|Year : 2014 | Volume
| Issue : 3 | Page : 137-142
Palatal dimension correlation in malocclusions for mixed Indian population
Ashish Bhalla1, SM Londhe2, Prasanna Kumar3, Sanjeev Datana2, Abhijeet Kadu2
1 Department of Pedodontics and Preventive Dentistry, Army Dental Centre (R and R), Delhi Cantt, New Delhi, India
2 Department of Orthodontics and Dentofacial Orthopedics. Army Dental Centre (R and R), Delhi Cantt, New Delhi, India
3 Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, Maharashtra, India
|Date of Web Publication||8-Dec-2014|
Department of Pedodontics and Preventive Dentistry, Army Dental Centre (R and R), Delhi Cantt, New Delhi
Source of Support: None, Conflict of Interest: None
Aims: To determine and compare the palatal dimensions in mixed Indian population with different malocclusions and to find correlation among them. Materials and Methods: The sample consisted of 152 study models of children aged 13-16 years consisting of 76 males and 76 females obtained from Govt. teaching institution divided into Angle's Class I (40), Class II (80) and Class III (32) based on molar relationship and cephalometric evaluation. Ten palatal parameters were measured using Korkhaus gauge, which included arch width at the canine, 1 st premolar, 2 nd premolar and 1 st molar, arch length, palatal depth at canine, 1 st premolar, 2 nd premolar, and 1 st molar and arch perimeter. The mean and standard deviation were calculated, analysis of variance (ANOVA), independent student t test and Pearson's correlation coefficient were used for the statistical analysis. Results: Angle's Class I occlusion group showed widest intercanine width. Palatal depth was shallowest in Class II Div 2 malocclusion and Class III malocclusion group showed shortest arch length and arch perimeter. There was no difference in palatal dimensions in between gender. Various palatal parameters were co related to each other. Conclusions: Significant differences existed in most of palatal dimensions among different types of Angle's occlusal relationships but no significant changes were observed among two genders. Many palatal dimension parameters were correlated to each other.
Keywords: Arch length, arch perimeter, co-relation, palatal depth
|How to cite this article:|
Bhalla A, Londhe S M, Kumar P, Datana S, Kadu A. Palatal dimension correlation in malocclusions for mixed Indian population. J Dent Res Rev 2014;1:137-42
|How to cite this URL:|
Bhalla A, Londhe S M, Kumar P, Datana S, Kadu A. Palatal dimension correlation in malocclusions for mixed Indian population. J Dent Res Rev [serial online] 2014 [cited 2022 Dec 9];1:137-42. Available from: https://www.jdrr.org/text.asp?2014/1/3/137/146492
| Introduction|| |
Clinicians in different streams of dental sciences have always been interested in information regarding maxillary arch dimensions in human populations. It is also of interest to anthropologists and other students of human oral biology.  Orthodontic treatment usually requires modifications in arch dimensions for the correction of the presenting malocclusions. Arch dimensions are also modified by the various arch wires used during treatment affecting the stability of the results achieved. Maxillary and mandibular arch width stability is reported to be influenced by multiple pre-treatment and post-treatment factors.  The dimensional changes ultimately affect arch form which reflects the underlying bone morphology.  Stability of arch form is one of the most desirable goals of orthodontics, yet unfortunately it is the least understood. 
Review of the literature reveals variations in arch dimensions, which exist between different Angle's malocclusion groups. Therefore, separate diagnostic standards and treatment planning strategies should be employed for different malocclusion groups. Palatal dimensions and its relations to various Angle's classes of malocclusion are still to be established for Indian population. Hence this study was carried out in a sample of mixed Indian population with the aim to correlate palatal dimensions like arch width, palatal depth, arch length and arch perimeter in Angle's Class I, Class II Div 1, Class II Div 2 and Class III malocclusion. The aim of the study was also to establish correlation among the different palatal parameters in each group separately to identify the possible relation among transverse, sagittal and vertical dimensions of palate.
| Materials and Methods|| |
The sample consisted of 152 study models of children aged 13-16 years consisting of 76 males and 76 females obtained from Govt. teaching institution, divided into Angle's Class I (Total 40, Male: 20, Female: 20), Class II Div 1 (Total 40, Male: 20, Female: 20), Class II Div 2 (Total 40, Male: 20, Female: 20) and Class III (Total 32, Male: 16, Female: 16) based on molar relationship and cephalometric evaluations, which were made available from archives of the institution. The selected cases had an average growth pattern determined by mandibular plane angle between 22 0 and 28 0 . The sample was divided into four groups based on molar relationship and ANB angle. Group I consisted of Class I occlusion group with Class I molar and canine relationship bilaterally  and ANB of 2 0 -4 0 . Group II consisted of Class II Div 1 occlusion group with Class II molar and canine relationship bilaterally, ANB of more than 4 0 and proclined upper anterior teeth. Group III consisted of Class II Div 2 malocclusion group with Class II canine and molar relation bilaterally,  ANB of more than 4 0 and retroclined upper central or central and lateral incisors. Group IV consisted of Class III malocclusion group with Class III molar and canine relationship bilaterally, ANB of less than 2 0 . The cases included in the study were non-syndromic and were not having any history of orthodontic treatment with average growth pattern and having a complete set of dentition for that age group. Cases with non-specific molar relationship, with history of extraction of permanent teeth and syndromic cases were excluded from the study.
Ten palatal parameters were measured by using Korkhaus three-dimensional bow divider (Korkhaus gauge). The parameters measured included arch width at the canine, 1 st premolar, 2 nd premolar and 1 st molar, arch length, palatal depth at canine, 1 st premolar, 2 nd premolar and 1 st molar and arch perimeter.
All palatal measurements were recorded on each subject's maxillary dental casts by a single observer recording the data to the nearest 0.1 mm. The measurements used in this study were as follows:
- The palatal width measurements were measured as the distance between the lingual surface at the gingival margin of the right and left; canines as intercanine width (ICW), 1 st premolar as inter-premolar 1 width (IP 1 W), 2 nd premolar as inter-premolar 2 width (IP 2 W) and at the gingival margin of mesiolingual cusp of 1 st molar as intermolar width (IMW) 
- Arch length (AL): The horizontal distance from the interincisal midline point to the intermolar distance at the mesiolingual cusp tips using Korkhauz three-dimensional bow divider
- Palatal depth: The vertical distance at the mid-palatal suture was measured by adjusting Korkhauz three-dimensional bow divider between the palate and a plane perpendicular to the right and left cusp tips of canines as palatal canine depth (PCD), buccal cusp tip of 1 st premolars as palatal premolar 1 depth (PP 1 D), buccal cusp tip of 2 nd premolars as palatal premolar 2 depth (PP 2 D) and mesiobuccal cusp tip of 1 st molars as palatal molar depth (PMD) 
- Arch perimeters (AP): This was measured from the distal surface of the right first molar around the arch to the distal surface of the left one over the contact points of the posterior teeth and incisal edges of the incisors by using brass wire
Data was recorded in Microsoft Excel Sheet and was analyzed using the statistical package program SPSS Version 16.0 (SPSS Inc, Chicago, Ill). Descriptive statistics, including the means and standard deviations were calculated for each group. ANOVA [Table 1] and independent Student t test [Table 2] were used to determine the presence of significant differences between the groups. Pearson's correlation coefficient was determined between all combinations of variables for male [Table 3] and female [Table 4] separately.
|Table 1: Comparison of palatal parameters among different occlusion groups |
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|Table 2: Independent student T test for comparison of males and females palatal parameters among different occlusion groups |
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|Table 3: Correlation between palatal dimension in different occlusion groups in male |
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|Table 4: Correlation between palatal dimension in different occlusion groups in female |
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| Results|| |
Among the palatal width measurements in the different occlusal groups, variation in ICW was found to be highly significant (P ≤ 0.001), with maximum in Class I group while least in Class II Div 2 group.
Among the AL measurements in the different occlusal groups, variation was found to be highly significant (P ≤ 0.001), with maximum AL in Class II Div 1 while least being in Class III group.
Among the palatal depth measurements in the different occlusal groups, all parameters showed variations, which were highly significant (P ≤ 0.001) except PCD, which was significant at P ≤ 0.005.
Among the AP measurements in the different occlusal groups, variation was found to be highly significant (P ≤ 0.001), with maximum in Class II Div 1 while least being in Class III group.
Independent Student t test for comparison of palatal parameters in male and female among different occlusion groups showed no statistically significant difference. Pearson's correlation coefficient to determine correlation between all combinations of variables for males revealed highly significant correlation among many variables. The strongest correlation (0.907) is between IP 2 W and IMW in Class II Div 2 group. In female highly significant correlation was found among many variables. The strongest correlation (0.922) is between ICW and IP 1 W in Class III group.
| Discussion|| |
Several researchers have investigated dental arch parameters in specific population and usually comparing Open Bite, Deep Bite and Normal Occlusion,  Class II malocclusion with Class I  or Class III with Class I.  Al-Sayagh  compared palatal dimensions in four classes of malocclusion based on Angle's classification in Iraqi population. The present study aimed to compare palatal dimensions in all four types of malocclusion based on Angle's classification with average mandibular plane angle in a mixed Indian population.
ICW in the present study showed highly significant difference (P ≤ 0.001) between the selected groups, which was in agreement with Staley et al. who reported that adults with normal occlusion had larger maxillary canine width than the malocclusion subjects. This study was also in agreement with Munjal et al.  who reported maxillary ICW significantly narrower in the Class II Div 1 group when compared with the Class I occlusion group. However, the results are in contrast to Al-Sayagh  and Sayin and Turkkahrama  who reported that no difference in the ICW between class I and class II Div 1 groups. The finding of the present study showed no significant difference among different occlusion groups in the intermolar and inter-premolar width, which is in contrast to Al-Sayagh  who concluded that class II Div 1 had smaller IP 1 W, IP 2 W and IMW than other occlusion groups. In the current study, difference in arch length measurements in the different occlusal groups were found to be highly significant (P ≤ 0.001), with maximum in Class II Div 1 while least being Class III group. This study showed deepest palatal depth in Class I group while shallow palatal depth in Class III or Class II Div 2, which is in contrast to Al-Sayagh  who found deepest palatal depth in Class II Div 1 group. This can be attributed to differences of the selected sample in both studies. These findings are in agreement with Johnson et al.  who reported that class I crowded subjects had a deepest palate and class II Div 2 samples had shallow palate.
Arch perimeter also showed significant variation among all the selected occlusion groups. The arch perimeter was greatest for Class II Div 1 and least for Class III group in contrast to the findings of the study done by Al-Sayagh  who reported maximum arch perimeter for class II Div 2 malocclusion group, as compared with other occlusion groups.
No statistically significant difference is observed in different malocclusion groups in male and female which was in agreement with Al-Sayagh  but in contrast to Munjal et al. 
A strong correlation was found among various palatal parameters in different occlusion groups and in male and female. In male strongest correlation (0.907) was found between IP 2 W and IMW in Class II Div 2 group. In female strongest correlation (0.922) is between ICW and IP 1 W in Class III group. The palatal depth was only correlated to each other, while these parameters were not significantly correlated to any other cast measurements which is in agreement with Al-Sayagh  and Kaddah  while in contradiction to Eid et al.  who reported correlation between the dental arch width and the corresponding palatal vault depth. The correlation among palatal dimensions revealed that palatal widths, arch perimeter and molar depth were highly and positively correlated with each other.
| Conclusion|| |
Maxillary arch palatal dimensions are influenced by several factors including the shape and size of the jaws and the type of malocclusion. Stability of the post-treatment results is one of the goals of orthodontic treatment, as the arch form tends to return back to original form. The results of present study can be of help to orthodontists in understanding the malocclusion in different ways. It can be helpful in selection of arch wire by taking guidance from the existing arch form and knowledge of stability of post treatment results in different malocclusions. The following conclusions can be drawn from the study:
- Class I group has large ICW while it is narrower in Class II Div 2 group
- Class III group has shortest arch length and arch perimeter
- Class I group has deep palatal depth while it is shallow for Class III and Class II Div 2 groups.
No significant difference in palatal dimensions of male and female.
Among palatal dimensions, a positive correlation is observed between palatal width and palatal depth.
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[Table 1], [Table 2], [Table 3], [Table 4]