Analysis of factors affecting angle ANB.

Cephalometric analyses based on angular and linear measurements have obvious fallacies, which have been discussed in detail by Moyers and Bookstein. However, the clinical application of such an analysis by the orthodontic profession in treatment planning is widely accepted. Variations of angle ANB are commonly used to determine relative jaw relationships in most of the cephalometric evaluations. Several authors, including points A and B influences angle ANB, as does rotational growth of the upper and lower jaws. In addition, the authors point out that growth in a vertical direction (distance N to B) and an increase of the dental height (distance A to B) may contribute to changes in angle ANB. For a Class I relation (Wits = 0 mm), a mathematical formula has been developed which enables the authors to study the geometric influence of angle ANB caused by the following four effects: (1) rotation of the jaws and/or occlusal plane relative to the anterior cranial base; (2) anteroposterior position of N relative to point B, (3) vertical growth (distance N to B); (4) increase in dental height (distance A to B). It was observed that, contrary to the common belief that an ANB angle of 2 +/- 3.0 degrees is considered normal for a skeletal Class I relation, the calculated values of angle ANB will vary widely with changes in these four controlling factors under the same skeletal Class I conditions (Wits = 0 mm). Therefore, in a case under consideration, angle ANB must be corrected for these geometric effects in order to get a proper perspective of the skeletal discrepancy. This is facilitated by comparing the measured ANB angle with the corresponding ANB angle calculated by a formula for a Class I relationship. The corresponding calculated angle ANB can be taken from the tables which are based upon the formula using the same values for SNB, omega (angle between occlusal plane and anterior cranial base), b (which is distance N to B) and a (dental height measured as perpendicular distance A to occlusal plane plus perpendicular distance occlusal plane to B). The difference between actual and calculated angle ANB is a measurement of the severity of the skeletal discrepancy. This leads to a new definition of what denotes skeletal Class II and III relationships, since and angle ANB calculated for a skeletal Class I (Wits = 0 mm) can vary widely and can be either negative or positive.(ABSTRACT TRUNCATED AT 400 WORDS)