Diagnosing Maxillary Occlusal Cant with Average 3-Dimensional Skeletofacial Model Template

Diagnosing maxillary occlusal cant involves varied methods, yet classification remains incomplete. This includes determining whether the cant results from equal faults on both sides or whether one side exhibits overdevelopment and the other underdevelops. This study introduces an innovative average 3-dimensional skull template for classifying maxillary occlusal cant instances.

Sixty adult patients were divided into 2 groups: 30 with a mesoprosopic facial type and 30 with a leptoprosopic facial type. Using 7 pairs of anatomical landmarks (nasion, orbitale [left (l), right (r)], lateral orbitale [L, R], and zygion [L, R]), the average skull models were aligned and superimposed onto the patients' skull models. Image resizing facilitated optimal registration area fitting. Vertical distances from the maxillary first molar mesial buccal cusp tip to the Frankfort horizontal plane were measured to analyze occlusal cant, classified into 3 classes: overdevelopment (class A), underdevelopment (class B), and equal fault on both sides (class C).

In the mesoprosopic group, class B was most common (40%), followed by class A (27%) and class C (33%). In the leptoprosopic facial type group, class B remained prevalent (50%), followed by class A (43%) and class C (7%). Statistical analysis revealed a significant association between facial types and the 3 classes.

Contrary to expectations, equal fault patterns were not predominant; instead, underdevelopment of the maxilla constituted the majority of occlusal cant cases. Using average 3-dimensional skeletofacial models as templates emerges as an effective tool and alternative for diagnosing instances of maxillary occlusal cant.