Class II subdivision: Cone beam computed tomography- CBCT Analysis

Abstract

Background: To estimate whether there is skeletal and/or dental asymmetry in class II subdivision patients, between the Class II side and the Class I side using of cone beam computed tomography (CBCT). Material and Methods: A sample of 30 patients, from a private clinic, retrospectively selected; with a class II sub division diagnosis requiring treatment, who underwent wide-field CBCT that met the inclusion criteria. The data was processed with Dolphin 3D version 11.95 Premium software. The craniometric points, as well as the spatial orientation scheme of the three-dimensional model were proposed by Craig Minich, et al. (1) Results: The Class II subdivision side and the Class I side of each patient were compared through intramaxillary, intramandibular, and intermaxillary measurements, evaluating each one in three dimensions (sagittal, frontal, and axial). Also, the measurements made from the three-dimensional volume, were contrasted with those generated in the biplane views. The level of significance used was 0.05. Statistical analysis was performed using the R program (R Development Core Team), version 3.4.4. The intraoperative variability was previously verified using the Dahl berg formula. This error is 0.35 -1.10, so the spatial orientation and placement of craniometric points are repeatable and reliable. Conclusions: Statistically significant differences have been found with respect to skeletal values and dentoalveolar position. Regarding the skeletal findings, the class II subdivision side is narrower and there is a shortening of the condylar branch. In the dentoalveolar position on this side, the upper molar and canine are in an advanced position, the lower molar is posterior and lower than the contralateral and the lower canine is in a delayed position. Further more, measurements made from a two-dimensional image cannot be extrapolated with those made directly from a three-dimensional volume. The problem is generated by a deviation in dental position as well as an underlying asymmetry.