Angle Class II/2nd Division: is there an alignment?

Interdisciplinary investigative study of the stomatognathic-cervical complex, necessary to understand the structure and biomechanics of this system in Angle Class I and II / 2nd Division participants.

Objective

To evaluate alignment and position of cranial cervical structures on radiographs and their functional relationship with the stomatognathic system.

Material and method

Trans Oral and Profile radiographs were submitted to biomechanical analysis, considered the linear and angular measurement of Atlas and Axis through the application included in the radiogram software.

Result

We observed a significant difference in the angular measurements of vertical alignment between the Skull, Axis, and the Mandible (p = <0.001), and in the left joint between the Atlas and the Axis (AE: p = 0.011; SEA: p = 0.042). Among the linear measures of the distances between the Atlas and the Axis, the AOD distance presented statistics quite close to the level of significance (p = 0.0502), but above. There was no statistically significant difference in the other measures.

Conclusion

In this study, the alignment between the Atlas and Axis cervical vertebrae and the mandible and angles of the atlanto-occipital joints are altered in Class II / 2nd Division participants. There is no difference in the size and distance of the Atlas and the Axis between the Classes.

Descriptors:
Interdisciplinary research; malocclusion; radiography; cervical column

Variable	Description	p-value
ALIGNMENT ANGLE	Frontal angle between the Axis-Atlas and Axis-Mandible lines	<0.001 *
*Angle*	*Vertical Angles between the Atlanto-Axial Joints on transoral X-ray (in degrees)*
RLBA	Articular angle of the Upper Right Lateral Base of the Axis	0.998
LLBA	Articular angle of the Upper Left Lateral Base of the Axis	0.184
RAA	Right Articular Angle of the Atlas	0.664
LAA	Left Articular Angle of the Atlas	0.011*
LLMA	Angle between the Lateral Atlas Masses	0.826
UBA	Upper Angle of the Base of the Axis	0.051*
RIGHT ANGLE	Angle of the Right Atlanto-axial Joint	0.820
LEFT ANGLE	Angle of the Left Atlanto-axial Joint	0.042*
*Length*	*Length of the Atlas, the Axis and the Hyoid bones on Cross-sectional and Profile Views (mm)*
*Cross-sectional (CS)*
RBLM	Length of the Lower Right Base of the Lateral Mass of the Atlas	0.710
LBLM	Length of the Lower Left Base of the Lateral Mass of the Atlas	0.831
BAX	Length of the Upper Base of the Axis	0.82
NOP	Length of the Neck of the Odontoid Process	0.675
Profile (mm)
LAT	Length of the Atlas Body	0.703
LAX	Length of the Axis Body	0.794
HAX	Height of the Axis Body	0.354
LOP	Length of the Head of the Odontoid Process	0.420
LHB	Length of the Hyoid Bone
*Distance*	*Distances between the Atlas(C1) and the Axis(C2) on Cross-sectional X -ray (mm)*
RAAD	Average Distance between the Atlas and the Axis on the right	0.167
LAAD	Average Distance between the Atlas and the Axis on the left	0.09
MRAA	Medial Distance of the Right Atlanto-Axial Joint	0,628
LRAA	Lateral Distance of the Right Atlanto-Axial Joint	0.190
MLAA	Medial Distance of the left Atlanto-Axial Joint	0.791
LLAA	Lateral Distance of the left Atlanto-Axial Joint	0.269
RAO	Average distance between the Atlas and the Odontoid Process on the right	0.0502*
LAO	Average distance between the Atlas and the Odontoid Process on the left	0.132

Universidade Estadual Paulista Júlio de Mesquita Filho Rua Humaitá, 1680 - Caixa Postal 331, 14801-903 Araraquara,São Paulo,SP, Tel.: (55 16) 3301-6376, Fax: (55 16) 3301-6433 - Araraquara - SP - Brazil
E-mail: adriana@foar.unesp.br

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[1] CONFLICTS OF INTERESTS

The authors declare no conflicts of interest.