Association between anterior open bite and frontal sinus, maxillary sinus, and nasal width: a cephalometric study

Anıl Demirel; Fırat Oğuz; Handan Göze Oğuz

doi:10.32322/jhsm.1966570

Association between anterior open bite and frontal sinus, maxillary sinus, and nasal width: a cephalometric study

Abstract

Aims: The aim of this study was to compare frontal sinus dimensions, maxillary sinus dimensions, and nasal width measurements between skeletal class I and class II patients with anterior open bite and a control group using lateral cephalometric and posteroanterior radiographs. Methods: This retrospective study included 110 individuals divided into three groups: skeletal class I anterior open bite (n=40), skeletal class II anterior open bite (n=40), and skeletal class I control group with normal overbite (n=30). Frontal sinus height and width, maxillary sinus height and width, sinus indices, and nasal width measurements were obtained from lateral cephalometric and posteroanterior radiographs using WebCeph software. Intergroup comparisons and correlation analyses between sinus/nasal measurements and cephalometric variables were performed. Results: Significant intergroup differences were observed for several cephalometric parameters, including SNB, ANB, Wits appraisal, FMA, SN-GoMe, IMPA, and L1-NB (p<0.05). However, frontal sinus height and width, maxillary sinus height and width, and nasal width measurements did not differ significantly among the groups (p>0.05). Only the Frontal Sinus Index demonstrated a significant overall intergroup difference (p=0.039); however, post-hoc pairwise comparisons did not reveal significant differences between any groups. Frontal sinus width was significantly greater in males, whereas Frontal Sinus Index values were significantly higher in females (p<0.05). Positive correlations were identified between age and maxillary sinus dimensions as well as nasal width. Conclusion: Patients with anterior open bite showed no significant differences in frontal sinus dimensions, maxillary sinus dimensions, or nasal width compared with the control group. Although weak associations were observed between certain cephalometric parameters and sinus/nasal measurements, age and gender were also associated with specific anatomical dimensions.

Keywords

Project Number

2026/9358

References

Subtelny JD, Sakuda M. Open-bite: diagnosis and treatment. Am J Orthod. 1964;50(5):337-358. doi:10.1016/0002-9416(64)90175-7
Beane RA, Reimann G, Phillips C, Tulloch C. A cephalometric comparison of black open-bite subjects and black normals. Angle Orthod. 2003;73(3):294-300. doi:10.1043/0003-3219(2003)073<0294>2.0.CO;2
Ngan P, Fields HW. Open bite: a review of etiology and management. Pediatr Dent. 1997;19(2):91-98.
Curto A, Albaladejo A, Alvarado-Lorenzo A. Oral-health-related quality of life (OHRQoL) and anterior open bite in adult patients: a case-control study. Healthcare (Basel). 2022;10(1):129. doi:10.3390/healthcare10010129
Keyser MMB, Lathrop H, Jhingree S, et al. Impacts of skeletal anterior open bite malocclusion on speech. FACE (Thousand Oaks). 2022;3(2):339-349. doi:10.1177/27325016221082229
Daer AA, Abuaffan AH. Skeletal and dentoalveolar cephalometric features of anterior open bite among Yemeni adults. Scientifica (Cairo). 2016;2016:3147972. doi:10.1155/2016/3147972
Umeh OD, Chegwe S, Utomi IL. An evaluation of cephalometric predictors of anterior open bite: an assessment of dental and skeletal parameters in an orthodontic population. J Orthod Sci. 2024;13:10. doi:10.4103/jos.jos_56_23
Ahmed HZ, Qamruddin I, Siddiqui H, et al. Morphology of maxillary and frontal sinuses in different skeletal vertical malocclusions. J Orthod Sci. 2025;14:5. doi:10.4103/jos.jos_215_23

Metin-Gürsoy G, Akay G, Baloş Tuncer B. Frontal sinus: is it a predictor for vertical malocclusions? Anat Sci Int. 2021;96(1):62-69. doi:10.1007/s12565-020-00557-9
Dhiman I, Singla A, Mahajan V, Jaj HS, Seth V, Negi P. Reliability of frontal sinus with that of maxillary sinus in assessment of different types of skeletal malocclusions. J Indian Orthod Soc. 2015;49(2):96-103. doi:10.4103/0301-5742.162265
Emirzeoglu M, Sahin B, Bilgic S, Celebi M, Uzun A. Volumetric evaluation of the paranasal sinuses in normal subjects using computer tomography images: a stereological study. Auris Nasus Larynx. 2007;34(2):191-195. doi:10.1016/j.anl.2006.09.003
Buyuk SK, Karaman A, Yasa Y. Association between frontal sinus morphology and craniofacial parameters: a forensic view. J Forensic Leg Med. 2017;49:20-23. doi:10.1016/j.jflm.2017.05.007
Okşayan R, Sökücü O, Yeşildal S. Evaluation of maxillary sinus volume and dimensions in different vertical face growth patterns: a study of cone-beam computed tomography. Acta Odontol Scand. 2017;75(5):345-349. doi:10.1080/00016357.2017.1310294
Sivasankari RSS, Khan N, Parameswaran R, Boovaraghavan S, Nagi M. Evaluation of dimensional changes in maxillary and frontal sinus in adult patients with anterior open bite and normal overbite: a retrospective cone beam computed tomography (CBCT) study. Cureus. 2024;16(2):e53710. doi:10.7759/cureus.53710
Said OT, Rossouw PE, Fishman LS, Feng C. Relationship between anterior occlusion and frontal sinus size. Angle Orthod. 2017;87(5):752-758. doi:10.2319/010617-18.1
Endo T, Abe R, Kuroki H, Kojima K, Oka K, Shimooka S. Cephalometric evaluation of maxillary sinus sizes in different malocclusion classes. Odontology. 2010;98(1):65-72. doi:10.1007/s10266-009-0108-5
Çolak S, Keldal MK, Keldal G, Başal A, Bıçakçı AA. Early skeletal, nasal, and soft tissue changes after surgically assisted rapid maxillary expansion: a retrospective cephalometric study. BMC Oral Health. 2026;26(1):801. doi:10.1186/s12903-026-08215-8
Bujang MA, Baharum N. A simplified guide to determination of sample size requirements for estimating the value of intraclass correlation coefficient: a review. Arch Orofac Sci. 2017;12(1):1-11.
Enlow DH, Hans MG. Essentials of Facial Growth. WB Saunders Co; 1996.
Dah-Jouonzo H, Baron P, Faure J. Correlations between the volume of the sinuses and the facial bones and parameters of 3-dimensional cephalometry. Orthod Fr. 2007;78(4):265-281. doi:10.1051/orthodfr: 2007030
Rossouw PE, Lombard CJ, Harris AMP. The frontal sinus and mandibular growth prediction. Am J Orthod Dentofacial Orthop. 1991; 100(6):542-546. doi:10.1016/0889-5406(91)70095-E
Alfawzan AA. Assessment of skeletal maturity in a sample of the Saudi population using cervical vertebrae and Frontal Sinus Index: a cephalometric study using Artificial Intelligence. Cureus. 2023;15(7). doi:10.7759/cureus.41811
Zheng B, Zhong Y, Al-Worafi NA, Liu Y. The dimensional and morphological assessment of the frontal sinus in sex estimation among different populations. Head Face Med. 2023;19(1):8. doi:10.1186/s13005-023-00355-4
Yassaei S, Emami A, Mirbeigi S. Cephalometric association of mandibular size/length to the surface area and dimensions of the frontal and maxillary sinuses. Eur J Dent. 2018;12(2):253-261. doi:10.4103/ejd.ejd_345_17
Oliveira MBCR, Marañón-Vásquez GA, Madalena IR, et al. Analysis of frontal sinus dimensions according to the skeletal malocclusion in German teenagers. Braz Dent J. 2024;35. doi:10.1590/0103-644020245964
Oktay H. The study of the maxillary sinus areas in different orthodontic malocclusions. Am J Orthod Dentofacial Orthop. 1992;102(2):143-145. doi:10.1016/0889-5406(92)70026-7
Barghouth G, Prior JO, Lepori D, Duvoisin B, Schnyder P, Gudinchet F. Paranasal sinuses in children: size evaluation of maxillary, sphenoid, and frontal sinuses by magnetic resonance imaging and Proposal of Volume Index percentile curves. Eur Radiol. 2002;12(6):1451-1458. doi: 10.1007/s00330-001-1218-9
Sánchez Fernández JM, Anta Escuredo JA, Sánchez Del Rey A, Santaolalla Montoya F. Morphometric study of the paranasal sinuses in normal and pathological conditions. Acta Otolaryngol. 2000;120(2):273-278. doi:10.1080/000164800750001080
Jun BC, Song SW, Park CS, Lee DH, Cho KJ, Cho JH. The analysis of maxillary sinus aeration according to aging process: volume assessment by 3-dimensional reconstruction by high-resolutional CT scanning. Otolaryngol Head Neck Surg. 2005;132(3):429-434. doi:10.1016/j.otohns. 2004.11.012
Ryu J, Choi SH, Cha JY, Lee KJ, Hwang CJ. Retrospective study of maxillary sinus dimensions and pneumatization in adult patients with an anterior open bite. Am J Orthod Dentofacial Orthop. 2016;150(5):796-801. doi:10.1016/j.ajodo.2016.03.032

Details

Primary Language

English

Subjects

Orthodontics and Dentofacial Orthopaedics

Journal Section

Research Article

Authors

Anıl Demirel ^*
0009-0007-1708-0712
Türkiye

Fırat Oğuz
0000-0001-6040-3790
Türkiye

Handan Göze Oğuz
0000-0002-1101-7540
Türkiye

Publication Date

September 19, 2026

Submission Date

June 8, 2026

Acceptance Date

August 31, 2026

Published in Issue

Year 2026 Volume: 9 Number: 5

DOI

https://doi.org/10.32322/jhsm.1966570

IZ

https://izlik.org/JA65MT22RE

Cite

RIS / Bibtex

APA

Demirel, A., Oğuz, F., & Oğuz, H. G. (2026). Association between anterior open bite and frontal sinus, maxillary sinus, and nasal width: a cephalometric study. Journal of Health Sciences and Medicine, 9(5), 1519-1528. https://doi.org/10.32322/jhsm.1966570

AMA

1.Demirel A, Oğuz F, Oğuz HG. Association between anterior open bite and frontal sinus, maxillary sinus, and nasal width: a cephalometric study. J Health Sci Med / JHSM. 2026;9(5):1519-1528. doi:10.32322/jhsm.1966570

Chicago

Demirel, Anıl, Fırat Oğuz, and Handan Göze Oğuz. 2026. “Association Between Anterior Open Bite and Frontal Sinus, Maxillary Sinus, and Nasal Width: A Cephalometric Study”. Journal of Health Sciences and Medicine 9 (5): 1519-28. https://doi.org/10.32322/jhsm.1966570.

EndNote

Demirel A, Oğuz F, Oğuz HG (September 1, 2026) Association between anterior open bite and frontal sinus, maxillary sinus, and nasal width: a cephalometric study. Journal of Health Sciences and Medicine 9 5 1519–1528.

IEEE

[1]A. Demirel, F. Oğuz, and H. G. Oğuz, “Association between anterior open bite and frontal sinus, maxillary sinus, and nasal width: a cephalometric study”, J Health Sci Med / JHSM, vol. 9, no. 5, pp. 1519–1528, Sept. 2026, doi: 10.32322/jhsm.1966570.

ISNAD

Demirel, Anıl - Oğuz, Fırat - Oğuz, Handan Göze. “Association Between Anterior Open Bite and Frontal Sinus, Maxillary Sinus, and Nasal Width: A Cephalometric Study”. Journal of Health Sciences and Medicine 9/5 (September 1, 2026): 1519-1528. https://doi.org/10.32322/jhsm.1966570.

JAMA

1.Demirel A, Oğuz F, Oğuz HG. Association between anterior open bite and frontal sinus, maxillary sinus, and nasal width: a cephalometric study. J Health Sci Med / JHSM. 2026;9:1519–1528.

MLA

Demirel, Anıl, et al. “Association Between Anterior Open Bite and Frontal Sinus, Maxillary Sinus, and Nasal Width: A Cephalometric Study”. Journal of Health Sciences and Medicine, vol. 9, no. 5, Sept. 2026, pp. 1519-28, doi:10.32322/jhsm.1966570.

Vancouver

1.Anıl Demirel, Fırat Oğuz, Handan Göze Oğuz. Association between anterior open bite and frontal sinus, maxillary sinus, and nasal width: a cephalometric study. J Health Sci Med / JHSM. 2026 Sep. 1;9(5):1519-28. doi:10.32322/jhsm.1966570