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. 2024 Dec 6:35:e245964.
doi: 10.1590/0103-644020245964. eCollection 2024.

Analysis of Frontal Sinus Dimensions According to the Skeletal Malocclusion in German Teenagers

Maria Beatriz Carvalho Ribeiro de Oliveira  1 , Guido Artemio Marañón-Vásquez  2 , Isabela Ribeiro Madalena  1 , Eva Paddenberg-Schubert  3 , Svenja Beisel-Memmert  4 , César Penazzo Lepri  1 , Ângela Graciela Deliga Schroder  5 , Peter Proof  3 , Christian Kirschneck  4 , Erika Calvano Küchler  4 , Maria Angélica Hueb de Meneze-Oliveira  1
Affiliations

Analysis of Frontal Sinus Dimensions According to the Skeletal Malocclusion in German Teenagers

Maria Beatriz Carvalho Ribeiro de Oliveira et al. Braz Dent J. .

Abstract
in English, Portuguese

The present study explored the association between the craniofacial sagittal skeletal patterns and frontal sinus dimensions in Germans. This cross-sectional study included orthodontic patients with age ranging from 11 to 18 (80 males, 82 females). Lateral cephalograms were used in the cephalometric and frontal sinus analysis. Cephalometric analysis was performed to measure SNA, SNB and ANB angles. Frontal sinus measurements were performed to obtain the frontal sinus height, antero-posterior dimension and frontal sinus lateral projection area. The frontal sinus dimensions were compared between genders with Mann Withney test. Kruskal Wallis and Dunn's post-hoc tests were used to compare the mean differences between the skeletal malocclusions. Spearman's correlation test and linear regression model were also performed. Statistical significance was set at 5%. Regarding skeletal malocclusion, 71 patients presented class I, 81 class II and 10 class III skeletal malocclusion. The frontal sinus height (p=0.009), frontal sinus antero-posterior dimension (p=0.001) and frontal sinus lateral projection area (p=0.007) were bigger in males than in females. The frontal sinus antero-posterior dimension was significantly greater in the class III when compared to the class I (p=0.010) and class II (p=0.027). Frontal sinus lateral projection area was also bigger in class III than class I (p=0.039). In the linear regression model a significant association was observed between frontal sinus lateral projection area and class III (skeletal class I as a reference). In conclusion, our result suggests that the frontal sinus lateral projection area might present morphometric differences in German teenagers with skeletal class III malocclusion.

O presente estudo teve como objetivo explorar a associação entre o padrão esquelético craniofacial sagital e a dimensão do seio frontal em adolescentes alemães. Tratou-se de um estudo transversal que incluiu pacientes ortodônticos alemães com idade variando entre 11 e 18 anos (80 homens, 82 mulheres). Cefalogramas laterais foram utilizados na análise cefalométrica e do seio frontal. A análise cefalométrica foi realizada para mensuração dos ângulos SNA, SNB e ANB. Medidas do seio frontal foram realizadas para obtenção da altura e dimensão ântero-posterior do seio frontal. A área da projeção lateral do seio frontal também foi determinada. As dimensões do seio frontal foram comparadas entre os sexos pelo teste de Mann Withney. Teste de Kruskal Wallis e pós teste de Dunn foram utilizados para comparar as diferenças entre as más oclusões esqueléticas. Também foram realizados o teste de correlação de Spearman e um modelo de regressão linear. A significância estatística foi estabelecida em 5%. Quanto à má oclusão esquelética, 71 pacientes apresentavam classe I, 81 classe II e 10 classe III. A altura (p = 0,009), dimensão ântero-posterior (p = 0,001) e área da projeção lateral do seio frontal (p = 0,007) foram maiores nos homens do que nas mulheres. A dimensão ântero-posterior do seio frontal foi significativamente maior na classe III quando comparada à classe I (p = 0,010) e classe II (p = 0,027). A área da projeção lateral do seio frontal também foi maior na classe III do que na classe I (p = 0,039). No modelo de regressão linear foi observada associação significativa apenas entre a área da projeção lateral do seio frontal e a classe III. Nossos resultados sugerem que a área da projeção lateral do seio frontal pode presentar diferenças morfométricas em adolescentes com maloclusão esquelética Classe III.

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Conflict of interest statement

Conflict of Interest: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1. Cephalometric and frontal sinus measurements evaluated. A- Cephalometric landmarks: S - Sella, N - Nasion, A - point A; B - point B, angle 1 = SNB (sagittal position of the mandible), angle 2 = ANB (skeletal class - intermaxillary sagittal relationship). B- Frontal sinus landmarks: SH - most superior point, SL - most inferior point, SAP - most anterior point, SPP - most posterior point, 3 - height of the frontal sinus, 4 - frontal sinus antero-posterior dimension, 5 - Frontal sinus lateral projection area. FH means Frankfurt Horizontal plane.
Figure 2
Figure 2. Frontal sinus dimensions according to gender. A - Frontal sinus height; B - Frontal sinus antero-posterior dimension; and C - Frontal sinus lateral projection area.
Figure 3
Figure 3. Frontal sinus dimensions according to the skeletal malocclusions. A - Frontal sinus height; B - Frontal sinus antero-posterior dimension; and C - Frontal sinus lateral projection area. *Means statistically significant difference. Kruskal Wallis and Dunn's post-hoc tests were used.
Figure 4
Figure 4. Correlation between the frontal sinus dimensions and cephalometric indices. A- Correlation between ANB and height (r=-0.073); B- Correlation between ANB and frontal sinus antero-posterior dimension (r=0.128); C- Correlation between ANB and frontal sinus lateral projection area (r=0.152); D- Correlation between SNA and height (r=0.085); E- Correlation between SNA and frontal sinus antero-posterior dimension (r=0.156); F- Correlation between SNA and frontal sinus lateral projection area (r=0.160); G- Correlation between SNB and height (r=0.147); H- Correlation between SNB and antero-posterior dimension (r=0.262); and I- Correlation between SNB and frontal sinus lateral projection area (r=0.160). Spearman’s correlation test was used.
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References

    1. Kiran CS, Ramaswamy P, Khaitan T. Frontal sinus index: new tool for sex determination. J Forensic Radiol Imaging. 2014;2:77‑79–77‑79.
    1. Prashar A, Sharma VP, Singh GK, Singh GP, Sharma N, Singh H. A cephalometric study of frontal sinus and its relation with craniofacial patterns. Indian J Dent Sci. 2012;4:4–8.
    1. Buyuk SK, Karaman A, Yasa Y. Association between frontal sinus morphology and craniofacial parameters: A forensic view. J Forensic Leg Med. 2017;49:20–23. - PubMed
    1. Hacl A, Costa ALF, Oliveira JM, Tucunduva MJ, Girondi JR, Nahas-Scocate ACR. Three-dimensional volumetric analysis of frontal sinus using medical software. J Forensic Radiol Imaging. 2017;11:1–5.
    1. de Mendonça DS, Ribeiro EC, de Barros Silva PG, Rodrigues AA, Kurita LM, de Aguiar ASW, et al. Diagnostic accuracy of paranasal sinus measurements on multislice computed tomography for sex estimation: A systematic review, meta-analysis, and meta-regression. J Forensic Sci. 2022;67:2151–2164. - PubMed

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