Popa George, Bratu Dana-Cristina, Mihali Sorin Gheorghe, Pop Silvia Izabella, Dragoș Bianca, Bratu Remus-Christian, Tudor Anca, Jivănescu Anca
Department of Orthodontics II, Orthodontic Research Centre, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy of Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.
Department of Prosthodontics, Faculty of Dentistry, "Vasile Goldis" Western University of Arad, 94 Revolutiei Blvd., 310025 Arad, Romania.
Medicina (Kaunas). 2025 Mar 6;61(3):463. doi: 10.3390/medicina61030463.
: The main objectives of our study were to assess sexual dimorphism and to compare the facial height, as well as the anteroposterior width of the upper airway, within adult Caucasians diagnosed with skeletal Class I and skeletal Class III malocclusion, based on a number of angular and linear cephalometric parameters. : One hundred lateral cephalograms were selected from orthodontic adult Caucasian patients from western Romania. Several angular parameters (SNA, SNB, ANB, FMA, Y-FH, Ba-S-PNS and NL-ML angles) and linear parameters (total, upper and lower anterior facial height-TAFH, UAFH, LAFH; total posterior facial height-TPFH) were analysed for each case. The upper airway width parameters included the width of the nasopharynx, as well as the upper, middle and lower pharyngeal airway width (UPAW, MPAW and LPAW). : Distinct sexual dimorphism was observed regarding the vertical cephalometric parameters within both Class I and Class III groups, with males exhibiting significantly larger facial height parameters, while females demonstrated larger nasopharyngeal depth angles (Ba-S-PNS). The Y-FH angle had significantly higher values in Class I than in Class III subjects, regardless of sex. Upper airway dimensions showed sexual dimorphism specifically in Class III subjects, with females exhibiting larger UPAW values than males. The inter-class comparisons showed larger values for LPAW, especially in females. Correlation analyses revealed no statistically significant relationships between the vertical and the upper airway parameters in Class I subjects. UPAW showed a tendency to decrease in Class III subjects as TAFH and LAFH increased. Ba-S-PNS showed consistent negative correlations with the vertical dimensions in both groups. These findings suggest that skeletal Class I and Class III malocclusions exhibit not only different sagittal relationships, but also distinctive, sex-related vertical skeletal patterns within each group, and therefore it would be advised that male and female patients should be diagnosed and treated according to separate protocols. In our population, Class III males are more likely to require orthognathic surgery, in addition to orthodontic treatment, with a more reserved prognosis and they might have a higher risk of OSA or other respiratory disorders in comparison with Class III females.
本研究的主要目的是基于一些角度和线性头影测量参数，评估成年白种人骨骼I类和骨骼III类错牙合患者的性别差异，并比较面部高度以及上气道的前后宽度。
从罗马尼亚西部的正畸成年白种人患者中选取了100张侧位头影测量片。对每个病例分析了几个角度参数（SNA、SNB、ANB、FMA、Y-FH、Ba-S-PNS和NL-ML角）和线性参数（总、上、下前面部高度——TAFH、UAFH、LAFH；总后面部高度——TPFH）。上气道宽度参数包括鼻咽宽度以及上、中、下咽气道宽度（UPAW、MPAW和LPAW）。
在I类和III类组中，关于垂直头影测量参数均观察到明显的性别差异，男性表现出明显更大的面部高度参数，而女性表现出更大的鼻咽深度角（Ba-S-PNS）。无论性别如何，I类受试者的Y-FH角值均显著高于III类受试者。上气道尺寸在III类受试者中表现出性别差异，女性的UPAW值大于男性。组间比较显示LPAW值更大，尤其是在女性中。相关性分析显示I类受试者的垂直参数与上气道参数之间无统计学显著关系。在III类受试者中，随着TAFH和LAFH增加，UPAW呈下降趋势。Ba-S-PNS在两组中均与垂直尺寸呈一致的负相关。这些发现表明，骨骼I类和III类错牙合不仅表现出不同的矢状关系，而且每组中还存在独特的、与性别相关的垂直骨骼模式，因此建议根据不同的方案对男性和女性患者进行诊断和治疗。在我们的人群中，III类男性除正畸治疗外更有可能需要正颌手术，预后更为保守，与III类女性相比，他们患阻塞性睡眠呼吸暂停或其他呼吸系统疾病的风险可能更高。
