Cephalometric Differences in Gummy Smile and Non-Gummy Smile Children: A Case-Control Study

Stefania Mesa Beltrán; Lucia Victoria Bernal de Jaramillo; Oscar Zapata-Noreña; Mónica Patricia Giraldo-Fernández; Diana Maria Barbosa-Liz

Authors

Stefania Mesa Beltrán
Lucia Victoria Bernal de Jaramillo
Oscar Zapata-Noreña
Mónica Patricia Giraldo-Fernández
Diana Maria Barbosa-Liz

Keywords:

Cephalometry, Malocclusion, Angle Class II, Case-Control Studies, Dental Occlusion

Abstract

Objective: To describe and compare children and adolescents' vertical and sagittal cephalometric characteristics with and without a gummy smile (GS). Material and Methods: From a population of 204 patients (7-17 years old) and after applying the selection criteria, a sample of 156 subjects were included: 37 cases (GS) and 119 controls (no GS [NGS]), in a proportion of 1:3. An operator calibrated performed linear and angular measurements on standardized digital lateral radiographs, and the skeletal, dental and soft tissue structures were then analyzed. Results: The mean age of the patients was 9.97 ± 2.12. There were differences in maxillary size and position (p<0.05), mandibular size and rotation (p<0.05), and anterior vertical proportions between SG and NSG patients. The logistic regression model (R²=0.63) showed that increased occlusal plane/palatal plane (OP/PP) and occlusal plane/mandibular plane (OP/MP) angles increase the possibility for GS, with an OR of 2.05 (95% CI: 1.30-3.22) and an OR of 2.32 (95% CI: 1.42-3.75), respectively. No statistically significant differences were found in sex or habits between the GS and NGS patients. Conclusion: Class II skeletal malocclusion with maxillary prognathism and mandibular retrognathism, the hyperdivergent growth pattern, and increased values for OP/PP and OP/PM were associated with GS in children and adolescents. This relationship was established in childhood and adolescence.

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