A craniometry-based predictive model to determine occlusal vertical dimension

Abstract

Statement of problem: Craniometry is a method of determining the occlusal vertical dimension (OVD); the current prediction models do not consider factors such as facial type and sex or normalizing the OVD by using 1 main variable.

Purpose: The purpose of this clinical study was to determine whether sex, facial type, and age can influence the creation of a predictive model by using the right or left eye-to-ear distance to determine the OVD in dentate and edentate individuals.

Material and methods: Healthy individuals (N=385) (238 women, 147 men) aged between 18 and 50 years were classified according to sex, age, and facial type. A single operator recorded all distances in millimeters between the anatomic landmarks proposed by Knebleman (nose-to-chin and right and left eye-to-ear distances) by using a computer numerical control (CNC) machined aluminum anatomic gauge. Measurements were converted into z-scores to determine abnormal values (±3 standard deviations criteria). The Pearson correlation coefficient was calculated for each facial type and for the entire sample between nose-to-chin and the right and left eye-to-ear distances. Multiple regression analysis was performed to establish the dependence of the measured variables on the OVD and the development of a further predictive model (α=.05).

Results: According to the z-scores of the measured distances, 4 participants were discarded, leaving a final sample of 381 participants (237 women, 144 men; 115 leptoprosopic, 164 mesoprosopic, 102 euryprosopic). The left eye-to-ear distance showed a better correlation with the nose-to-chin distance (leptoprosopic r=0.54, mesoprosopic r=0.60, euryprosopic r=0.55, total sample=0.56) than the right eye-to-ear distance (leptoprosopic r=0.48, mesoprosopic r=0.56, euryprosopic r=0.54, total sample=0.51). Multiple regression analysis revealed that age was not a predictive variable (P=.57), that OVD depended on sex (P<.001) and facial type (P<.01), and that women had shorter OVD than men, as well as more euryprosopic faces than leptoprosopic faces. Using these relationships, the following equation to determine OVD was constructed as a model: OVD=42.17+(0.46×left eye-to-ear distance)+sex (women=-3.38, men=0)+facial type (leptoprosopic=0, mesoprosopic=-1.19, euryprosopic=-2.19).

Conclusions: OVD depends on facial type and sex, both of which are craniometric variables. This study proposed a baseline method of determining OVD by using the left eye-to-ear distance as an initial reference that involves a straightforward mathematical calculation.