An Examination of the Craniofacial Morphology of Adult and Juvenile Individuals with Class II Malocclusions

Abstract

Introduction: Proper alignment of the teeth and jaws is important because it not only creates a harmonious aesthetic among the features of the face but is also necessary for optimal function of the craniofacial complex. A malocclusion is the misalignment of the teeth or jaws that is considered clinically abnormal. Evaluating morphological relationships associated with malocclusions can aid in understanding underlying mechanisms and determining proper treatments for a malocclusion. This paper aims to analyze how craniofacial morphology differs among individuals with Class II malocclusion and those without malocclusion (Class I) during both childhood and adulthood. Methodology: Cephalograms from 485 individuals were classified into the control group, Class I, or malocclusion groups: Class II Division 0, Class II Division 1, or Class II Division 2. Class II indicates a retrognathic mandible, and Divisions 0, 1, and 2 indicate maxillary incisor orientation. One cephalogram was taken between ages 4-6 (juvenile) and another between ages 16-21 (adult) to compare morphology during childhood and adulthood. Variation in the craniofacial morphology was compared across classification groups using ANOVA and post-hoc t-tests for 7 angular and 9 linear measurements to quantify the morphology of various craniofacial regions. Results: The main differences among malocclusion groups in adults were in the antero-posterior positioning of the maxilla (CII,D0 and CII,D1) and mandible (CII,D2). However, there are also some vertical differences more prevalent in adult males pertaining to the upper face specifically in Class II Division 1 cases. The juvenile groups are less morphologically distinct compared to the adults. Summary: Although fewer differences are found among juvenile groups, some significant differences that are present can be used to predict possible adult malocclusion to inform on possible growth modification during adolescence.