Farklı Maloklüzyon Tiplerinde Tweed Sefalometrik Analiz Ölçümlerinin Değerlendirilmesi: Kesitsel Bir Çalışma
Abstract
Amaç: Bu çalışmada farklı dental ve iskeletsel maloklüzyona sahip bireylerde Tweed sefalometrik analiz ölçümlerinin maloklüzyon ve cinsiyete göre ilişkisi ve farklılıklarının değerlendirilmesi amaçlanmıştır. İkincil amaç olarak ise Türk popülasyonu için referans değerlerin gösterilmesi açısından katkı sağlanması hedeflenmektedir.
Gereç ve Yöntem: Retrospektif olarak planlanan bu çalışmaya her bir dental maloklüzyon grubunda kadın ve erkek aynı sayıda olmak üzere 50 birey toplam 200 bireye ait sefalometrik radyografiler dahil edilmiştir. Dental maloklüzyon incelemesi Angle sınıflamasına göre (sınıf I, sınıf II bölüm 1, sınıf II bölüm 2, sınıf III), iskeletsel maloklüzyon sınıflaması ise ANB açısına göre (sınıf I, sınıf II, sınıf III) gerçekleştirilmiştir. Tweed tarafından önerilen sefalometrik analize ait FMA, FMIA ve IMPA açılarının ölçümleri gerçekleştirilmiştir. Dental ve iskeletsel maloklüzyon ile cinsiyetlere ve bunların etkileşimine ait istatistiksel değerlendirmeler MANOVA analizi kullanılarak gerçekleştirilmiştir.
Bulgular: FMA açısı hem dental hem de iskeletsel maloklüzyona göre farklılık göstermemektedir. FMIA açısı dental ve iskeletsel sınıf I ve II bireylerde benzer ve sınıf III bireylerden daha düşük olarak bulunmuştur (p<0.05). Dental ve iskeletsel maloklüzyonlarda IMPA açısı en düşük sınıf III bireylerde en yüksek ise sınıf II bireylerde bulunmuştur (p<0.05). Tweed sefalometrik analiz ölçümleri cinsiyetler arasında farklı değildir.
Sonuç: Çalışmadan elde edilen FMA açısı ortalama değerleri Tweed tarafından önerilen ile benzer iken FMIA ve IMPA açılarının ortalama değerleri farklıdır. Dental ve iskeletsel maloklüzyona göre FMA açısı farklılık göstermez iken FMIA ve IMPA açıları farklılık göstermektedir.
Keywords
References
- 1. Proffit W, Sarver D, Fields Jr H. In: Proffit W, Larson B, Sarver D, Fields Jr H (eds). Orthodontic diagnosis: The problem-oriented approach. Contemporary orthodontics. 6th ed. Elsevier; c2019:140-208.
- 2. Dinesh A, Mutalik S, Feldman J, Tadinada A. Value-addition of lateral cephalometric radiographs in orthodontic diagnosis and treatment planning. Angle Orthod 2020;90:665-671.
- 3. Vaden JL, Klontz HA. Tweed Analysis. In: Jacobson A, Jacobson RL (eds). Radiographic Cephalometry - From Basics to 3-D Imaging, Second Edition. 2nd ed. Quintessence Publishing Co, Inc; c2006:188-204.
- 4. Ülgen M. Ortodonti: Anomaliler, Sefalometri, Etioloji, Büyüme ve Gelişim, Tanı. 4. Baskı. Ankara Üniversitesi Diş Hekimliği Fakültesi Yayınları; c2010.
- 5. Kumari S, Bapat SM, Gupta K, Thomas B. Comparative evaluation of Tweed's analyses in Class I, Class II, and Class III participants of Central India: A pilot study. Int J Orthod Rehabil 2019;10:70-74.
- 6. Yağcı A, Büyük SK. Dengeli Yüz Oranlarına ve Normal Oklüzyona Sahip Genç Türk Erişkinlerin Mcnamara Sefalometrik Normları. Sağlık Bilimleri Dergisi 2013;22:1-6.
- 7. Wahl N. Orthodontics in 3 millennia. Chapter 8: The cephalometer takes its place in the orthodontic armamentarium. Am J Orthod Dentofacial Orthop 2006;129:574-580.
- 8. Ajisafe OA, Ogunbanjo BO, Adegbite KO, Oyapero A. Evaluation of Tweed’s Facial Triangle among Students in Lagos, Nigeria. Orthod Journ Nepal 2020;10:32-39.
- 9. Tweed CH. The diagnostic facial triangle in the control of treatment objectives. Am J Orthod 1969;55:651-667.
- 10. Drummond RA. A determination of cephalometric norms for the Negro race. Am J Orthod 1968;54:670-82.
- 11. Kumari L, Das A. Determination of Tweed's cephalometric norms in the Bengali population. Eur J Dent 2017;11:305-310.
- 12. Ouédraogo Y, Benyahia H, Diouf JS, Camara T, Bationo R, Ngom PI. Cephalometric norms of a Burkina Faso population. Int Orthod 2019;17:136-142.
- 13. Rizvi H, Hossain M. Cephalometric profile of Bangladeshis: Tweed's analysis. APOS Trends Orthod 2017;7:130-134.
- 14. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-191.
- 15. Celikoglu M, Bayram M, Sekerci AE, Buyuk SK, Toy E. Comparison of pharyngeal airway volume among different vertical skeletal patterns: a cone-beam computed tomography study. Angle Orthod 2014;284:782 787.
- 16. Bernabé E, Flores-Mir C. Dental morphology and crowding. A multivariate approach. Angle Orthod 2006;76:20-25.
- 17. Altan B, Demirtürk Kocasaraç H, Sinanoğlu E, Mutaf H. Türk bireylerde çeşitli maturasyon indikatörleri arasındaki ilişkilerin değerlendirilmesi [The evaluation of the relationship among various maturation indicators in Turkish subjects]. Cumhuriyet Dent J 2015;18;235-248.
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- 19. Ozturk T, Gumus H, Ozturk G. Are dental maturation, skeletal maturation, and chronological age associated with complete cleft lip and palate? Cleft Palate-Craniofac J 2021;58:275-283.
- 20. Germa A, Kaminski M, Nabet C. Impact of social and economic characteristics on orthodontic treatment among children and teenagers in France. Community Dent Oral Epidemiol 2010;38:171-179.
- 21. Çoban G, Türker G, Öztürk T, Hashimli N, Göksu M, Ömer Faruk A. Ortodontik Malokluzyonların Orta Anadolu Bölgesinde Yaşayan Bireylerdeki Prevelanslarının ve Karakteristiklerinin İncelenmesi. Sağlık Bilimleri Dergisi 2022;31:15-23.
- 22. Basciftci FA, Uysal T, Buyukerkmen A. Craniofacial structure of Anatolian Turkish adults with normal occlusions and well-balanced faces. Am J Orthod Dentofacial Orthop 2004;125:366-372.
- 23. Piao Y, Kim SJ, Yu HS, Cha JY, Baik HS. Five-year investigation of a sizeable orthodontic patient population at a dental hospital in South Korea. Korean J Orthod 2016;46(3):137-145.
- 24. Kirschneck C, Proff P, Lux C. Ideal treatment timing of orthodontic anomalies—a German clinical S3 practice guideline. J Orofac Orthop 2022;83:225-232.
- 25. Uysal T, Yagci A, Aldrees AM, Ekizer E. Ethnic differences in dentofacial relationships of Turkish and Saudi young adults with normal occlusions and well-balanced faces. The Saudi Dent J 2011;23:183-190.
- 26. Nazir SZ, Mushtaq M. Incisor mandibular plane angle (IMPA), Frankfort mandibular plane angle (FMA) and lower incisor to A-Pog distance, and their relation in different skeletal classes. Int J Appl Dent Sci 2020;6:468-473.
- 27. Ahmed M, Shaikh A, Fida M. Diagnostic performance of various cephalometric parameters for the assessment of vertical growth pattern. Dental Press J Orthod 2016;21:41-49.
- 28. Kang H-K, Liu T, Kaczynski R, Vaden JL. Treatment change comparisons between skeletal Class I and II white adolescents with 3 different vertical divergencies—part 1: Frankfort-Mandibular Incisor Angle (FMIA) and soft-tissue profile. Am J Orthod Dentofacial Orthop 2023;164:377-385.
Evaluation of Tweed Cephalometric Analysis Measurements in Different Malocclusion Types: A Cross-sectional Study
Abstract
Objective: This study aims to evaluate the relationship and differences in Tweed cephalometric analysis measurements according to malocclusion type and gender in individuals with different dental and skeletal malocclusions. A secondary aim is to contribute to the establishment of reference values for the Turkish population.
Material-Methods: This retrospective study included cephalometric radiographs of 200 individuals, with an equal number of males and females in each dental malocclusion group (50 individuals per group). Dental malocclusion was classified according to Angle’s classification (Class I, Class II division 1, Class II division 2, Class III). In contrast, skeletal malocclusion was classified based on the ANB angle (Class I, Class II, Class III). The FMA, FMIA, and IMPA angles, which are part of the cephalometric analysis proposed by Tweed, were measured. Statistical analyses of dental and skeletal malocclusion, gender, and their interactions were conducted using MANOVA analysis.
Results: The FMA angle did not differ significantly based on dental or skeletal malocclusion. The FMIA angle was similar in individuals with dental and skeletal Class I and Class II malocclusions but significantly lower in Class III individuals (p<0.05). The IMPA angle was lowest in Class III individuals and highest in Class II individuals for both dental and skeletal malocclusions (p<0.05). No significant differences in Tweed cephalometric analysis measurements were observed between genders.
Conclusion: The mean FMA angle obtained in this study was similar to the values proposed by Tweed, whereas the mean FMIA and IMPA angles differed. While the FMA angle did not vary according to dental and skeletal malocclusion, the FMIA and IMPA angles showed significant differences.
Keywords
Ethical Statement
Ethics committee approval was received for this study from the Clinical Research Ethics Committee of XXX University (Date: 31.01.2024, Number: 2024/64). The study was carried out in accordance with the Declaration of Helsinki, and informed consent forms were obtained from all individuals at the beginning of the study.
Supporting Institution
None.
Thanks
Support was received from the artificial intelligence-based ChatGPT (Ver. 4.0, OpenAI. (2025). ChatGPT [Large language model]. https://chatgpt.com) application in the proofreading phase of the relevant article and in creating graphics.
References
- 1. Proffit W, Sarver D, Fields Jr H. In: Proffit W, Larson B, Sarver D, Fields Jr H (eds). Orthodontic diagnosis: The problem-oriented approach. Contemporary orthodontics. 6th ed. Elsevier; c2019:140-208.
- 2. Dinesh A, Mutalik S, Feldman J, Tadinada A. Value-addition of lateral cephalometric radiographs in orthodontic diagnosis and treatment planning. Angle Orthod 2020;90:665-671.
- 3. Vaden JL, Klontz HA. Tweed Analysis. In: Jacobson A, Jacobson RL (eds). Radiographic Cephalometry - From Basics to 3-D Imaging, Second Edition. 2nd ed. Quintessence Publishing Co, Inc; c2006:188-204.
- 4. Ülgen M. Ortodonti: Anomaliler, Sefalometri, Etioloji, Büyüme ve Gelişim, Tanı. 4. Baskı. Ankara Üniversitesi Diş Hekimliği Fakültesi Yayınları; c2010.
- 5. Kumari S, Bapat SM, Gupta K, Thomas B. Comparative evaluation of Tweed's analyses in Class I, Class II, and Class III participants of Central India: A pilot study. Int J Orthod Rehabil 2019;10:70-74.
- 6. Yağcı A, Büyük SK. Dengeli Yüz Oranlarına ve Normal Oklüzyona Sahip Genç Türk Erişkinlerin Mcnamara Sefalometrik Normları. Sağlık Bilimleri Dergisi 2013;22:1-6.
- 7. Wahl N. Orthodontics in 3 millennia. Chapter 8: The cephalometer takes its place in the orthodontic armamentarium. Am J Orthod Dentofacial Orthop 2006;129:574-580.
- 8. Ajisafe OA, Ogunbanjo BO, Adegbite KO, Oyapero A. Evaluation of Tweed’s Facial Triangle among Students in Lagos, Nigeria. Orthod Journ Nepal 2020;10:32-39.
- 9. Tweed CH. The diagnostic facial triangle in the control of treatment objectives. Am J Orthod 1969;55:651-667.
- 10. Drummond RA. A determination of cephalometric norms for the Negro race. Am J Orthod 1968;54:670-82.
- 11. Kumari L, Das A. Determination of Tweed's cephalometric norms in the Bengali population. Eur J Dent 2017;11:305-310.
- 12. Ouédraogo Y, Benyahia H, Diouf JS, Camara T, Bationo R, Ngom PI. Cephalometric norms of a Burkina Faso population. Int Orthod 2019;17:136-142.
- 13. Rizvi H, Hossain M. Cephalometric profile of Bangladeshis: Tweed's analysis. APOS Trends Orthod 2017;7:130-134.
- 14. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-191.
- 15. Celikoglu M, Bayram M, Sekerci AE, Buyuk SK, Toy E. Comparison of pharyngeal airway volume among different vertical skeletal patterns: a cone-beam computed tomography study. Angle Orthod 2014;284:782 787.
- 16. Bernabé E, Flores-Mir C. Dental morphology and crowding. A multivariate approach. Angle Orthod 2006;76:20-25.
- 17. Altan B, Demirtürk Kocasaraç H, Sinanoğlu E, Mutaf H. Türk bireylerde çeşitli maturasyon indikatörleri arasındaki ilişkilerin değerlendirilmesi [The evaluation of the relationship among various maturation indicators in Turkish subjects]. Cumhuriyet Dent J 2015;18;235-248.
- 18. The jamovi project. Version 2.5. 2024. Retrieved from https://www.jamovi.org
- 19. Ozturk T, Gumus H, Ozturk G. Are dental maturation, skeletal maturation, and chronological age associated with complete cleft lip and palate? Cleft Palate-Craniofac J 2021;58:275-283.
- 20. Germa A, Kaminski M, Nabet C. Impact of social and economic characteristics on orthodontic treatment among children and teenagers in France. Community Dent Oral Epidemiol 2010;38:171-179.
- 21. Çoban G, Türker G, Öztürk T, Hashimli N, Göksu M, Ömer Faruk A. Ortodontik Malokluzyonların Orta Anadolu Bölgesinde Yaşayan Bireylerdeki Prevelanslarının ve Karakteristiklerinin İncelenmesi. Sağlık Bilimleri Dergisi 2022;31:15-23.
- 22. Basciftci FA, Uysal T, Buyukerkmen A. Craniofacial structure of Anatolian Turkish adults with normal occlusions and well-balanced faces. Am J Orthod Dentofacial Orthop 2004;125:366-372.
- 23. Piao Y, Kim SJ, Yu HS, Cha JY, Baik HS. Five-year investigation of a sizeable orthodontic patient population at a dental hospital in South Korea. Korean J Orthod 2016;46(3):137-145.
- 24. Kirschneck C, Proff P, Lux C. Ideal treatment timing of orthodontic anomalies—a German clinical S3 practice guideline. J Orofac Orthop 2022;83:225-232.
- 25. Uysal T, Yagci A, Aldrees AM, Ekizer E. Ethnic differences in dentofacial relationships of Turkish and Saudi young adults with normal occlusions and well-balanced faces. The Saudi Dent J 2011;23:183-190.
- 26. Nazir SZ, Mushtaq M. Incisor mandibular plane angle (IMPA), Frankfort mandibular plane angle (FMA) and lower incisor to A-Pog distance, and their relation in different skeletal classes. Int J Appl Dent Sci 2020;6:468-473.
- 27. Ahmed M, Shaikh A, Fida M. Diagnostic performance of various cephalometric parameters for the assessment of vertical growth pattern. Dental Press J Orthod 2016;21:41-49.
- 28. Kang H-K, Liu T, Kaczynski R, Vaden JL. Treatment change comparisons between skeletal Class I and II white adolescents with 3 different vertical divergencies—part 1: Frankfort-Mandibular Incisor Angle (FMIA) and soft-tissue profile. Am J Orthod Dentofacial Orthop 2023;164:377-385.
Details
| Primary Language | English |
|---|---|
| Subjects | Orthodontics and Dentofacial Orthopaedics |
| Journal Section | Research Article |
| Authors | |
| Publication Date | September 30, 2025 |
| Submission Date | February 12, 2025 |
| Acceptance Date | August 17, 2025 |
| Published in Issue | Year 2025 Volume: 28 Issue: 3 |
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