2D:4D Oranı İskeletsel Maloklüzyonlarda Cinsel Dimorfizm Gösterir Mi? Bir Retrospektif Çalışma

Year 2024, Volume: 10 Issue: 2, 95 - 106, 28.08.2024

Orhan Çiçek

https://doi.org/10.21306/dishekimligi.1418197

Abstract

Amaç: Yaşam boyu sabit kalabilme özelliğine sahip olan ikinci parmağın (2D) uzunluğunun dördüncü parmağın (4D) uzunluğuna oranı olarak da adlandırılan 2D:4D oranının erken tanıda biyobelirteç olarak çeşitli hormonlar ve kraniofasiyal iskelet gelişimi ile ilişkili olması dikkat çekicidir. Bu çalışmanın amacı 2D:4D oranı ile sagittal iskelet malokluzyonları arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntemler: Vertikal açıları normal olan toplam 117 hasta (57 kadın, ort. yaş 13.44±1.98; 60 erkek, ort. yaş 13.56±2.14) çalışmaya dahil edildi ve gruplar ANB açısına göre iskeletsel sınıf I, II ve III olarak ayrıldı. İskeletsel sınıf I grubu, hem SNA hem de SNB açıları için ideal değerlere sahip hastalardan oluşuyordu. İskeletsel gruplar ayrıca cinsiyete göre kadın ve erkek olarak alt gruplara ayrıldı. Tedavi öncesi lateral sefalometrik grafilerde SNA, SNB, SN/GoGn ve ANB açıları ile ANS-PNS ve Go-Pog uzunlukları ölçüldü. Parmak uzunluk ölçümleri 0,01 mm’ye kadar ölçüm yapabilen hassas dijital kumpas ile gerçekleştirildi. 2D:4D oranı, 2D uzunluğunun 4D uzunluğa bölünmesiyle her grup için hesaplandı. İstatistiksel analizler normal dağılan verilerde bağımsız örneklem t-testi ve tek yönlü ANOVA, normal dağılmayan verilerde Kruskal-Wallis ve Man-Whitney U testleri ile yapıldı. İstatistiksel anlamlılık düzeyi p < 0.05 olarak kabul edildi.
Bulgular: İskeletsel sınıflarda aynı elin parmak uzunlukları arasında ve sağ-sol 2D:4D oranları arasında istatistiksel olarak anlamlı farklılık bulunmadı. İskelet sınıfı I’lerde parmak uzunlukları ve 2D:4D oranlarında istatistiksel olarak anlamlı cinsel dimorfizm gözlenirken, maloklüzyonun şiddeti arttıkça bu anlamlılığın azaldığı gözlendi. İskeletsel sınıf III’lerde hiçbir parametrede cinsel dimorfizm açısından anlamlı farklılık bulunmadı. 2D:4D oranı ve iskeletsel kaide uzunlukları açısından iskeletsel maloklüzyonlar arasında anlamlı farklılık bulunmadı.
Sonuç: Tüm parametrelerde özellikle iskeletsel sınıf I hastalarda cinsel dimorfizm görülmüş ve erkeklerin 2D ve 4D uzunluklarının kadınlara göre daha uzun olduğu ve 2D:4D oranının daha düşük olduğu saptanmıştır. Ayrıca maloklüzyon şiddeti arttıkça cinsel dimorfizm ile gözlenen parametrelerin istatistiksel anlamlılığının azaldığı sonucuna varılmıştır. Cinsel dimorfizmin iskeletsel sınıf I’de tüm ölçümlerde görülmesi, ancak iskeletsel sınıf III’lerde görülmemesi nedeniyle, cinsiyete göre 2D:4D oranının özellikle iskelet III maloklüzyonlarının erken tanısında tanısal bir biyobelirteç olarak kullanılmasının yolunu açmıştır.

Keywords

2D:4D oranı, cinsel dimorfizm, tanı, iskeletsel maloklüzyon, ortodonti

Does the 2D:4D Ratio Exhibit Sexual Dimorphism in Sagital Skeletal Malocclusions? A Retrospective Study

Abstract

Objective: It is noteworthy that the 2D:4D ratio, also called as the ratio of the length of the second digit (2D) to the length of the fourth digit (4D), which has the ability to remain stable lifetime, is associated with various hormones and craniofacial skeletal development as a biomarker in early diagnosis. The aim of this study was to investigate the relationship between the 2D:4D ratio and sagittal skeletal malocclusions.
Materials and Method: A total of 117 patients (57 females, mean age 13.44±1.98; 60 males, mean age 13.56±2.14) with normal vertical angles were included, and the groups were divided into skeletal classes I, II and III according to the ANB angle. The skeletal class I group consisted of patients with ideal values for both SNA and SNB angles. The skeletal groups were further divided into female and male subgroups by gender. SNA, SNB, SN/GoGn and ANB angles and ANS-PNS and Go-Pog lengths were measured on pretreatment lateral cephalometric radiographs. Digit length measurements were performed with a digital caliper capable of measuring up to 0.01 mm. The 2D:4D ratio was calculated for each group by dividing the 2D length by the 4D length. Statistical analyzes were performed with independent sample t-test and one-way ANOVA in normally distributed data, and Kruskal-Wallis and Man-Whitney U tests in non-normally distributed data. Statistical significance level was accepted as p < 0.05.
Results: There was no statistically significant difference between right and left 2D:4D ratios and right and left digit lengths of the same hand in skeletal classes. While statistically significant sexual dimorphism was observed in digit lengths and 2D:4D ratios in skeletal class Is, it was observed that the significance decreased as the severity of malocclusion increased. No significant difference was found in terms of sexual dimorphism in skeletal class IIIs. There was no significantly difference between the skeletal groups in terms of 2D:4D ratio and length measurements.
Conclusions: Sexual dimorphism was seen in all parameters, especially in skeletal class I patients, and it was found that males had more 2D and 4D lengths and a lower 2D:4D ratio than females. It was also concluded that as the severity of malocclusion increased, the statistical significance of the parameters observed with sexual dimorphism decreased. The fact that sexual dimorphism is fully seen in skeletal class Is but not in skeletal class III has led to the use of the 2D:4D ratio as a diagnostic biomarker in the early diagnosis of sagittal skeletal malocclusions by gender.

Keywords

2D:4D ratio, sexual dimorphism, diagnostic, skeletal malocclusion, orthodontics

Ethical Statement

This study was presented as an oral presentation at the Cukurova 11th International Scientific Researches Conference on August 22-24, 2023, Adana, Turkiye.

References

• 1. Rajawat A, Majeti, C, Podugu UK, Kaushik M, Nagamaheshwari X, Mehra N. Association of hormonal fingerprints and dental caries: A pilot study. J. Conserv. Dent. 2020;23:337-40.
• 2. Biomarkers and Risk Assessment: Concepts and Principles. Available from: https://www.who.int/publications/i/item/9241571551 (accessed on 31 May 2023).
• 3. Canan F, Tegin C, Gecici O. The second to fourth digit (2D: 4D) ratios, smoking, and problem drinking in a young adult university student sample. Neurol. Psychiatry Brain Res. 2019;32:63-7.
• 4. Priyanka GND, Prasad MG, Radhakrishna AN, Ramakrishna J, Jyothi V. The hormonal fingerprints and BMI: Implications for risk factors in dental caries and malocclusion. J. Clin. Diagnostic Res. 2016;10:ZC06-ZC09.
• 5. Issrani R, Aljohani F, Prabhu N, Alam MK. Assessment of 2D: 4D ratio for the early diagnosis of caries and malocclusion in 7-15-year-old children. Bangladesh J Medical Sci. 2021;20:154-58.
• 6. Islam MS, Kundu B. Low digit ratio (2D: 4D) and masculine attributes: a critical analysis. Int J Res Granthaalayah. 2020;8:384-90.
• 7. Warrington NM, Shevroja E, Hemani G, et al. Genome-wide association study identifies nine novel loci for 2D: 4D finger ratio, a putative retrospective biomarker of testosterone exposure in utero. Hum Mol Genet. 2018; 27:2025-38.
• 8. Jägetoft Z, Unenge Hallerbäck M, Julin M, Bornehag CG, Wikström S. Anthropometric measures do not explain the 2D: 4D ratio sexual dimorphism in 7 year old children. Am J Hum Biol. 2022;34:e23776.
• 9. Manning JT, Fink B. Sexual dimorphism in the ontogeny of second (2D) and fourth (4D) digit lengths, and digit ratio (2D: 4D). Am J Hum Biol. 2018;30: e23138.
• 10. Beegum F, Khan N, George S, Anandaraj S. Early Prediction of Dental Caries using Hormonal Fingerprint in 6–12 Years Old Children: A Cross-sectional Study. Int J Clin Pediatr Dent. 2022;15:247-50.
• 11. Bull R, Benson PJ. Digit ratio (2D: 4D) and the spatial representation of magnitude. Horm Behav. 2006;50(2):194-9.
• 12. Jeevanandam S, Muthu PK. 2D: 4D ratio and its implications in medicine. J. Clin Diagnostic Res. 2016; 10:CM01-CM03.
• 13. Sivakumar N, Bansal D, Narwal A, Kamboj M, Devi A. Gender determination analysis using anthropometrical dimensions of 2D: 4D, foot index and mandibular canine index. J Oral Maxillofac Pathol. 2020;24:510.
• 14. Dusseja SH, Rao D, Panwar S, Ameen S. Determining caries risk susceptibility in children of Udaipur city with genetic taste sensitivity and hormonal fingerprint. J. Indian Soc Pedod Prev Dent. 2021;39: 36-41.
• 15. Çağlar Torun A, Uğurlu K. The ratio of the second finger to the fourth finger (2D: 4D); can it be a marker for dental anxiety? Turkiye Klin J Medical Sci. 2021; 27:178-83.
• 16. Penmetsa GS, Anusha B, Gadde P, Itha J, Manchala B, Beldhi M. Hormonal Fingerprints: A Potential Biomarker for Periodontal Disease. J Coast. Life Med. 2023:11:80-7.
• 17. Garg S, Sharma A, Gupta P, Gupta N. Association of 2D: 4D Ratio (Hormonal Fingerprints) with Dental Caries and Malocclusion among 18–25-year-old Dental Students. J Oral Health Comm Dent. 2022:16;73-6.
• 18. Şatir S, Büyükçavuş MH, Sari ÖF, Çimen T. A novel approach to radiographic detection of growth development period with hand‐wrist radiographs: A preliminary study with ImageJ imaging software. Orthod Craniofac Res. 2023;26:100-06.
• 19. Kapetanović A, Oosterkamp BC, Lamberts AA, Schols JG. Orthodontic radiology: development of a clinical practice guideline. Radiol Med. 2021;126: 72- 82.
• 20. Shetty SS, Li GS, Babji NAB, Yusof LS, Yang NNJ, Jun TD, Magandran K. Dermatoglyphics: A prediction tool for malocclusion. J. Datta Meghe Inst Med Sci Univ. 2019;14:27-30.
• 21. Belludi AC, Sridhara A, Kumar NC, Konde S, Noojadi SR. Dermatoglyphics: A Noninvasive Diagnostic Tool in Predicting Class III Skeletal Malocclusion in Children. Int J Clin. Pediatr Dent. 2021;14:63-9.
• 22. Charles A, Ramani P, Sherlin HJ, Dilip S, Srinivas S, Jayaraj G. Evaluation of dermatoglyphic patterns using digital scanner technique in skeletal malocclusion: A descriptive study. Indian J Dent Res. 2018;29:711-15.
• 23. Rani RV, Jeergal VA, Jeergal PA, Gami KS, Mankar S, Mankar S. Lip prints and dermal prints as a tool to detect the skeletal malocclusion: A clinical study. J Pharm Bioall Sci. 2022;14(Suppl 1):888-92.
• 24. Gv V, Tripathi T. Non-invasive methods for the assessment of biomarkers and their correlation with radiographic maturity indicators—a scoping review. Prog Orthod. 2021;22(1):1-10.
• 25. Valla K, Halazonetis DJ. Correlation of 2D: 4D digit ratio and craniofacial shape in prepubertal children. Am J Hum Biol 2014;26:337-46.
• 26. Lauc T, Nakaš E, Latić-Dautović M, Džemidžić V, Tiro A, Rupić I, Kostić M, Galić I. Dental age in orthodontic patients with different skeletal patterns. BioMed Res Int. 2017;8976284.
• 27. Asadujjaman M, Molla MBA, Al Noman SN. Stature estimation from hand anthropometric measurements in Bangladeshi population. J Forensic Leg Med. 2019;65:86-91.
• 28. Burriss RP, Little AC, Nelson EC. 2D: 4D and sexually dimorphic facial characteristics. Arch. Sex Behav. 2007;36:377-84.
• 29. Meindl K, Windhager S, Wallner B, Schaefer K. Second-to-fourth digit ratio and facial shape in boys: the lower the digit ratio, the more robust the face. Proc R Soc B Biol Sci. 2012;279:2457-63.
• 30. Weinberg SM, Parsons TE, Raffensperger ZD, Marazita ML. Prenatal sex hormones, digit ratio, and face shape in adult males. Orthod Craniofac Res. 2015;18:21-6.
• 31. Premkumar S, Gurumurthy B. Assessment of 2D: 4D in subjects with anteroposterior mandibular dysplasia. J Contemp Dent Pract. 2013;14:582-85.
• 32. Lakshmi CR, Radhika D, Prabhat M, mulk Bhavana S, Madhavi NS. Association between genetic taste sensitivity, 2D: 4D ratio, dental caries prevalence, and salivary flow rate in 6-14-year-old children: a crosssectional study. J Res Dent Prospects. 2016;10:142-47.
• 33. Lobud A, Lowati S. Relationship between ratio of 2nd and 4th digit lengths (2D: 4D) and malocclusion in 13-15-years-old children: a case study at Unismuh Junior High School. Makassar Dent J. 2020;9:82-6.
• 34. Achalli S, Patla M; Nayak K, Bhat M. Assessment of dermatoglyphic patterns in malocclusion. J Dent Indones. 2018;25:104-07.
• 35. Eslami N, Jahanbin A, Ezzati A, Banihashemi E, Kianifar H. Can dermatoglyphics be used as a marker for predicting future malocclusions?. Electron Physician, 2016;8:1927-32.
• 36. Devereux L, Moles D, Cunningham SJ, McKnight M. How important are lateral cephalometric radiographs in orthodontic treatment planning?. Am J Orthod Dentofacial Orthop. 2011;139:e175-e181.
• 37. Durão AR, Alqerban A, Ferreira AP, Jacobs R. Influence of lateral cephalometric radiography in orthodontic diagnosis and treatment planning. Angle Orthod. 2015;85:206-10.
• 38. Ahmed M, Shaikh A, Fida M. Diagnostic validity of different cephalometric analyses for assessment of the sagittal skeletal pattern. Dental Press J Orthod. 2018;23:75-81.