BACKGROUND: Underlying disorders of the maxillary sinus (MS), including a history of sinus surgeries, chronic sinusitis, or congenital anomalies can potentially impact sinus function and structure, necessitating careful evaluation and management. Moreover, intact sinuses are crucial in gender determination in forensic anthropology. The present study was undertaken to check the accuracy and reliability of MS in gender determination using morphometric parameters.
METHODS: This retrospective study was carried out on 74 lateral cephalograms (37 males and 37 females) aged between 18 to 50 years from the North Indian population. The MS area was measured using a NewTom CBCT machine (NewTom, Imola, Italy) with slicer software. The anatomical landmarks for the sinus were identified, and the area was calculated in square millimeters (mm2).
RESULTS: In terms of surface area, females had a mean of 13,210.40 mm2 with a standard error of 713.46. Males, however, exhibited a higher mean surface area of 18,713.82 mm2, but with a significantly larger standard error of 3,371.70. The difference in MS area between males and females was statistically significant (p<0.01). In the receiver operating characteristic (ROC) curve, the area under the curve (AUC) was 0.77, suggesting good discriminative ability.
CONCLUSIONS: The MS area on lateral cephalograms shows significant sexual dimorphism. Overall, the findings suggest that the MS surface area can be a useful anatomical feature for distinguishing between male and female North Indian subjects, given the statistically significant difference and the good discriminative performance indicated by the ROC curve analysis.

This study investigated compensation in skeletal Class III subjects to compare various severities of abnormal jaws. A retrospective analysis of 137 skeletal Class III cephalograms (63 males and 74 females) was conducted, with cephalometric assessments determining skeletal and dental values. The results were compared with Class I cephalograms. Incisor compensation was examined by pairing normal jaws with varied abnormal jaws, classified by severity using one standard deviation (SD). Statistical analyses included Kruskal-Wallis tests, Bonferroni tests, Spearman\'s correlations, and multiple linear regression. Four skeletal Class III groups were identified: OMx+PMd, RMx+OMd, OMx+OMd, and PMx+PMd (P = prognathic; O = orthognathic; R = retrognathic; Mx = maxilla; Md = mandible.). The upper central incisor (U1) showed proclination, and the lower central incisor (L1) showed retroclination across all groups except for U1 in PMx+PMd and L1 in OMx+OMd, which exhibited normal inclination. U1 exhibited limited compensation even with progressive maxillary retrognathism, while L1 showed limited compensation after one SD of mandibular prognathism. Maxilla (SNA) and jaw discrepancy (ANB) were inversely related to the U1 degree, whereas only jaw discrepancy (ANB) was positively related to the L1 degree. U1 in PMx+PMd and L1 in OMx+OMd showed no incisor compensation. U1 had limited compensation even with progressive maxillary retrognathism while L1 showed limited compensation after one SD mandibular prognathism.

Background: The sella turcica is a structure readily seen on lateral cephalograms and sella point is routinely traced for various cephalometric analyses. The aim of the present study was to evaluate the morphometric variation in size and shape of sella turcica via lateral cephalogram. The objectives were to introduce a novel sella turcica index (STI) and assess its reliability that could be helpful in gender determination. Materials and Methods: A total of 80 lateral cephalograms of the patients of age group 10-30 years were included for the study. The morphological variations of the sella turcica was done based on the classification given by Axelsson et al. (2004). The length, depth and perimeter of the sella turcica was measured and STI derived and calculated. The data was further subjected to discriminant analysis to validate the gender outcome. Reliability of the novel index was determined by calculating the sensitivity and specificity. Results: The overall most common morphological type of sella turcica was Type A (56.25%) followed by Type B (18.75%) and Type E (13.75%). The mean perimeter and depth of sella turcica was higher in females whereas the mean length of sella turcica was higher in males. The mean STI was higher in males and statistically highly significant. The sensitivity and specificity of this index was 72.5% and 90% respectively. Conclusion: A significant relationship was observed between the morphometric measurements of sella turcica and gender. STI could be of great help as a reliable tool for personal identification in forensic sciences.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-04082-9.

BACKGROUND: This prospective study aimed to evaluate the influence of the computer type (tablet or desktop) on accuracy and tracing time of cephalometric analyses.
METHODS: Dental students used a web-based application specifically developed for this purpose to perform cephalometric analyses on tablet and desktop computers. Landmark locations and timestamps were exported to measure the accuracy, successful detection rate and tracing time. Reference landmarks were established by six experienced orthodontists. Statistical analysis included reliability assessment, descriptive statistics, and linear mixed effect models.
RESULTS: Over a period of 8 semesters a total of 277 cephalometric analyses by 161 students were included. The interrater reliability of the orthodontists establishing the reference coordinates was excellent (ICC > 0.9). For the students, the mean landmark deviation was 2.05 mm and the successful detection rate for the clinically acceptable threshold of 2 mm suggested in the literature was 68.6%, with large variations among landmarks. No effect of the computer type on accuracy and tracing time of the cephalometric analyses could be found.
CONCLUSIONS: The use of tablet computers for cephalometric analyses can be recommended.

OBJECTIVE: Skeletal class II malocclusion is one of the most common malocclusions. Among the functional appliances for skeletal class II malocclusion, the Twin-Block appliance with a maxillary expander is effective in repositioning the mandible forward. In this study, we focused our efforts on investigating the effects of Twin-Block appliances with maxillary expanders on the upper airway in growing children with skeletal class II malocclusion by tracing and measuring lateral cephalograms after evaluating the consistency of three-dimensional CBCT data and two-dimensional lateral cephalogram data.
METHODS: A total of 102 patients ranging from 9 to 15 years old (11.37 ± 2.80, male/female ratio = 1:1) with skeletal class II malocclusion were selected to evaluate the consistency of CBCT data and lateral cephalogram data. The strongly and moderately correlated segments were then selected to study the effects of Twin-Block with a maxillary expander on the upper airway in 66 growing children with skeletal class II malocclusion (11.31 ± 1.23 years old, male/female ratio = 1:1) by lateral cephalograms.
RESULTS: The results showed a strong significant correlation in the nasopharynx (r = 0.708) and moderate significant correlations in the overall upper airway (r = 0.641), palatopharynx (r = 0.553), and glossopharynx (r = 0.575) but a weak correlation in the hypopharynx (r = 0.323). The corresponding determination coefficient (R2) was also determined by scatter plot analysis. Moreover, compared with the pretreatment data (T1), the total area of the upper airway and the areas of the nasopharynx, palatopharynx, and glossopharynx after functional treatment (T2) increased statistically and significantly.
CONCLUSIONS: Lateral cephalograms can reflect the volume of the nasopharynx and oropharynx in skeletal class II children to a certain extent, while Twin-Block appliances with maxillary expanders can widen the volume of the nasopharynx and oropharynx significantly.
CONCLUSIONS: The lateral cephalogram is reliable for analyzing the nasopharynx, palatopharynx, and glossopharynx in orthodontic clinical practice. Twin-Block appliances with maxillary expanders have a positive effect on skeletal class II patients with airway stenosis.

Orientation of the occlusal plane is an important clinical procedure for complete denture fabrication. An attempt had been made to reconstruct the occlusal plane using a different reference plane. The aim of this study was to find the correlation of the \"K\" plane to the occlusal plane and to assess the angular deviation between the K-plane to the occlusal plane (KO) with different skeletal forms.
An in vivo observational study was conducted on dentulous subjects having Class I dental occlusion with different skeletal forms undergoing orthodontic treatment.
The study was conducted on 54 subjects aged 18-30 years. Metallic balls (3 mm in diameter) were attached to the desired landmarks, and a lateral cephalogram was taken for each subject. Cephalometric analysis was done using the Dolphin Imaging software, and the values obtained were recorded and subjected to statistical analysis.
The values obtained were recorded and subjected to statistical analysis using simple descriptive analysis, Shapiro-Wilk test, Mann-Whitney U-test, and Pearson\'s correlation.
A positive correlation was found between KO with a mean angular deviation of 8.59° ± 3.05°. The angle was found to be steeper in skeletal Class II subjects.
Clinical application of the K-plane to use as a reference plane to orient the posterior occlusal plane can enhance the treatment outcome for a removable prosthesis. The results of this study provide a theoretical foundation for the practical restoration of the occlusal plane in different skeletal forms.

UNASSIGNED: The study aimed to determine the muscle pattern of medial pterygoid, lateral pterygoid, and masseter (length, cross-section, and angulation) in adult non-orthodontic patients and its effect on craniofacial structures.
UNASSIGNED: The study was conducted from January 14, 2019 to January 14, 2020. Ethical clearance of this study was obtained from the ethical committee Ethical Clearance was obtained from Faculty of Dental Sciences, IMS, BHU, Institutional Ethical Committee with Ref no. Dean/2019/EC/1824 dated 23.04.2019 of the university. The sample size was estimated using the G-power statistical program. Power analysis indicated a minimum sample size of 27. Inclusion and exclusion criteria were set. Consent was taken from participants. Seventy-seven subjects who were willing to participate and have given written consent were enrolled for the study. Participants were sent for lateral cephalometry (Dolphin Cephalometric software) Dolphin Imaging and management solution, for 6 angular and 11 linear measurements. Nineteen subjects did not turn up for the scan. Twenty-eight participants underwent MRI (magnetic resonance imaging) to evaluate muscle patterns (masseter, medial, and lateral pterygoid). The intra-class correlation coefficient (ICC), Kolmogorov-Smirnov (KS) test, descriptive statistics, and multiple regression analysis were computed. The P value was set as ≤0.001(highly statistically significant) and ≤0.05 (significant relation).
UNASSIGNED: There was a highly statistically significant (p ≤ 0.001) association between masseter length to upper facial height (N-Ans) and ramal length (Cd-Go). Length of medial pterygoid was significantly related (p ≤ 0.05) with SNB and length of body of mandible (Pog-Go). The cross-section of this muscle showed significant relation with upper facial height (N-Ans) and ramal length (Cd-Go). The correlation of the length of lateral pterygoid with upper facial height (N-Ans) and maxillary length (A-Ptm) was highly significant.
UNASSIGNED: The muscle pattern has a significant correlation with maxillofacial morphology. The masseter muscle is the longest and thickest (cross-section) and is angulated vertically than the other two muscles (medial pterygoid and lateral pterygoid). Of the three muscles, the medial pterygoid influences more common craniofacial parameters suggestive of its symbiotic activity. Lateral pterygoid affects the maxillary length and facial height.

UNASSIGNED: Age estimation allows the identification of living individuals, dead victims and estimation of age in children using maxillofacial radiographs.
UNASSIGNED: To compare age estimation by mandibular third molar developmental stages using modified Demirjian\'s method on OPG with age estimation by mandibular linear dimensions on lateral cephalogram.
UNASSIGNED: A total of 200 randomly selected subjects (100 males and 100 females), with age range from 9 to 20 years, and 200 Digital Orthopantomograms and 200 Digital Lateral Cephalograms were utilized for the study.
UNASSIGNED: Radiographs were taken with Kodak 8000C Digital Panoramic and Cephalometric machine operating at 60-90 kvp, with exposure time of 8-18 s at 2-15 mA, with an inbuilt magnification factor. A flat screen Compaq TFT-LCD monitor was used to view the OPG images. Linear mandibular dimensional measurements were made on each Digital Lateral Cephalogram using Trophy Dicom Software.
UNASSIGNED: Regression analysis and regression coefficient for establishing gender-specific equation were observed. Evaluation of results and statistical analysis was carried by using Student\'s \'t\' test. For all test, \'P\' value of 0.05 or less was utilized for measuring the degree of significance. Intra-observer variability was detected using reliability analysis.
UNASSIGNED: The accuracy of age estimation by OPG was 93.8% and by lateral cephalogram was 79.7%.
UNASSIGNED: The OPG analysis is more reliable than the cephalometric parameters.

Background Sella turcica (ST) is a crucial structure that is morphologically situated in the median position and is well-utilised in cephalometrics. This saddle-shaped sella constitutes a significant radiographic landmark for various related analyses. Therefore, studying its varying dimensions in different populations is of utmost importance. This paper evaluates and compares the linear dimensions and morphological variations of ST in different facial skeletal classes in relation to age and gender using lateral cephalograms in the Sri Ganganagar population. Methodology The study population was selected through simple random sampling from the accessible population of the Sri Ganganagar district. A total of 180 participants of both genders were selected from patients who visited the outpatient clinic of the Department of Oral Medicine and Radiology of Surendra Dental College and Research Institute in Sri Ganganagar. These samples were equally divided into three age groups. Apart from typical morphology, five possible variations of ST were determined. The area of ST on the lateral cephalogram was also evaluated. The extent of ST was calculated from the tubercle portion to the top of the dorsal side. The relative deepness of the sella was assessed by making a tangent across the innermost point of the sella. SPSS software was utilised for statistical analysis and related inferences. Results In the study sample (n = 180), 50% were men and 50% were women. The sample was divided into three equal groups based on age: Group I (n = 60; 33.33%) consisted of participants aged 15-20; Group II (n = 60; 33.33%) consisted of participants aged 21-25; and Group III (n = 60; 33.33%) consisted of participants aged 26-30. Conclusions The anteroposterior diameter of the sella structure is strongly related to age progression with no significant gender correlation. The most common shape of ST other than the normal one was oblique. Additionally, skeletal relationships showed a significant relationship with the shape of ST in the study population.

The aim of this study was the development of a statistical model for reliable prediction of Posterior Airway Space (PAS) changes in lateral cephalograms (LCR) of patients after bimaxillary orthognathic surgery. The LCRs of patients who underwent bimaxillary orthognathic surgery were retrospectively analyzed. The anteroposterior dimension of the PAS was measured at three levels in the pre-operative and postoperative LCR: On the nasopharyngeal (SPAS), oropharyngeal (MAS), and hypopharyngeal level (IAS). The data of 139 patients were collected. The following changes of the PAS were measured: in class II patients SPAS: 0.291 mm (SD = 2.570 mm); MAS: 2.444 mm (SD = 2.986 mm); IAS: 0.750 mm (SD = 3.017 mm); in class III patients SPAS: 1.377 mm (SD 3.212 mm); MAS: 0.962 (SD: = 3.135 mm); IAS: 0.370 mm (SD = 3.468 mm). Linear regression analysis showed for class II patients, a significant influence of mandibular movement on MAS (p = 0.049) and a significant effect of maxillary and mandibular movements on SPAS (p = 0.001) and MAS (p = 0.022) in class III patients. The other jaw displacements had no significant impact on the investigated PAS levels. While the presented method does not permit exact prediction of the dimension of the PAS, it is still an easily accessible method of orientation for the surgeon. The surgeon can initiate three-dimensional examinations to provide exact three-dimensional prediction based on this calculation.