CC BY 4.0 · Eur J Dent 2023; 17(01): 097-106
DOI: 10.1055/s-0042-1743149
Original Article

Soft-Tissue Analysis of Different Sagittal Skeletal Patterns Using the Geometric Morphometric Method

Tamana Sazgar
1   Centre of Pediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
2   Department of Orthodontics, Faculty of Dentistry, Kabul University of Medical Sciences, Kabul, Afghanistan
,
3   Centre of Comprehensive Care Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
,
1   Centre of Pediatric Dentistry and Orthodontic Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
,
Aspalilah Alias
4   Department of Basic Sciences and Oral Biology, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
› Author Affiliations

Abstract

Objectives This study aimed to investigate the size and shape variations of soft-tissue patterns in different sagittal skeletal patterns using the geometric morphometrics method (GMM) obtained from lateral cephalograms.

Materials and Methods This is a retrospective study, where the sample comprised of 188 Malaysian Malay subjects aged between 18 and 40 years and with different sagittal skeletal patterns. Overall, 71 males and 117 females were gathered for all size and shape analyses. This study incorporated 11 soft-tissue landmarks, which underwent landmark application using tpsDig2 software version 2.31, while the shape analysis was done using MorphoJ software version 1.07a.

Statistical Analysis Statistical analyses were performed using IBM SPSS Statistics 26. The result of the analysis of variance (ANOVA) test showed significant differences in some of the parameters between the landmarks. Length D, Length E, Length F, Length H, and Length I showed significant differences (p < 0.05), while other parameters showed no difference (p > 0.05).

Results The shape variation of soft-tissue landmarks in different skeletal patterns existed in 18 different dimensions which showed by 18 principal components (PCs). Procrustes ANOVA and canonical variate analysis showed the size and shape differences of soft-tissue patterns between Class II and III and gender groups (p < 0.0001). In discriminant function analysis for Class II subjects, the classification accuracy was 98.4%, whereas subsequent to cross-validation, the classification accuracy was 90.6%. For Class III subjects, the classification accuracy was 96.6%, while after cross-validation, the classification accuracy was 90%.

Conclusion Different sagittal skeletal patterns demonstrated different soft-tissue shape variations. Class III showed the most protrusive upper and lower lips, while Class II demonstrated the most retrusive lower lip.

Ethical Approval

This research was approved by the Research and Ethics committee of UiTM and USIM. The Ethics approval codes for this study were {REC/09/2020 (MR/245)} and (USIM/JKEP/2021/125) from Universiti Teknologi MARA (UiTM) and Universiti Sains Islam Malaysia (USIM), respectively.




Publication History

Article published online:
18 April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Anić-Milosević S, Lapter-Varga M, Slaj M. Analysis of the soft tissue facial profile by means of angular measurements. Eur J Orthod 2008; 30 (02) 135-140
  • 2 Rehan A, Iqbal R, Ayub A, Ahmed I. Soft tissue analysis in Class I and Class II skeletal malocclusions in patients reporting to Department of Orthodontics, Khyber College of Dentistry, Peshawar. Pakistan Oral Dent J 2014; 34 (01) 87-90
  • 3 Somaiah S, Khan MU, Muddaiah S, Shetty B, Reddy G, Siddegowda R. Comparison of soft tissue chin thickness in adult patients with various mandibular divergence patterns in Kodava population. Int J Orthod Rehabil 2017; 8: 51-56
  • 4 Halazonetis DJ. Morphometric evaluation of soft-tissue profile shape. Am J Orthod Dentofacial Orthop 2007; 131 (04) 481-489
  • 5 Zedníková Malá P, Krajíček V, Velemínská J. How tight is the relationship between the skeletal and soft-tissue facial profile: a geometric morphometric analysis of the facial outline. Forensic Sci Int 2018; 292: 212-223
  • 6 Kamak H, Celikoglu M. Facial soft tissue thickness among skeletal malocclusions: is there a difference?. Korean J Orthod 2012; 42 (01) 23-31
  • 7 Bravo-Hammett S, Nucci L, Christou T, Aristizabal JF, Kau CH. 3D analysis of facial morphology of a Colombian population compared to adult Caucasians. Eur J Dent 2020; 14 (03) 342-351
  • 8 Bhaskar E, Kau CH. A comparison of 3D facial features in a population from Zimbabwe and United States. Eur J Dent 2020; 14 (01) 100-106
  • 9 Kau CH, Wang J, Davis M. a cross-sectional study to understand 3D facial differences in a population of African Americans and Caucasians. Eur J Dent 2019; 13 (04) 485-496
  • 10 Broadbent BH. The new x-ray technique and its application to orthodontia. The introduction of cephalometric radiography. Angle Orthod 1931; 51 (02) 46-66
  • 11 Baumrind S, Frantz RC. The reliability measurements. Am J Orthod 1971; 60 (02) 111-127
  • 12 Gravely JF, Benzies PM. The clinical significance of tracing error in cephalometry. Br J Orthod 1974; 1 (03) 95-101
  • 13 McIntyre GT, Mossey PA. Size and shape measurement in contemporary cephalometrics. Eur J Orthod 2003; 25 (03) 231-242
  • 14 Rohlf FJ. On the use of shape spaces to compare morphometric methods. Hystrix – Ital. J Mammal 2000; 11 (01) 9-25
  • 15 James Rohlf F, Marcus LF. A revolution morphometrics. Trends Ecol Evol 1993; 8 (04) 129-132
  • 16 Kouli A, Papagiannis A, Konstantoni N, Halazonetis DJ, Konstantonis D. A geometric morphometric evaluation of hard and soft tissue profile changes in borderline extraction versus non-extraction patients. Eur J Orthod 2019; 41 (03) 264-272
  • 17 Taju W, Sherriff M, Bister D, Shah S. Association between severity of hypodontia and cephalometric skeletal patterns: a retrospective study. Eur J Orthod 2018; 40 (02) 200-205
  • 18 Rohlf FJ. tpsDig2 Software; Version 2.31; The State University of New York at Stony Brook: Stony Brook, NY, USA 2017. Accessed on 30 November 2020 at: http://www.sbmorphometrics.org/soft-dataacq.html
  • 19 Klingenberg CP, Morpho J. MorphoJ: an integrated software package for geometric morphometrics. Mol Ecol Resour 2011; 11 (02) 353-357 Accessed on 10 December 2020 at: https://morphometrics.uk/MorphoJ_page.html
  • 20 Klingenberg CP, Monteiro LR. Distances and directions in multidimensional shape spaces: implications for morphometric applications. Syst Biol 2005; 54 (04) 678-688
  • 21 Phulari B. An Atlas on Cephalometric Landmarks. 1st ed.. Jaypee Brothers Medical Publishers (P) LTD New Delhi; London, Philadelphia, Panama: 2013
  • 22 Burstone CJ. The integumental profile. Am J Orthod 1958; 44 (01) 1-25
  • 23 Arnett GW, Bergman RT. Facial keys to orthodontic diagnosis and treatment planning—part II. Am J Orthod Dentofacial Orthop 1993; 103 (05) 395-411
  • 24 Holdaway RA. A soft tissue cephalometric analysis and its use in orthodontic part II. Am J Orthod 1984; 85 (04) 279-293
  • 25 Kasai K. Soft tissue adaptability to hard tissues in facial profiles. Am J Orthod Dentofacial Orthop 1998; 113 (06) 674-684
  • 26 Halazonetis DJ. Morphometric correlation between facial soft-tissue profile shape and skeletal pattern in children and adolescents. Am J Orthod Dentofacial Orthop 2007; 132 (04) 450-457
  • 27 Woon CK, Jamal NAA, Noor MNIM. et al. Geometric morphometric analysis of malocclusion on lateral cephalograms in Malaysian population. Anat Cell Biol 2019; 52 (04) 397-405
  • 28 Díaz MA, Manríquez SG. Skeletodental diagnosis using a geometric morphometric approach. Int J Odontostomatol 2014; 8 (01) 5-11
  • 29 Freudenthaler J, Čelar A, Ritt C, Mitteröcker P. Geometric morphometrics of different malocclusions in lateral skull radiographs. J Orofac Orthop 2017; 78 (01) 11-20
  • 30 Alkofide EA. The shape and size of the sella turcica in skeletal Class I, Class II, and Class III Saudi subjects. Eur J Orthod 2007; 29 (05) 457-463
  • 31 Linjawi AI, Afify AR, Baeshen HA, Birkhed D, Zawawi KH. Mandibular symphysis dimensions in different sagittal and vertical skeletal relationships. Saudi J Biol Sci 2021; 28 (01) 280-285
  • 32 Moon YM, Ahn SJ, Chang YI. Cephalometric predictors of long-term stability in the early treatment of Class III malocclusion. Angle Orthod 2005; 75 (05) 747-753
  • 33 Baccetti T, Franchi L, Stahl F. Comparison of 2 comprehensive Class II treatment protocols including the bonded Herbst and headgear appliances: a double-blind study of consecutively treated patients at puberty. Am J Orthod Dentofacial Orthop 2009; 135 (06) 698.e1-698.e10 , discussion 698–699
  • 34 Franchi L, Baccetti T. Prediction of individual mandibular changes induced by functional jaw orthopedics followed by fixed appliances in Class II patients. Angle Orthod 2006; 76 (06) 950-954