Influence of maxillomandibular ratio dynamics on post-pubertal sagittal classification: A retrospective historical cohort study

IF 1.8 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International Orthodontics Pub Date : 2026-06-01 Epub Date: 2025-12-15 DOI:10.1016/j.ortho.2025.101109

Rodrigo Oyonarte , Mónica Valeria Castro , Mackarena Sáez , Florencia Arancibia , Valeria Ramírez , Andreu Puigdollers

{"title":"Influence of maxillomandibular ratio dynamics on post-pubertal sagittal classification: A retrospective historical cohort study","authors":"Rodrigo Oyonarte , Mónica Valeria Castro , Mackarena Sáez , Florencia Arancibia , Valeria Ramírez , Andreu Puigdollers","doi":"10.1016/j.ortho.2025.101109","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Cephalometric measurements, like the ANB or the Wits, enable sagittal skeletal classification; however, they can be affected by compensations, and the maxillomandibular differential may be subject to radiographic magnification. The maxillomandibular ratio (MxMdR) could provide a dynamic, magnification-independent intermaxillary sagittal assessment.</div></div><div><h3>Aims</h3><div>To describe the MxMdR throughout facial development and assess its impact on determining post-pubertal sagittal classification.</div></div><div><h3>Material and methods</h3><div>Retrospective cohort study of 224 untreated individuals (AAOF-Craciofacial Growth Collection), including 1301 profile radiographs from 9 centers (1950s–1970s) with records spanning at least five stages of cervical maturation (CVS 1-6), classified based on final ANB and Wits (97 Class I, 82 Class II, 45 Class III). Measurements included the ANB, SNA, SNB, SN-GoGn, anterior facial height ratio, Wits, maxillary length, mandibular length, and MxMdR. Statistical analysis involved descriptive statistics, mixed models to assess developmental variations, and LASSO regression to identify early-stage predictors for the post-pubertal ANB angle.</div></div><div><h3>Results</h3><div>No significant differences were observed between sexes in sagittal measurements. MxMdR decreased progressively and significantly during growth, showing a class-specific distribution similar to ANB, while Wits decreased in Class III, remained stable in Class I, and increased in Class II individuals. LASSO regression identified initial ANB and MxMdR as key predictors for the post-pubertal ANB.</div></div><div><h3>Conclusions</h3><div>MxMdR evolves differently across skeletal classes, correlating with the final sagittal classification at all developmental stages. Including it alongside the initial ANB improves predictions of post-pubertal relationships. The MxMdR serves as a valuable, magnification-independent tool for early skeletal assessment, complementing traditional diagnostic methods.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101109"},"PeriodicalIF":1.8000,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Orthodontics","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1761722725001445","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/12/15 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Cephalometric measurements, like the ANB or the Wits, enable sagittal skeletal classification; however, they can be affected by compensations, and the maxillomandibular differential may be subject to radiographic magnification. The maxillomandibular ratio (MxMdR) could provide a dynamic, magnification-independent intermaxillary sagittal assessment.

Aims

To describe the MxMdR throughout facial development and assess its impact on determining post-pubertal sagittal classification.

Material and methods

Retrospective cohort study of 224 untreated individuals (AAOF-Craciofacial Growth Collection), including 1301 profile radiographs from 9 centers (1950s–1970s) with records spanning at least five stages of cervical maturation (CVS 1-6), classified based on final ANB and Wits (97 Class I, 82 Class II, 45 Class III). Measurements included the ANB, SNA, SNB, SN-GoGn, anterior facial height ratio, Wits, maxillary length, mandibular length, and MxMdR. Statistical analysis involved descriptive statistics, mixed models to assess developmental variations, and LASSO regression to identify early-stage predictors for the post-pubertal ANB angle.

Results

No significant differences were observed between sexes in sagittal measurements. MxMdR decreased progressively and significantly during growth, showing a class-specific distribution similar to ANB, while Wits decreased in Class III, remained stable in Class I, and increased in Class II individuals. LASSO regression identified initial ANB and MxMdR as key predictors for the post-pubertal ANB.

Conclusions

MxMdR evolves differently across skeletal classes, correlating with the final sagittal classification at all developmental stages. Including it alongside the initial ANB improves predictions of post-pubertal relationships. The MxMdR serves as a valuable, magnification-independent tool for early skeletal assessment, complementing traditional diagnostic methods.

查看原文本刊更多论文

上颌骨比例动态对青春期后矢状位分型的影响：一项回顾性历史队列研究

头颅测量，如ANB或Wits，可以进行矢状骨分类；然而，它们可能会受到代偿的影响，并且上颌骨下颌骨差异可能会受到x线放大的影响。上颌下颌比（MxMdR）可以提供一个动态的，放大无关的上颌间矢状面评估。目的描述面部发育过程中的MxMdR，并评估其对确定青春期后矢状位分类的影响。材料和方法回顾性队列研究224例未经治疗的个体（AAOF-Craciofacial Growth Collection），包括来自9个中心（1950 - 70年代）的1301张侧位x线片，记录至少跨越5个颈椎成熟阶段（CVS 1-6），根据最终ANB和Wits（97例I类，82例II类，45例III类）进行分类。测量包括ANB、SNA、SNB、SN-GoGn、前面部高度比、Wits、上颌长度、下颌长度和MxMdR。统计分析包括描述性统计、评估发育变化的混合模型和LASSO回归，以确定青春期后ANB角度的早期预测因子。结果两性间矢状面测量无明显差异。MxMdR在生长过程中逐渐显著下降，表现出与ANB相似的类特异性分布，而Wits在III类个体中下降，在I类个体中保持稳定，在II类个体中增加。LASSO回归发现初始ANB和MxMdR是青春期后ANB的关键预测因子。结论smxmdr在不同骨骼类别的进化存在差异，并与所有发育阶段的最终矢状位分类相关。将其与最初的ANB结合起来可以改善青春期后关系的预测。MxMdR是一种有价值的、独立于放大倍数的早期骨骼评估工具，是传统诊断方法的补充。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Orthodontics DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

2.50

自引率

13.30%

发文量

审稿时长

26 days

期刊介绍： Une revue de référence dans le domaine de orthodontie et des disciplines frontières Your reference in dentofacial orthopedics International Orthodontics adresse aux orthodontistes, aux dentistes, aux stomatologistes, aux chirurgiens maxillo-faciaux et aux plasticiens de la face, ainsi quà leurs assistant(e)s. International Orthodontics is addressed to orthodontists, dentists, stomatologists, maxillofacial surgeons and facial plastic surgeons, as well as their assistants.