Morphological integration of mandible and cranium: Orthodontic implications

Objectives: This study aimed at clarifying the morphological interactions among the cranial base, face, and mandible, to improve the assessment and treatment of skeletal malocclusions involving the mandible. Design: Untreated adult subjects (n = 187) were grouped according to standard cephalometric criteria of vertical and sagittal relationships. Geometric morphometrics were used to test the null hypothesis that integration patterns between the mandible and its associated basicranial and upper midfacial counterparts would be similar among various vertical and sagittal facial patterns. Results: The null hypothesis was rejected for vertical groups, because the dolicho- and brachyfacial subjects showed significantly different integration patterns, but was accepted for sagittal groups, which showed identical covariation patterns. The morphological integration between the cranium-face and mandible were similarly high in the three skeletal classes, which explained the similarly large covariance between the two structures (57.80% in Class II to 60% in Class III). Conclusions: Dolicho- and brachi-facial subjects showed specific and different cranium-face and associated mandible configurations. The cranium-face configuration may have an important influence (similar to 60%) on the generation of sagittal (anteroposterior) skeletal malocclusions. The remaining morphological component of the skeletal malocclusion (similar to 40%) would be independent of this particular integration (PLS1) between the cranium-face and mandible. (C) 2013 Elsevier Ltd. All rights reserved.