Sex-Dependent Prevalence of Sagittal Skeletal, Dental Malocclusions in Romanian Orthodontic Patients: An Observational Study

Objectives: The present study aimed to evaluate the sexual dimorphism of skeletal and dental anomalies in Romanian orthodontic patients and to describe several important cephalometric measurements in patients with dental malocclusions. Materials and Methods: A total of 450 orthodontic records of patients older than 8 years were evaluated. On lateral cephalometric radiographs, the following cephalometric angles were digitally determined: SNA, SNB, ANB, FMA, IMPA, Max1-FH, SN-Go-Gn, N-A-Pog, Ar-Go-Me, and interincisal angle. The sagittal skeletal and dental malocclusions were diagnosed by two calibrated investigators. Results: The sample comprised 58% females, with a mean age of 20.07 (±8.63) years. The prevalence of dental malocclusions within the Romanian orthodontic sample taken into study was: 50.7% class I, 26.7% class II division 1, 13.3% class III, 4.7% class II, and class II division 2. The prevalence of skeletal anomalies within the Romanian orthodontic patient sample was: 43.3% class I, 28.7% class II due to retrognathic mandible, 17.3% class II due to prognathic maxilla, 8.7% class III due to prognathic mandible, and 2% class III due to retrognathic maxilla. Female patients presented more frequently with Class I or Class II division 2 malocclusion, whereas male patients more frequently exhibited Class III malocclusion. Female patients exhibited skeletal Class II more frequently due to retrognathic mandible, while skeletal Class III, due to prognathic mandible, was more common in male patients. Male patients were more frequently normodivergent, while female patients were more frequently hyperdivergent. Female patients exhibited retroclined upper incisors more frequently, whereas male patients exhibited proclined upper incisors more frequently. Most of the patients with class II division 1 malocclusion were females and exhibited the following cephalometric characteristics: a class II skeletal anomaly due to retrognathic mandible, normal SNA angle, decreased SNB angle, increased ANB angle, proclined upper incisors, proclined lower incisors, decreased interincisal angle, normal vertical growth pattern, closed mandibular angle, and convex facial profile. Most of the patients with class II division 2 malocclusion were females and exhibited the following cephalometric characteristics: a class II skeletal anomaly due to retrognathic mandible, normal SNA angle, decreased SNB angle, increased ANB angle, retroclined upper incisors, proclined lower incisors, increased interincisal angle, hypodivergent vertical growth pattern with a short face tendency, closed mandibular angle, and convex facial profile. Most of the patients with class III malocclusion were males and exhibited the following cephalometric characteristics: both class I and III skeletal anomaly due to prognathic mandible, normal SNA angle, increased SNB angle, decreased ANB angle, proclined upper incisors, normally inclined lower incisors, increased interincisal angle, hypodivergent, normal vertical growth pattern, and a short face tendency, normal mandibular angle, and balanced facial profile. Conclusions: The observed cephalometric differences between Class I, II and III malocclusions provide clinically relevant markers in vertical, sagittal, and dental dimensions that may provide descriptive reference data for similar orthodontic clinical samples.