Jaw Mechanics in Dolichofacial and Brachyfacial Phenotypes: A Longitudinal Cephalometric-Based Study

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Objectives: To determine whether dolichofacial (Frankfort horizontal mandibular plane angle (FHMPA) ≥30°) vs brachyfacial (FHMPA ≤22°) phenotypes differ in temporomandibular joint (TMJ) loads and whether these differences correlate longitudinally with mandibular ramus height (Condylion-Gonion, Co-Go). Setting and Sample Population: Lateral and posteroanterior cephalographs from ten dolichofacial and ten brachyfacial individuals made at average ages of 6 (T1), 12 (T2) and 18 (T3) years and available online (http://www.aaoflegacycollection.org/aaof_home.html) were used. Materials and Methods: Three-dimensional anatomical data were derived from cephalographs and used in numerical models to predict TMJ loads for a range of biting angles on incisors, canines and first molars. Two criteria were used to define clinically important between-group TMJ load differences: statistical significance was defined with a two-group t-test, and where differences were also ≥20%. A statistical approach called response surface analysis was used to assess correlation between TMJ loads and its predictors considered in this study. Results: The two phenotypes had significantly different FHMPA at all ages (P<.05). No differences in TMJ loads were found at T1. Ipsilateral and contralateral TMJ loads at T2 and T3 were significant and ≥20% larger in dolichofacial than brachyfacial phenotypes for specific biting angles (all adjusted P<.05). Regression analysis indicated age and ramus height contribute 53% of the variability in normalized values of TMJ loads. At higher ages, dolichofacial phenotypes had significantly higher TMJ loads which were correlated with shorter ramus heights compared to brachyfacial phenotypes. Conclusions: Craniofacial mechanics may explain, in part, mandibular growth differences between dolichofacial and brachyfacial phenotypes.