Cephalometric analysis of Indian races: A systematic review

This study is intended to review the cephalometric data pertaining to the diverse Indian populace through a systematic literature survey. To conduct a systematic review of literature, an electronic search was done on Medline, Embase, and Central databases. The available data were categorized based on the existing five geographic locations of the country (north, south, east, west, and central India) and analyzed. The following inclusion criteria were considered: (1) studies depicting the cephalometric data of any ethnic group identified as belonging to India, (2) studies originating from the Indian subcontinent, (3) studies which included data of subjects' gender separately, (4) studies which compared the cephalometric data of the Indian population with the that of the Caucasians using Burstone and Legan analysis alone, and (5) articles in English language only. The following exclusion criteria were considered: (1) studies conducted on participants with developmental craniofacial anomalies, post traumatic facial deformities or with a history of previous orthognathic surgery, (2) studies which used analysis other than Burstone and Legan for obtaining the data, (3) editorials, commentaries, case reports, systematic reviews, meta-analyses, and articles not available in English language. Seventeen articles met the inclusion criteria. The Indian population showed greater cranial base dimensions than the Caucasians. In the horizontal dimension, the Indian population exhibited a more convex profile with prognathic maxilla, mandible, and chin along with more protrusive upper and lower incisors. However, in the vertical dimension, they exhibited a decreased middle third facial height as well as a decreased ramal and corpus length of the mandible when compared with the Caucasians. The posterior maxillary height and the posterior facial divergence were relatively less in the Indian population when compared with the Caucasians. Sexual dimorphism was noted among the Indian population with regard to a few vertical skeletal parameters which were significantly greater in males than in females. It was observed that the data pertaining to the cephalometric norms on Indian populace in comparison with the Caucasian race are scanty. Compared to the other geographic locations of India, very less literature is available pertaining to the cephalometric data of the Eastern Indian population. It was observed that very less data are available pertaining to the cephalometric norms for the Indian population considering the ethnic, racial, and geographic diversity. The low sample size, studies being restricted to a specific race, or the lack of comparative studies largely impacts the reliability of the available cephalometric data on the Indian population. Considering the fact that the prevalence of dentofacial deformities in India is high, there is a huge ambit for corrective jaw surgery. Hence, it is essential to compile cephalometric data for the Indian populace to establish ethnic and racial-based cephalometric norms.