Orthodontic implants have found widespread use as means of maximum skeletal anchorage in fixed orthodontic treatment, their optimal insertion location in the hard palate, however, is still controversial. The aim of this study was therefore to assess mean bone height across the hard palate and possible age- and sex related differences to identify the most favourable location according to maximum bone height, optimizing primary stability and survival of inserted orthodontic implants. In this retrospective cross-sectional study, maxillary pretreatment CBCT scans of 180 healthy orthodontic patients (95♀, 85♂, age 8–40 years) were analysed with regard to vertical palatal bone height in the midpalatal area at 88 validated points distanced 2 mm from each other forming a grid of 0–14 mm posterior to the incisive foramen and 10 mm lateral of the midpalatal suture. Differences in bone height regarding sex and topographical location were assessed by three-way ANOVA. In general, the midpalatal suture as well as the anterior-lateral palatal region showed distinctly higher mean palatal bone height with its maximum 4 mm posterior of the incisive foramen, whereas bone height was limited at the posterior region of the midpalatal suture. Women generally had significantly decreased palatal bone height compared to men at all measurement points. Higher age was associated with a decrease of bone height in the anterior and posterior lateral palatal region and the median palatal raphe with significant age differences. The midpalatal suture as well as the anterior lateral palate seem to be most suitable for the insertion of orthodontic implants. Palatal bone height, however, was found to be sex- and age-specific, thus sex- and age-related differences should be taken into account, particularly regarding implant length. The ideal insertion site in the palate with sufficient bone height for orthodontic implants is 0-8 mm (men) or 0-6 mm (women) posterior to the incisive foramen and 10 mm lateral to the midpalatal suture. This study has been registered and approved by the Ethics Committee of the University of Witten/Herdecke, Germany (12/2016).

Three-dimensional landmarks of the face are important for orthodontic examination, harmony assessment and treatment planning. Currently, facial landmarks are often measured by orthodontists via direct observation and manual soft tissue image analysis. This study wants to evaluate and present an objective method for measuring selected facial landmarks based on an analysis of curvature maps and of sagittal profile obtained by a laser-scanning method. The faces of 15 people were scanned in 3D by means of the laser scanner FastSCAN™. It allowed the recording of a curvature map of the face in under a minute, which depicted the distribution of Gaussian and mean curvatures. The median-sagittal profile line of the face was localized in this map, and a mathematical analysis comprising its first and second derivatives was performed. Anatomical landmarks were identified and facial measurements performed. To assess validity the obtained data were compared with manual measurements by orthodontists by means of Lin’s concordance correlation CCC coefficient and reliability was determined by consecutive measurements. Facial landmarks, such as the soft tissue glabella and nasal tip, could be easily and accurately identified and located. Lin’s CCC showed substantial agreement between digital and manual measurements for 4 of the 7 distances evaluated. Larger discrepancies were due to inadequate image quality and scanning errors. Reliability of consecutive measurements by the same operator was excellent. In our pilot study the three-dimensional laser-scanning method FastSCAN™ allowed a reliable and accurate identification of anatomical landmarks of the face. The obtained distances between certain landmarks, such as the intercanthal distance, were largely consistent with those from manual measurements. Due to its easy and rapid implementation, the method facilitates facial analysis and could be a clinically valid alternative to manual measurements, when remaining problems in scanning accuracy can be resolved.

The aim of this study is to determine correlations between the parameters of body posture in the sagittal profile and sagittal jaw position by obtaining objective and valid three-dimensional measurements of the dorsal profile by means of rasterstereography. Fifty-three adults with Class II or III malocclusions were examined, and six angular parameters were determined. For the sagittal analysis of body posture, the Fleche Cervicale and Lombaire as well as trunk inclination were evaluated. Statistically significant correlations (P < .05) were found between Facial Axis and Fleche Cervicale, Mandibular Plane angle and Fleche Cervicale, and Facial Depth and the Fleche Cervicale. It can be concluded that the mandible seems to have a greater effect on body posture than other craniofacial parameters. As a clinical result of this study, patients with severe malocclusions should be examined interdisciplinarily before orthognathic surgery is performed to minimize postural influence on the altered jaw relationship after surgery.

To analyze the correlation ratios between the spinal posture (thoracic, lordotic, and pelvic inclination) and the craniofacial morphology. The sample consisted of 53 healthy adults (32 women, 21 men; mean age 24.6 years). Six angular skeletal measurements (facial axis, mandibular plane angle, inner gonial angle, lower facial height, facial depth, and maxilla position) were determined based on the analysis of lateral head cephalographs. Rasterstereography was used for a precise reconstruction of the back sagittal profile. From the profile parameters, the upper thoracic inclination, the thoracic angle, the lordotic angle, and the pelvic inclination were determined. The correlations to the craniofacial morphology were calculated by means of the Pearson and Mann-Whitney U-test. Significant correlations could be obtained with respect to the facial axis and the lordotic angle, the facial axis and the pelvic inclination, the inner gonial angle and the lordotic angle, the inner gonial angle and the pelvic inclination, the mandibular plane angle and the lordotic angle, the mandibular plane angle and the pelvic inclination, as well as the facial depth and the pelvic inclination. In the case of postural disorders of the back shape, an interdisciplinary treatment approach seems to be of clinical value. Further prospective studies are necessary to prove how changes in craniofacial parameters can affect the postural balance of an individual.

Studies on the relationship between body posture and craniofacial parameters often focus on the cervical spine. Thus, less attention has been paid to the morphology of the vertebra C2 that serves as both a structural and functional link between the craniofacial area and the other part of the spine. The objective of this study was to assess the relation of craniofacial features to certain morphological and positional characteristics of the cervical vertebrae and the spine during growth. We determined body posture indices for 69 children and adolescents by means of a radiation-free method (rasterstereography). The morphological and positional analysis of the craniofacial area and the cervical vertebrae was based on standardized lateral X-ray cephalograms. Medium to strong correlations were found between body posture, C2 morphology, and craniofacial parameters. We found significant correlations between the C2 dens axis height and maxillary indices as well as between the C2 dens axis inclination and cephalometrical values of the mandibular area. Similarly the correlation between the C2 dens axis inclination and the postural index flèche cervicale was highly significant (P<0.05,r=0.333). These results suggest that morphological features of the odontoid process may serve as valuable predictive markers in interdisciplinary orthopedic-orthodontic diagnostics.