“Evaluating Vertical Components of Maxillary First Molar to Craniofacial Frame in Average and High Angle Subjects: A Lateral Cephalometric Study”

Abstract

Introduction: Hyperdivergent skeletal patterns, such as mandibular rotation and vertical maxillary excess, pose treatment challenges, often requiring compensatory dentoalveolar changes. Significant differences in dentoalveolar heights are observed in long versus short faces. Treatment options include orthodontics and orthognathic surgery, with skeletal anchorage systems offering improved non-surgical alternatives. One key factor in evaluating treatment outcomes is the vertical position of the upper molar.

Aim: This study aimed to evaluate the vertical position of the maxillary first molar (U6-SN) in relation to the cranial base in average and high mandibular plane angle cases.

Materials and Methods: Cephalometric radiographs of 120 volunteers (ages 16-25) were analyzed. Skeletal Class I patients were identified using the ANB, W, Yen, and Beta angles, and high- and average-angle groups were selected based on Jaraback’s ratio, SN-MP, and FMA. Linear and angular measurements were taken from lateral cephalograms using AutoCAD 2024 to assess molar and maxillary positioning relative to cranial base parameters.

Results: Vertical molar heights (U6-SN, U6-PP) were significantly greater in high-angle cases. Angular measurements also showed higher values in high-angle cases, except for the upper gonial angle, Rickett’s facial axis, and overbite depth. Calibrating with the posterior cranial base revealed a stronger correlation with vertical molar height. Males had greater vertical molar heights and certain linear measurements.

Conclusion: Vertical molar heights are higher in high-angle Class I cases. Angular and vertical characteristics, particularly S-PP and N-PP, influence vertical molar location, with gender differences aiding diagnosis and treatment planning.