Cephalometric Characteristics of Class III Orthodontic Malocclusion in a Group of Yemeni Adults

Abstract

Class III orthodontic malocclusion is a challenging dentofacial deformity with significant esthetic and functional implications. This descriptive cross-sectional study aimed to determine the cephalometric characteristics of class III orthodontic malocclusion among Yemeni adults, investigate gender differences, and compare the findings with published Caucasian reference values. Cephalometric radiographs were obtained from 50 Yemeni males (mean age 22.06 ± 2.63 years) and 50 Yemeni females (mean age 22.5 ± 2.50 years). Yemeni adults with skeletal class III relationship (ANB < 2ᵒ, W-Angle > 56ᵒ), dental class III relationship, and fully erupted permanent dentition in both arches were included in this study. Dolphin imaging software was employed for cephalometric analysis. A total of 66 cephalometric variables (37angular, 27 linear, and 2 ratios) were evaluated to assess skeletal, dental and soft tissue relationships. Descriptive and comparative statistical analyses were performed to evaluate gender differences and interethnic variations. Method error for identifying and marking landmarks was minimal and acceptable. Among Yemeni class III orthodontic malocclusion subjects, the majority of linear dimensions were significantly greater in males than in females (P < 0.001). Males also significantly exhibited smaller cranial base angles ( P < 0.001), a more retruded maxilla (P < 0.05), a more protruded and downward rotated mandible (P < 0.05), a steeper occlusal plane ( P < 0.05), greater maxillomandibular discrepancy ( P < 0.001), more proclined mandibular incisors ( P < 0.05) and reduced overjet ( P < 0.01) compared with females. When compared with Caucasians, Yemeni subjects showed significantly shorter cranial fossa lengths (P < 0.001), increased cranial base angles (P < 0.001), a less retruded maxilla (P < 0.01), shorter maxillary and mandibular lengths ( P < 0.001), decreased ANB angle ( P < 0.01), reduced maxillomandibular discrepancy ( P < 0.001), reduced vertical facial heights ( P < 0.001), more protruded and proclined anterior teeth (P < 0.001), and less retruded upper and lower lips (P < 0.001). The dental and craniofacial characteristics of Yemeni adults with class III orthodontic malocclusion differed significantly between males and females, and also differed from those of Caucasian populations. These differences should be considered during orthodontic diagnosis and orthognathic treatment planning. The clinical implication of this study lies in providing a comprehensive understanding of dentoskeletal and soft tissue patterns in Yemeni males and females with Class III orthodontic malocclusion, which may aid both clinical practice and future research.