Bimaxillary protrusion trait in the Indian population: A cephalometric study of the morphological features and treatment considerations

• Published in: Orthodontic waves (English ed.) 2014-09, Vol.73 (3), p.95-101
• Main Authors: Sivakumar, Arunachalam, Sivakumar, Indumathi, Sharan, Jitendra, Kumar, Santosh, Gandhi, Sumit, Valiathan, Ashima
• Format: Article
• Language: English
• Subjects: Bialveolar protrusion; Bidental protrusion; Bimaxillary protrusion; Cephalometrics
• ISSN: 1344-0241; 1878-1837
• DOI: 10.1016/j.odw.2014.06.004

The orthodontic literature is discordant with the diagnosis of bimaxillary protrusion with no single anatomic answer and the anomaly has been referred in the literature with protean characteristics. The trait denotes a particular facial configuration and its cephalometric representation in certain ethnic and racial groups revealed a mixed pattern with individual variations. The present study was aimed at analyzing the dento-skeletal characteristics of bimaxillary protrusion in a sample of Indian men and women. Forty-six Indian subjects (28 women and 18 men; 19±3.6 years of age) with Class I malocclusion and interincisal angle ≤110°, who attended orthodontic clinics for a comprehensive fixed orthodontic treatment were included for the study. The lateral films were hand traced and 27 parameters were measured. The data were imported to SPSS version 13 US package and statistical manipulation included means, standard deviation, and coefficient of variation (%). Male and female data were compared by Student's t-test (unpaired). Correlation and regression analysis were performed to assess any relationship between different parameters. There was a marked increase in proclination of the maxillary incisors both to the maxillary plane (125.3±5.7°), the NA line (35.1±5.0°) and to sella–nasion (117.7±5.5°). The positional relationship of the mandible to the maxilla with reference to the cranial base was within the normal limits (ANB=3.1±1.3°) and the skeletal pattern was Class I. The effective lengths of maxilla and mandible did not correlate significantly with sagittal skeletal discrepancy. Unlike in other ethnic and racial groups, bimaxillary protrusion in Indian subjects is likely a bidental protrusion over normal dento-alveolar bases. The skeletal characteristics suggested a normal relationship of the functional components of the face. The condition could be treated successfully with orthodontic mechanotherapy alone.