 | 0.6 | 4.9 |
PNS-AD1 (mm) | 0.6 | 2.2 | 0.4 | 3.5 | 0.2 | 0.855 | −1.6 | 1.9 |
AD1-Ba (mm) | −0.1 | 2.3 | 0.3 | 3.0 | −0.4 | 0.211 | ||
PNS-AD2 (mm) | 1.5 | 2.4 | 0.4 | 2.7 | 1.1 | 0.162 | −0.5 | 2.7 |
AD2-H (mm) | −1.2 | 2.5 | 0.1 | 3.1 | −1.3 | 0.130 | −3.0 | 0.4 |
McNa Upper Pharinx (mm) | 1.6 | 2.5 | 0.9 | 2.4 | 0.7 | 0.342 | −0.8 | 2.2 |
McNa Lower Pharinx (mm) | 1.9 | 0.4 | 1.6 | 0.5 | 0.3 | 0.641 | −1.7 | 1.1 |
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Statie, M.D.; Franceschi, D.; Pierleoni, F.; Barone, V.; Popovic, N.; Nardi, C.; Franchi, L.; Giuntini, V. Evaluation of Skeletal, Dentoalveolar, and Sagittal Airway Changes Induced by the Mandibular Anterior Repositioning Appliance (MARA) in Class II Malocclusion: A Retrospective Controlled Study on Lateral Cephalograms. Appl. Sci. 2022, 12, 1484. https://doi.org/10.3390/app12031484
Statie MD, Franceschi D, Pierleoni F, Barone V, Popovic N, Nardi C, Franchi L, Giuntini V. Evaluation of Skeletal, Dentoalveolar, and Sagittal Airway Changes Induced by the Mandibular Anterior Repositioning Appliance (MARA) in Class II Malocclusion: A Retrospective Controlled Study on Lateral Cephalograms. Applied Sciences. 2022; 12(3):1484. https://doi.org/10.3390/app12031484
Chicago/Turabian StyleStatie, Maria Denisa, Debora Franceschi, Felicita Pierleoni, Valeria Barone, Nenad Popovic, Cosimo Nardi, Lorenzo Franchi, and Veronica Giuntini. 2022. "Evaluation of Skeletal, Dentoalveolar, and Sagittal Airway Changes Induced by the Mandibular Anterior Repositioning Appliance (MARA) in Class II Malocclusion: A Retrospective Controlled Study on Lateral Cephalograms" Applied Sciences 12, no. 3: 1484. https://doi.org/10.3390/app12031484
APA StyleStatie, M. D., Franceschi, D., Pierleoni, F., Barone, V., Popovic, N., Nardi, C., Franchi, L., & Giuntini, V. (2022). Evaluation of Skeletal, Dentoalveolar, and Sagittal Airway Changes Induced by the Mandibular Anterior Repositioning Appliance (MARA) in Class II Malocclusion: A Retrospective Controlled Study on Lateral Cephalograms. Applied Sciences, 12(3), 1484. https://doi.org/10.3390/app12031484