Professional Documents
Culture Documents
Postgraduate Research Fellow, Department of Craniofacial Growth and Development Dentistry, Division of Orthodontics,
Kanagawa Dental College, Yokosuka, Japan
2
Department of Pediatric and Preventive Dentistry, Universidad de Valparaiso, Valparaiso, Chile
3
Post-Doctoral Researcher, Department of Craniofacial Growth and Development Dentistry, Division of Orthodontics,
Kanagawa Dental College, Yokosuka, Japan
4
Department of Craniofacial Growth and Development Dentistry, Division of Orthodontics, Kanagawa Dental College,
Yokosuka, Japan
5
Course Director of Dental Science, Danube-University, Krems, Austria
6
Department of Craniofacial Growth and Development Dentistry, Research Institute of Occlusion Medicine,
Research Center of Brain and Oral Science Division of Orthodontics, Kanagawa Dental College, Yokosuka, Japan
Received July 7, 2009; Accepted September 28, 2009
Introduction
The craniofacial architecture is the result of a very complex
interrelation between different structures, which varies
among individuals. Some theories have been developed to
Correspondence: Cristian Basili, Department of Craniofacial Growth
and Development Dentistry, Division of Orthodontics, Kanagawa Dental
College, 82 Inaoka-cho, Yokosuka 238-8580, Japan.
E-mail: cristianbasili@gmail.com
represent these dynamic relations emphasizing on the articular mobility of the cranium and the interaction between the
different craniofacial structures. Among these theories, Dr.
Sadao Sato emphasizes the importance of synchondroses
between the bones, which allows them to be situated within
a exible or moving structure when pressure or tension is
exerted on craniofacial structures. These synchondroses permit slight relative movements called articular mobility of the
cranium [30]. This mobility between the structures is important during growth and development of the mid-face, because
of the varying relation between different bone structures,
muscles, and functional inuences that modulate the expression of the morphological skeletal patterns. In this interrelation, the nasal septum especially vomer bone, because of its
spatial location between the cranial base and the mid-face,
shape and the anatomical relation to important structures,
serves as an important structure that inuences the growth of
this area of the facial skeleton. Therefore, it could play a major
role in the organization of the craniofacial architecture.
Some researchers have partially described the role of
vomer bone in the development of the maxillary complex as a
possible inuencing factor in the lowering of the hard palate or
in the distribution of masticatory forces to the cranial base. At
the same time, some approaches for the development of the
anterior portion of the maxilla [3, 7, 11, 14, 21], and some
inuence on the evolution of patients with cleft palate have
been described [8, 10, 17]. However, its inuence on the
morphology of the craniofacial architecture still remains
unclear.
Most of the information from previous studies about
craniofacial interrelations was obtained from 2D cephalometric images, with limitation in the identication of this structure. Nowadays, the development of the Cone beam
Three-dimensional CT analysis of vomer bone
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original article
Abbreviation
Denition on CT image
Nasion
Sella
Basion
Ba
Upper vomer
UV
Lower vomer
LV
ANS
PNS
A point
Right tuberosity
TubR
Left tuberosity
TubL
Tuberosity medial
TubMed
Right canine
3R
Left canine
3L
5R
5L
Premed
6R
Bucal area of the contact point between right rst molar and right second premolar
6L
Bucal area of the contact point between left rst molar and left second premolar
7R
7L
B point
Menton
Me
TGoR
TGoL
UII
The most incisal point between the two upper central Incisors
Fig. 1: 3D Landmarks. Frontal and lateral images of the 3D virtual model of the skull with the cephalometric landmarks. 1. Nasion; 2. Sella;
3. Basion; 4. Upper vomer; 5. Lower vomer; 6. Anterior nasal spine; 7. Posterior nasal spine; 8. A point; 9. Right tuberosity; 10. Left tuberosity;
11. Tuberosity medial; 12. Right canine; 13. Left canine; 14. Right 2nd premolar; 15. Left 2nd premolar; 16. Right 1st molar; 17. Left 1st molar;
18. Right 2nd molar; 19. Left 2nd molar; 20. B point; 21. Menton; 22. Tangent gonion right; 23. Tangent gonion left; 24. Interincisor point;
25. Median second premolar
192 4/2009
original article
computed tomography systems and its applications in craniofacial diagnosis provide new alternatives to evaluate the
morphology of the craniofacial skeleton in a three-dimensional way with great accuracy [1, 19, 20, 23, 24, 33].
The purpose of this study was to analyze the inuence of
vomer bone on the morphology of the craniofacial architecture, evaluate its correlation with different structures, and
compare the spatial position and dimensions between dentoskeletal frames in 3D digitally reconstructed skulls of a
caucasic European adult population.
Abbreviation
Denition
Horizontal
plane
HP
Vertical plane
VP
Sagital plane
SP
Sella nasion
plane
SN
Palatal plane
PP
Anterior
occlusal plane
AOP
Posterior
occlusal plane
POP
Mandibular
plane
MP
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original article
Abbreviation
Denition
Cranial base
Cr Base
AOP-POP
AOP-POP
AOP-SN
AOP-SN
POP-SN
POP-SN
Vomer diagonal-SN
Dvo-SN
SN-PP
SN-PP
MP-AB
MP-AB
PP-AB
PP-AB
S-Me-SP
S-Me-SP
SN-MP
SN-MP
Vomer Base-SN
Bvo-SN
Vomer Post-SN
Pvo-SN
Vomer Sup-SN
Svo-SN
ANB
ANB
ANS-S-Me
ANS-SMe
N-S-Me
NSMe
SNA
SNA
SNB
SNB
194 4/2009
Results
3D data obtained from the analysis of correlations between
vomer bone and different structures and measurements of
the skulls are presented. Figure 5 shows the lateral representation of a constructed vomer bone. Table 5 presents
descriptive data of angular and linear measurements. Table 6
shows the correlations between angular measurements and
different parameters of the skull. Table 7 presents the correlations of linear measurements of vomer bone. For the
analysis, correlations were determined by their relation to
different structures.
Vomer bone and cranial base
In the sample group, the relation between the cranial base and
the inclination of vomer bone in the angular measurements
Springer-Verlag J. Stomat. Occ. Med.
original article
Abbreviation
Denition
ANS-PNS
ANS-PNS
N-Ba
N-Ba
S-Me
S-Me
Ant Cr Base
Sagital maxilla
Max Dist
Fv (L)
Fv (S)
Fv (T)
Post Cr Base
Vo Diag
Vo Post
Vo Sup
5-SN
A-VP
A-VP
ANS-VP
ANS-VP
B-VP
B-VP
Me-VP
Me-VP
N-VP
N-VP
Int 7 on PP
Int 5 on PP
Intertuberosity
Int Tub
Distance between projections of landmarks TubR and TubL on the palatal plane
UV-ANS
Up Vo-ANS on VP
UV-PNS
Up Vo-PNS on VP
A-6 Lt on PP
A-6 Rt on PP
Int 6 on PP
Intercanine
Int 3 on PP
Max Post Lt on PP
Max Post Rt on PP
Left tuberosity-A on PP
Tub Lt-A on PP
Right tuberosity-A on PP
Tub Rt-A on PP
Vo Post Lo on VP
Vo Post Up on HP
Vo Post Up on VP
Vo Ant Up on HP
Aver A-6 on PP
Average tuberosity-A on PP
Aver Tub-A on PP
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Fig. 4: Image of the 3D linear transversal measurements between landmarks, projected on the Palatal Plane (red color) to avoid vertical
variations. 1. Inter canine (Int 3 on PP); 2. Inter second premolars (Int
5 on PP); 3. Inter rst molars (Int 6 on PP); 4. Inter second molars (Int 7 on
PP); 5. Inter tuberosity (Int Tub); 6. Anterior right maxilla (A-6 Rt on PP); 7.
Anterior left maxilla (A-6 Lt on PP); 8. Posterior right maxilla (Max post Rt
on PP); 9. Posterior left maxilla (Max post Lt on PP); 10. Right tuberosityA point (Tub Rt-A on PP); 11. Left tuberosity-A point (Tub Lt-A on PP)
196 4/2009
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Mean
S.D.
Min.
Max.
302
131.0
5.4
115
147.4
Angular measurements
CrBase
AOP-POP
101
7.9
4.0
1.2
18.4
AOP-SN
113
12.7
4.6
3.1
25
POP-SN
138
19.9
4.2
6.6
29.9
Dvo-SN
302
23.0
3.0
14.5
32.1
MP-AB
302
75.9
5.7
55.7
89.8
PP-AB
302
82.6
5.5
70.2
107.5
SN-MP
302
27.5
5.7
11.7
43.1
Bvo-SN
302
158.3
5.7
140.5
173.6
Pvo-SN
302
57.0
6.5
40.5
77.8
Svo-SN
302
38.3
3.6
25.3
47.9
ANB
302
3.0
2.8
6.1
9.1
ANS-S-Me
302
30.5
3.0
20.8
39.5
NSMe
302
68.2
3.5
58.3
78
SNA
302
83.1
4.1
72.2
92.7
SNB
302
80.1
3.6
70.8
92.2
SN-PP
302
7.1
3.5
4.6
15.7
ANS-PNS
302
51.1
3.2
41.3
60.9
N-Ba
302
101.5
4.4
89.1
112.9
S-Me
302
121.6
5.9
Ant Cr Base
302
67.9
3.6
57.2
77.9
Max Dist
302
52.5
2.9
45.2
63
Fv(L)
302
66.0
5.8
46.9
79.7
Fv(S)
302
50.0
2.7
38.9
55.9
Fv(T)
302
115.1
6.1
90.5
126.4
Post Cr Base
302
43.2
2.8
30.9
51
Vo Diag
302
70.0
3.7
59.5
79.5
Vo Post
302
25.4
3.0
17.8
35.9
Linear measurements
103
134.7
Vo Sup
302
56.9
3.4
47.6
65.7
5-SN
137
72.5
3.1
57.5
78.8
A-VP
302
66.6
4.7
52.6
79
ANS-VP
302
69.2
4.4
55.1
81.6
B-VP
302
61.1
6.5
42.5
80.2
Me-VP
302
56.7
7.5
34.8
77.9
N-VP
302
67.6
3.5
56.9
77.4
Int 7 on PP
239
62.2
4.4
50.4
79.1
Int 5 on PP
136
51.3
3.1
40.8
60.8
Int Tub
302
43.2
3.0
34.6
49.7
(Continued)
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original article
Tab. 5: Continued
Measurements
Mean
S.D.
Min.
Max.
Up Vo-ANS on VP
302
30.4
3.1
19.4
40.3
Up Vo-PNS on VP
302
29.6
2.9
20.1
37.7
Int 6 on PP
245
53.3
3.9
38.8
63.6
Int 3 on PP
152
36.1
2.8
25.7
42
Vo Post Lo on VP
302
19.6
2.8
11.6
27.8
Vo Post Up on HP
302
19.0
2.6
11.9
27.3
Vo Post Up on VP
302
10.1
2.2
5.2
17.8
Vo Ant Up on HP
302
48.0
3.8
35.5
60.6
Aver A-6 on PP
288
34.0
2.2
27.65
41.9
288
29.2
3.3
17.5
52.55
Aver Tub-A on PP
302
54.2
2.8
47.3
62.8
Tab. 6: Correlation of craniofacial morphology between vomer angular measurements and the different
parameters
Measurement
Dvo-SN
Bvo-SN
Cor. Co.
Signif.
Pvo-SN
Cor. Co.
Signif.
Svo-SN
Cor. Co.
Signif.
Cor. Co.
Signif.
CrBase
302
0.326
0.000
0.279
0.000
0.078
NS
0.177
0.316
0.000
AOP-POP
110
0.153
NS
0.127
0.051
NS
0.611
0.164
NS
0.102
0.127
NS
0.207
AOP-SN
122
0.440
0.000
0.037
NS
0.696
0.328
0.000
0.413
0.000
POP-SN
168
0.365
0.000
0.072
NS
0.402
0.205
0.016
0.360
0.000
Dvo-SN
302
0.345
0.000
0.504
0.000
0.778
0.000
MP-AB
302
0.037
NS
0.527
0.017
NS
0.466
0.082
NS
0.155
0.004
NS
0.944
PP-AB
302
0.182
0.001
0.010
NS
0.820
0.143
0.013
0.167
0.004
SN-MP
302
0.235
0.000
0.143
0.050
0.184
0.001
0.166
0.004
Bvo-SN
302
0.345
0.000
0.026
NS
0.654
0.033
NS
0.572
Pvo-SN
302
0.504
0.000
0.026
NS
0.654
0.427
0.000
Svo-SN
302
0.778
0.000
0.033
NS
0.572
0.427
ANB
302
0.115
0.045
0.051
NS
0.381
0.137
ANS-Sme
302
0.200
0.000
0.029
NS
0.614
0.051
NSMe
302
0.376
0.000
0.201
0.000
0.325
SNA
302
0.431
0.000
0.171
0.003
SNB
302
0.391
0.000
0.218
0.000
SN-PP
302
0.607
0.000
0.260
ANSPNS
302
0.272
0.000
0.052
NS
N-Ba
302
0.199
0.001
0.011
NS
S-Me
302
0.239
0.000
0.145
Ant Cr Base
302
0.211
0.000
Max Dist
302
0.275
0.000
Fv(L)
302
0.269
0.000
0.000
0.017
0.202
0.000
NS
0.379
0.191
0.001
0.000
0.333
0.000
0.327
0.000
0.514
0.000
0.262
0.000
0.423
0.000
0.000
0.095
NS
0.099
0.545
0.000
0.366
0.114
0.047
0.260
0.000
0.844
0.251
0.000
0.145
0.012
0.012
0.098
NS
0.090
0.309
0.000
0.038
NS
0.513
0.239
0.000
0.191
0.001
0.006
NS
0.921
0.153
0.008
0.351
0.000
0.063
NS
0.276
0.023
NS
0.692
0.296
0.000
(Continued)
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original article
Tab. 6: Continued
Measurement
Dvo-SN
Bvo-SN
Cor. Co.
Signif.
Pvo-SN
Cor. Co.
Signif.
Svo-SN
Cor. Co.
Signif.
Cor. Co.
Signif.
302
0.631
0.000
0.175
0.002
0.191
0.001
0.474
0.000
Fv(T)
302
0.036
NS
0.432
0.019
NS
0.737
0.110
0.056
0.050
NS
0.386
Post Cr Base
302
0.347
0.000
0.166
0.004
0.191
0.001
0.261
0.000
Vo Diag
302
0.210
0.000
0.185
0.001
0.441
0.000
0.345
0.000
Vo Post
302
0.127
0.027
0.224
0.000
0.118
0.041
0.119
0.039
Vo Sup
302
0.045
NS
0.225
0.271
0.000
0.201
0.000
0.262
0.000
5-SN
154
0.039
NS
0.368
0.003
NS
0.975
0.018
NS
0.836
0.038
NS
0.656
A-VP
302
0.515
0.000
0.174
0.002
0.447
0.000
0.567
0.000
ANS-VP
302
0.516
0.000
0.204
0.000
0.368
0.000
0.561
0.000
B-VP
302
0.471
0.000
0.221
0.000
0.368
0.000
0.487
0.000
Me-VP
302
0.417
0.000
0.230
0.000
0.319
0.000
0.407
0.000
N-VP
302
0.210
0.002
0.037
NS
0.517
0.237
0.002
0.191
0.002
Int 7 on PP
240
0.129
0.046
0.061
NS
0.347
0.123
NS
0.057
0.158
0.014
Int 5 on PP
154
0.118
NS
0.172
0.009
NS
0.917
0.258
0.002
0.111
NS
0.200
Fv(S)
Int Tub
302
0.086
NS
0.136
0.038
NS
0.507
0.121
0.035
0.095
NS
0.099
Up Vo-ANS on VP
302
0.728
0.000
0.109
NS
0.059
0.287
0.000
0.812
0.000
Up Vo-PNS on VP
302
0.085
NS
0.142
0.423
0.000
0.395
0.000
0.239
0.000
Aver A-6 on PP
288
0.236
0.000
0.035
NS
0.553
0.078
NS
0.188
0.206
0.000
Int 6 on PP
252
0.220
0.001
0.001
NS
0.990
0.255
0.000
0.215
0.001
Int 3 on PP
161
0.105
NS
0.200
0.112
NS
0.168
0.106
NS
0.193
0.193
0.017
288
0.083
NS
0.158
0.160
NS
0.073
0.354
0.000
0.199
0.001
Aver Tub -A on PP
302
0.261
0.000
0.064
NS
0.267
0.312
0.000
0.362
0.000
Vo Post Lo on VP
302
0.436
0.000
0.179
0.002
0.547
0.000
0.177
0.002
Vo Post Up on HP
302
0.087
NS
0.446
0.470
0.000
0.286
0.000
0.219
0.000
Vo Post Up on VP
302
0.426
0.000
0.742
0.000
0.164
0.004
0.084
NS
0.147
Vo Ant Up on HP
302
0.420
0.000
0.217
0.000
0.360
0.000
0.694
0.000
Cor. Co Correlation Coefcient. NS not signicant. Statistical signicance at level 0.05. Statistical signicance at level 0.01
time, the posterior height (UV-PNS on VP) showed a signicant negative correlation, but the anterior height (UV-ANS on
VP) showed a positive one, in relation to the spatial and
structural variation.
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original article
Tab. 7: Correlation of craniofacial morphology between vomer Linear Measures and the different
parameters
Measurement
Vo Diag
Vo Post
Vo Sup
Cor. Co.
UV-ANS on VP
Signif.
Cor. Co.
UV-PNS on VP
Signif.
Cr Base
302
0.010
NS 0.886
0.116
0.043
0.097
NS 0.091
0.265
0.000
0.157
0.006
AOP-POP
110
0.089
NS 0.376
0.008
NS 0.939
0.023
NS 0.817
0.130
NS 0.194
0.103
NS 0.306
AOP-SN
122
0.220
0.019
0.193
0.041
0.086
NS 0.365
0.329
0.000
0.037
NS 0.699
POP-SN
168
0.218
0.010
0.142
NS 0.096
0.169
0.048
0.240
0.005
0.072
NS 0.404
DVoSN
302
0.210
0.000
0.127
0.027
0.045
NS 0.433
0.728
0.000
0.085
NS 0.142
MP-AB
302
0.126
0.029
0.139
0.016
0.060
NS 0.295
0.028
NS 0.623
0.129
0.025
PP-AB
302
0.027
NS 0.642
0.053
NS 0.360
0.032
NS 0.584
0.190
0.001
0.131
0.023
SN-MP
302
0.101
NS 0.079
0.014
NS 0.803
0.094
NS 0.104
0.099
NS 0.085
0.041
NS 0.480
Bvo-SN
302
0.185
0.001
0.224
0.000
0.271
0.000
0.109
NS 0.059
0.423
0.000
Pvo-SN
302
0.441
0.000
0.118
0.041
0.201
0.000
0.287
0.000
0.395
0.000
Svo-SN
302
0.345
0.000
0.119
0.039
0.262
0.000
0.812
0.000
0.239
0.000
ANB
302
0.242
0.000
0.037
NS 0.517
0.191
0.001
0.097
NS 0.094
0.169
0.003
ANS-Sme
302
0.006
NS 0.914
0.092
NS 0.112
0.081
NS 0.163
0.247
0.000
0.074
NS 0.198
NSMe
302
0.220
0.000
0.135
0.019
0.225
0.000
0.178
0.002
0.086
NS 0.137
SNA
302
0.338
0.000
0.193
0.001
0.363
0.000
0.299
0.000
0.021
NS 0.714
SNB
302
0.192
0.001
0.239
0.000
0.253
0.000
0.262
0.000
0.145
SN-PP
302
0.037
NS 0.520
0.353
0.000
0.035
NS 0.549
0.554
0.000
0.482
0.000
ANSPNS
302
0.612
0.000
0.237
0.001
0.489
0.000
0.032
NS 0.582
0.028
NS 0.062
N-Ba
302
0.513
0.000
0.040
NS 0.487
0.362
0.000
0.087
NS 0.130
0.021
NS 0.711
S-Me
302
0.421
0.000
0.369
0.000
0.454
0.000
0.051
NS 0.380
0.322
0.000
Ant Cr Base
302
0.514
0.000
0.162
0.005
0.410
0.000
0.064
NS 0.266
0.123
0.033
Max Dist
302
0.759
0.000
0.153
0.008
0.642
0.000
0.037
NS 0.520
0.122
0.034
Fv(L)
302
0.149
0.009
0.159
0.006
0.117
0.042
0.242
0.000
0.152
0.008
Fv(S)
302
0.331
0.000
0.161
0.416
0.000
0.703
0.000
0.135
Fv(T)
302
0.252
0.000
0.224
0.000
0.260
0.000
0.083
NS 0.150
0.210
0.000
Post Cr Base
302
0.210
0.000
0.056
NS 0.333
0.168
0.003
0.154
0.007
0.004
NS 0.939
Vo Diag
302
0.438
0.000
0.775
0.000
0.122
0.034
0.093
NS 0.107
Vo Post
302
0.438
0.000
0.414
0.000
0.127
0.028
0.539
0.000
Vo Sup
302
0.775
0.000
0.414
0.000
0.330
0.000
0.329
0.000
5-SN
154
0.301
0.000
0.294
0.000
0.317
0.000
0.120
NS 0.163
0.233
0.006
A-VP
302
0.664
0.000
0.279
0.000
0.608
0.000
0.197
0.001
0.112
NS 0.052
ANS-VP
302
0.732
0.000
0.252
0.000
0.683
0.000
0.145
0.011
0.169
0.003
B-VP
302
0.447
0.000
0.300
0.000
0.447
0.000
0.206
0.000
0.194
0.001
Me-VP
302
0.355
0.000
0.259
0.000
0.372
0.000
0.172
0.003
0.198
0.001
N-VP
302
0.515
0.000
0.163
0.004
0.411
0.000
0.065
NS 0.262
0.124
Int 7 on PP
240
0.201
0.002
0.055
NS 0.401
0.126
NS 0.052
0.075
NS 0.247
0.028
NS 0.664
Int 5 on PP
154
0.263
0.001
0.078
NS 0.367
0.296
0.000
0.072
NS 0.403
0.011
NS 0.901
Int Tub
302
0.248
0.000
0.130
0.024
0.180
0.002
0.020
NS 0.733
0.071
NS 0.216
UV-ANS on VP
302
0.122
0.127
0.330
0.000
0.433
0.000
0.034
0.05
0.028
0.012
0.019
0.031
(Continued)
200 4/2009
original article
Tab. 7: Continued
Measurement
Vo Diag
Vo Post
Vo Sup
Cor. Co.
UV-ANS on VP
Signif.
Cor. Co.
UV-PNS on VP
Signif.
UV-PNS on VP
302
0.093
NS 0.107
0.539
0.000
0.329
0.000
0.433
0.000
Aver A-6 on PP
288
0.336
0.000
0.115
0.050
0.250
0.000
0.048
NS 0.417
0.154
0.009
Int 6 on PP
252
0.327
0.000
0.068
NS 0.286
0.241
0.000
0.055
NS 0.392
0.012
NS 0.851
Int 3 on PP
161
0.377
0.000
0.038
NS 0.645
0.277
0.000
0.021
NS 0.793
0.066
NS 0.420
0.499
0.000
0.137
0.414
0.000
0.053
NS 0.372
0.131
Aver Tub-A on PP
302
0.732
0.000
0.231
0.000
0.595
0.000
0.001
NS 0.984
0.043
NS 0.459
Vo Post Lo on VP
302
0.086
NS 0.137
0.757
0.000
0.218
0.000
0.294
0.000
0.712
0.000
Vo Post Up on HP
302
0.349
0.000
0.000
NS 0.998
0.225
0.000
0.117
0.043
0.078
NS 0.177
Vo Post Up on VP
302
0.025
NS 0.663
0.220
0.000
0.165
0.004
0.218
0.000
0.444
0.000
Vo Ant Up on HP
302
0.751
0.000
0.367
0.000
0.876
0.000
0.160
0.005
0.124
0.020
0.026
0.031
Cor. Co Correlation coefcient. NS not signicant. Statistical signicance at level 0.05. Statistical signicance at level 0.01
4/2009
201
original article
Class I
Class III
Signif.
Mean
S.D.
Mean
S.D.
Mean
S.D.
I vs. II
I vs. III
II vs. III
Dvo-SN
22.26
2.85
23.13
2.99
23.78
2.71
NS
NS
Bvo-SN
158.98
6.28
158.41
5.9
158.72
4.82
NS
NS
NS
Pvo-SN
58.34
6.78
57.01
6.86
55.11
5.69
NS
NS
Svo-SN
37.18
3.1
38.69
3.82
39.3
3.66
NS
5.8
1.87
3.52
2.43
1.13
2.38
Vo Diag
69.9
3.7
69.84
3.86
69.44
3.39
NS
NS
NS
Vo Post
25.78
2.87
25.28
3.05
25.19
2.96
NS
NS
NS
ANB
Vo Sup
56.43
3.46
56.64
3.37
56.55
3.61
NS
NS
NS
UV-ANS on VP
29.26
2.51
30.52
31.09
3.36
NS
UV-PNS on VP
29.97
2.63
29.47
2.87
28.84
3.18
NS
NS
NS
Vo Post Lo on VP
20.27
2.79
19.49
2.76
18.95
2.59
NS
NS
Vo Post Up on HP
19.02
2.55
19.14
2.65
19.07
2.55
NS
NS
NS
Vo Post Up on VP
9.91
2.29
10.08
2.19
10.06
2.3
NS
NS
NS
Vo Ant Up on HP
48.25
3.85
47.61
4.06
47.18
3.79
NS
NS
NS
202 4/2009
Discussion
The results of this study show that vomer bone has very
interesting interrelations within craniofacial architecture. This
bone usually remains hidden from our cephalometric analysis, because of the difculties in identifying it in a two-dimensional X-ray. The application of the three-dimensional
Computerized Tomography, and the possibility of creating
3D volumetric digital skull reconstruction provided us the
opportunity to analyze the skull, with great accuracy [1, 20, 24,
33] and reproducibility [23], by applying a different computerbased software, like the one used in this study. The analysis of
the structures was developed by dening landmarks and
planes. These were extracted initially from the traditional
2D cephalometric analysis, allowing us to compare the data
with other study results; and some of them redened to a
three-dimensional environment, in order to be able to correlate anatomical structures.
The denition of the constructed vomer bone slightly
differs from that of a real vomer bone. The reason for this was
to obtain clear landmarks and excellent reproducibility in
positioning them. In this way, the constructed vomer bone
was extended forward to the ANS point. This must be considered in the interpretation of the results.
Springer-Verlag J. Stomat. Occ. Med.
original article
4/2009
203
original article
Conclusions
1. Vomer bone seems to play an important role in the interrelation of the craniofacial architecture.
2 Changes in the inclination and the dimensions of vomer
bone are strongly correlated with other craniofacial
structures.
3 There are signicant variations of vomer bone between the
different dentoskeletal frames.
Take-home message
The potential inuence of vomer bone in the craniofacial
architecture has been described in a dynamic functional
complex involving occipital, sphenoid, vomer, and maxilla
bones. Vomer bone seems to play an important role
modulating the interrelation between cranial base and
maxilla, showing signicant variations between dentoskeletal frames.
Conict of interest
The authors declare that there is no conict of interest.
Acknowledgments
This work was performed in the Research Institute of Occlusion Medicine and Research Center of Brain and Oral Science,
Kanagawa Dental College and supported by grant-in-aid for
Open Research from the Japanese Ministry of Education,
Culture, Sports, Science and Technology. The authors would
like to express their gratitude to the research project postgraduate students (Skull Project) involved in the data collection
process, especially Drs. Tanaka EM, Fujii M, Taguchi C,
Koizumi S, Sugimoto K, Sato C, Kodama T, Shinomiya M,
Okada S, Horisawa A, Yamashita R, Takahashi T, Kim Y,
Shirazu M, Park H, Sato S, Kawai Y, Onodera K, Tajima K,
Onodera Y, Tajima K.
The results of this research were partially presented at
Summer School 2009 in Tokyo, Japan.
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