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Three-dimensional evaluation of maxillary second molar position in untreated patients with normal occlusion

Implications for preadjusted appliance prescriptions

Dreidimensionale Auswertung der Position des zweiten Molaren im Oberkiefer bei unbehandelten Patienten mit normaler Okklusion

Implikationen für Vorgaben voreingestellter Apparaturen

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

The study was aimed at evaluating the sagittal and transversal inclinations of upper second molars in untreated adolescents with normal occlusion.

Methods

A sample of 41 subjects (16 females, 25 males) was selected from the University of Michigan Growth Study (UMGS). Digital dental casts with fully erupted second molars in occlusion were chosen (mean age 14.9 ± 1.3 years). Digital measurements were recorded with the open source software 3D Slicer (www.slicer.org). The digital measurements of the UMGS sample were compared with the manual measurements collected by Andrews from his sample of untreated class I subjects with normal overbite and overjet. Two mixed effect models (sagittal and transversal inclinations) were performed. The “random effect” was represented by the subjects, while the “fixed effects” were the two compared groups, the side of the arch (right and left), and the group × side interaction. Outcome variables were sagittal and transversal inclinations of the upper second molars.

Results

The UMGS group showed a significantly greater distal crown angulation (−18.9°) with respect to the Andrews sample (0.4°, P < 0.0001). As for the transversal inclination, the UMGS group exhibited significantly greater lingual crown inclination (−10.6° versus −8.0°, P = 0.0118).

Conclusions

Fully erupted maxillary second molars in a sample of adolescent subjects with normal occlusion showed significantly greater distal and lingual inclinations when compared with Andrews’ values. The finding of a distal crown inclination in contrast with Andrews’ observation of a mesial crown inclination suggests that revision in tip prescription for preadjusted brackets may be considered.

Zusammenfassung

Ziel

Ziel der Studie war es, die sagittale und transversale Neigung der oberen zweiten Molaren bei unbehandelten Jugendlichen mit normaler Okklusion zu evaluieren.

Methoden

Eine Stichprobe von 41 Probanden (16 weiblich, 25 männlich) wurde aus der University of Michigan Growth Study (UMGS) ausgewählt. Es wurden digitale Zahnabdrücke mit vollständig durchgebrochenen zweiten Molaren in Okklusion ausgesucht (Durchschnittsalter 14,9 ± 1,3 Jahre). Die digitalen Messungen erfolgten mit der Open-Source-Software 3D Slicer (www.slicer.org). Die digitalen Messungen der UMGS-Stichprobe wurden mit den manuellen Messungen verglichen, die Andrews an seiner Stichprobe von unbehandelten Klasse-I-Probanden mit normalem Overbite und Overjet erhoben hatte. Zwei Mixed-effect-Modelle (sagittale und transversale Neigungen) wurden durchgeführt. Der „Zufallseffekt“ wurde durch die Probanden repräsentiert, die „festen Effekte“ durch die beiden verglichenen Gruppen, die Seite des Zahnbogens (rechts und links) und die Interaktion Gruppe × Seite. Ergebnisvariablen waren sagittale und transversale Inklinationen der oberen zweiten Molaren.

Ergebnisse

Die UMGS-Gruppe zeigte im Vergleich zur Andrews-Gruppe eine signifikant größere distale Kronenangulation (−18,9° vs. 0,4°, p < 0,0001). Hinsichtlich der transversalen Neigung wies die UMGS-Gruppe eine signifikant größere linguale Kronenneigung auf (−10,6° vs. −8,0°, p = 0,0118).

Schlussfolgerungen

Vollständig durchgebrochene obere zweite Molaren in einer Stichprobe von jugendlichen Probanden mit normaler Okklusion zeigten im Vergleich zu den Andrews-Werten signifikant größere distale und linguale Neigungen. Der Befund einer distalen Kronenneigung im Gegensatz zu Andrews’ Beobachtung einer mesialen Kronenneigung deutet darauf hin, dass eine Überarbeitung der Tip-Vorgabe bei voreingestellten Brackets in Betracht gezogen werden kann.

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Author information

Authors and Affiliations

  1. Department of Medical Biotechnologies, University of Siena, Policlinico Le Scotte, Siena, Italy

    Cecilia Goracci DDS, PhD

  2. Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, 48109, Ann Arbor, MI, USA

    Antonio C. Ruellas DDS, PhD, James A. McNamara Jr DDS, PhD &  Lorenzo Franchi DDS, PhD

  3. Department of Experimental and Clinical Medicine, The University of Florence, Florence, Italy

    Michele Nieri DDS, PhD &  Lorenzo Franchi DDS, PhD

  4. Private practice limited to orthodontics, Traverse City, MI, USA

    Spencer Crouch DDS, MS

  5. School of Medicine, Ann Arbor, MI, USA

    James A. McNamara Jr DDS, PhD

  6. Center for Human Growth and Development, The University of Michigan, Ann Arbor, MI, USA

    James A. McNamara Jr DDS, PhD

  7. Private practice of orthodontics, Ann Arbor, MI, USA

    James A. McNamara Jr DDS, PhD

Authors
  1. Cecilia Goracci DDS, PhD
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  2. Antonio C. Ruellas DDS, PhD
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  3. Michele Nieri DDS, PhD
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  4. Spencer Crouch DDS, MS
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  5. James A. McNamara Jr DDS, PhD
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  6. Lorenzo Franchi DDS, PhD
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Corresponding author

Correspondence to Lorenzo Franchi DDS, PhD.

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Conflict of interest

C. Goracci, A.C. Ruellas, M. Nieri, S. Crouch, J.A. McNamara Jr and L. Franchi declare that they have no competing interests.

Ethical standards

This study was exempted from review by the Medical School Institutional Review Board of the University of Michigan (HUM00160161).

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Goracci, C., Ruellas, A.C., Nieri, M. et al. Three-dimensional evaluation of maxillary second molar position in untreated patients with normal occlusion. J Orofac Orthop 83, 172–180 (2022). https://doi.org/10.1007/s00056-021-00290-6

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  • DOI: https://doi.org/10.1007/s00056-021-00290-6

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