Mild and Severe Obesity Reduce the Effectiveness of Lumbar Fusions: 1-Year Patient-Reported Outcomes in 8171 Patients

Neurosurgery ◽  
2020 ◽  
Author(s):  
Graham Mulvaney ◽  
Olivia M Rice ◽  
Vincent Rossi ◽  
David Peters ◽  
Mark Smith ◽  
...  
Keyword(s):  
Risk Factor ◽  
Surgical Complications ◽  
Surgical Complication ◽  
Lumbar Fusion ◽  
Class Ii ◽  
Class I ◽  
Class Iii ◽  
Class I Obesity ◽  
Patient Reported ◽  
One Year

Abstract BACKGROUND Elevated body mass index (BMI) is a well-known risk factor for surgical complications in lumbar surgery. However, its effect on surgical effectiveness independent of surgical complications is unclear. OBJECTIVE To determine increasing BMI’s effect on functional outcomes following lumbar fusion surgery, independent of surgical complications. METHODS We retrospectively analyzed a prospectively built, patient-reported, quality of life registry representing 75 hospital systems. We evaluated 1- to 3-level elective lumbar fusions. Patients who experienced surgical complications were excluded. A stepwise multivariate regression model assessed factors independently associated with 1-yr Oswestry Disability Index (ODI), preop to 1-yr ODI change, and achievement of minimal clinically important difference (MCID). RESULTS A total of 8171 patients met inclusion criteria: 2435 with class I obesity (BMI 30-35 kg/m2), 1328 with class II (35-40 kg/m2), and 760 with class III (≥40 kg/m2). Increasing BMI was independently associated with worse 12-mo ODI (t = 8.005, P < .001) and decreased likelihood of achieving MCID (odds ratio [OR] = 0.977, P < .001). One year after surgery, mean ODI, ODI change, and percentage achieving MCID worsened with class I, class II, and class III vs nonobese cohorts (P < .001) in stepwise fashion. CONCLUSION Increasing BMI is associated with decreased effectiveness of 1- to 3-level elective lumbar fusion, despite absence of surgical complications. BMI ≥ 30 kg/m2 is, therefore, a risk factor for both surgical complication and reduced benefit from lumbar fusion.

scholarly journals Classification of Pain Dynamics in Sickle Cell Disease from Mobile App Reporting

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 983-983
Author(s):  
Gary Nave ◽  
Swati Padhee ◽  
Amanuel Alambo ◽  
Kumar Utkarsh ◽  
Tanvi Banerjee ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Research Funding ◽  
Class Ii ◽  
Mobile App ◽  
Class I ◽  
Class Iii ◽  
Cell Disease ◽  
Patient Reported ◽  
Pain Trajectories ◽  
Over Time

Abstract Background: Sickle Cell Disease (SCD) is a chronic blood disorder in which complications result from vaso-occlusion. Pain is the most common symptom reported in patients with SCD and includes both acute unpredictable pain as well as chronic pain. Chronic pain is clinically defined as having more days with pain than without pain over a period of 6 months. Various classifications systems have been developed to better understand pain phenotypes, however, there is variability in data and groupings of patients. Recent work based on patient-reported outcome data has shown that patients may be classified into three subgroups: infrequent acute pain, limited recent pain with moderate long-term pain, and persistent severe pain. An improved understanding of the ways in which pain dynamics manifest over time will allow patients and medical providers to better manage pain. Using previously-published data which collected self-reported data through a mobile app over 6 months (Clifton et al., 2017, J. Comput. Biol.), we aimed to characterize the different ways in which patients experienced pain over time. In this work, we sought to identify classes of patients based only on their self reported pain levels. Methods: Patients within the previously-published study were asked to self-report their pain levels from 0-10 on a daily basis through a mobile app. The study included 39 patients (16 male, 23 female), with a mean age of 33.4. Patients reported their pain an average of 0.4 times per day over an average of 164.6 days. To allow for the possibility that patients' experiences change over time, we windowed the time series of pain dynamics into non-overlapping two-week windows. Within each window, the data were linearly interpolated to regularly-spaced samples. Then, we applied spectral clustering to identify classes of similar pain trajectories within the windowed data. Within the data, we also identified patients with and without chronic pain within the sample based on whether or not they have taken long-acting opioid medications, which are commonly prescribed for those with a diagnosis of chronic pain. With this identification, we compared patients within the identified classes with patients diagnosed with chronic pain. Results: We found that three classes of pain dynamics may be identified from the data considered: class I, class II, and class III (Figure). Class I pain trajectories have mild baseline pain, typically 0, with acute exacerbations of low to medium pain levels. Class II trajectories show moderate mean pain values, and show large variation within each trajectory. Class III trajectories show consistently high pain levels, rarely dropping below 7. All three classes include patients who have been diagnosed with chronic pain, but the proportion of patients with chronic pain differs. Patients with chronic pain represented 32% of samples in class I, 83% of samples in class II, and 86% of samples in class III. Conclusions: Based only on self-reported pain over time, clustering pain experiences into classes yields three distinct classes. These classes do not perfectly align with chronic pain diagnoses, but classes II and III both contain mostly chronic pain patients. Based on this and the unique behaviors of those classes, it may be useful to differentiate chronic pain into persistent chronic pain and intermittent chronic pain. Moreover, the findings of these classes are similar to results found from analyzing patient reported outcomes and show promise for the continued use of mHealth apps to acquire patient reported symptoms. Figure 1 Figure 1. Disclosures Shah: CSL Behring: Consultancy; Emmaus: Consultancy; Novartis: Research Funding, Speakers Bureau; Bluebird Bio: Consultancy; Guidepoint Global: Consultancy; GLG: Consultancy; Alexion: Speakers Bureau; GBT: Consultancy, Research Funding, Speakers Bureau.

scholarly journals EPID-24. OBESITY IN MALES WITH MENINGIOMA: A U.S. POPULATION-BASED STUDY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii83-ii83
Author(s):  
Maryam Shahin ◽  
Ali Rae ◽  
Christian Lopez Ramos ◽  
Jacob Bagley ◽  
Stephen Bowden ◽  
...  
Keyword(s):  
Class Ii ◽  
Population Based ◽  
Class I ◽  
Class Iii ◽  
Improvement Program ◽  
Steroid Synthesis ◽  
Class I Obesity ◽  
Significant Difference ◽  
Icd 10 ◽  
Male Patients

Abstract BACKGROUND The female predominance of meningiomas may reflect a hormonal influence on tumorigenesis. Obesity alters steroid synthesis and chronically exposes men to hyperestrogenemia. OBJECTIVE Identify differences in males undergoing craniotomy for meningioma compared to other tumors or aneurysms. METHODS The National Surgical Quality Improvement Program was retrospectively queried from 2013–2018 for cases of craniotomy for resection of meningioma, other tumor, and aneurysm by CPT code in male patients and confirmed with postoperative ICD-10 code. Height and weight data were used to create body mass index (BMI): underweight (< 18.5), normal (18.5 to< 25), overweight (25 to< 30), class I obesity (30 to< 35), class II obesity (35 to< 40), and class III obesity (40+). RESULTS We identified 2,458 males who underwent craniotomy for meningioma, 9,889 for other tumor, and 386 for aneurysm. Using multivariable logistic regression, age (OR 1.01 per year, 95% CI 1.01-1.01, p< 0.001), diabetes mellitus (OR 1.32, 95% CI 1.17–1.48, p< 0.001), and increasing BMI (overweight: OR 1.55, 95% CI 1.36–1.76, p< 0.001; class I: OR 2.00, 95% CI 1.75–2.30, p< 0.0001; class II: OR 2.05, 95% CI 1.24–1.76, p< 0.001; class III: OR 1.47, 95% CI 1.24–1.76, p< 0.0001) were significantly and independently associated with craniotomy for meningioma compared to other tumor or aneurysm. For other tumor, higher BMI was associated with lower likelihood (overweight: OR 0.70, 95% CI 0.62–0.79, p< 0.001; class I: OR 0.55, 95% CI 0.49–0.63, p< 0.001; class II: OR 0.52, 95% CI 0.44–0.62, p< 0.001; class III: OR 0.74, 95% CI 0.63–0.87, p< 0.001). For aneurysm, there was no significant difference (overweight p=0.70; class I p=0.65; class II p=0.76; class III p=0.57). CONCLUSIONS BMI independently predicts having craniotomy for meningioma when compared to other tumor or aneurysm amongst US male patients.

scholarly journals Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 413
Author(s):  
Hui-Ling Chen ◽  
Jason Chen-Chieh Fang ◽  
Chia-Jung Chang ◽  
Ti-Feng Wu ◽  
I-Kuan Wang ◽  
...  
Keyword(s):  
Cadmium Concentration ◽  
Class Ii ◽  
Cadmium Exposure ◽  
Class I ◽  
P Value ◽  
Tooth Decay ◽  
Class Iii ◽  
Orthodontic Patients ◽  
Urine Cadmium ◽  
The Mean

Background. Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with some dental or skeletal traits such as malocclusions, sagittal skeletal pattern, and tooth decay. Methods. Between August 2019 and June 2020, 60 orthodontic patients with no history of previous orthodontics, functional appliances, or surgical treatment were examined. The patients were stratified into two groups according to their urine cadmium concentrations: high (>1.06 µg/g creatinine, n = 28) or low (<1.06 µg/g creatinine, n = 32). Results. The patients were 25.07 ± 4.33 years old, and most were female (female/male: 51/9 or 85%). The skeletal relationship was mainly Class I (48.3%), followed by Class II (35.0%) and Class III (16.7%). Class I molar relationships were found in 46.7% of these patients, Class II molar relationships were found in 15%, and Class III molar relationships were found in 38.3%. The mean decayed, missing, and filled surface (DMFS) score was 8.05 ± 5.54, including 2.03 ± 3.11 for the decayed index, 0.58 ± 1.17 for the missing index, and 5.52 ± 3.92 for the filled index. The mean index of complexity outcome and need (ICON) score was 53.35 ± 9.01. The facial patterns of these patients were within the average low margin (26.65 ± 5.53 for Frankfort–mandibular plane angle (FMA)). There were no significant differences in the above-mentioned dental indices between patients with high urine cadmium concentrations and those with low urine cadmium concentrations. Patients were further stratified into low (<27, n = 34), average (27–34, n = 23), and high (>34, n = 3) FMA groups. There were no statistically significant differences in the urine cadmium concentration among the three groups. Nevertheless, a marginally significant p-value of 0.05 for urine cadmium concentration was noted between patients with low FMA and patients with high FMA. Conclusion. This analysis found no association between environmental cadmium exposure and dental indices in our orthodontic patients.

scholarly journals A convenient method of preparation of high-activity urease from Canavalia ensiformis by covalent chromatography and an investigation of its thiol groups with 2,2'-dipyridyl disulphide as a thiol titrant and reactivity probe

1976 ◽  
Vol 159 (2) ◽  
pp. 245-257 ◽  
Author(s):  
R Norris ◽  
K Brocklehurst
Keyword(s):  
Convenient Method ◽  
Specific Activity ◽  
Class Ii ◽  
High Reactivity ◽  
Class I ◽  
Thiol Groups ◽  
Class Iii ◽  
Active Centre ◽  
Class Ib ◽  
Covalent Chromatography

1. A convenient method of preparation of jack-bean urease (EC3.5.1.5) involving covalent chromatography by thiol-disulphide interchange is described. 2. Urease thus prepared has specific activity comparable with the highest value yet reported (44.5 ± 1.47 kat/kg, Km = 3.32 ± 0.05 mM; kcat. = 2.15 × 104 ± 0.05 × 104s-1 at pH7.0 and 38°C). 3. Titration of the urease thiol groups with 2,2'-dipyridyl disulphide (2-Py-S-S-2-Py) and application of the method of Tsou Chen-Lu [(1962) Sci. Sin.11, 1535-1558] suggests that the urease molecule (assumed to have mol.wt. 483000 and ε280 = 2.84 × 105 litre·mol-1-cm-1) contains 24 inessential thiol groups of relatively high reactivity (class-I), six ‘essential’ thiol groups of low reactivity (class-II) and 54 buried thiol groups (class-III) which are exposed in 6M-guanidinium chloride. 4. The reaction of the class-I thiol groups with 2-Py-S-S-2-Py was studied in the pH range 6-11 at 25°C(I = 0.1 mol/l) by stopped-flow spectrophotometry, and the analogous reaction of the class-II thiol groups by conventional spectrophotometry. 5. The class-I thiol groups consist of at least two sub-classes whose reactions with 2-Py-S-S-2-Py are characterized by (a) pKa = 9.1, k = 1.56 × 104M-1·s-1 and (b) pKa = 8.1, k = 8.05 × 102M-1·s-1 respectively. The reaction of the class-II thiol groups is characterized by pKa = 9.15 and k = 1.60 × 102M-1·s-1. 6. At pH values 7-8 the class-I thiol groups consist of approx. 50% class-Ia groups and 50% class-Ib groups. The ratio class Ia/class Ib decreases as the pH is raised according to a pKa value ≥ approx. 9.5, and at high pH the class-I thiol groups consist of at most 25% class-Ia groups and at least 75% class-Ib groups. 7. The reactivity of the class-II thiol groups towards 2-Py-S-S-2-Py is insensitive to the nature of the group used to block the class-I thiols. 8. All the ‘essential’ thiol groups in urease appear to be eeactive only as uncomplicated thiolate ions. The implications of this for the active-centre chemistry of urease relative to that of the thiol proteinases are discussed.

Epidemiology and outcomes of obese critically ill patients in Australia and New Zealand

2020 ◽  
Vol 22 (1) ◽  
pp. 35-44
Author(s):  
Paul Secombe ◽  
◽  
Richard Woodman ◽  
Sean Chan ◽  
David Pilcher ◽  
...  
Keyword(s):  
New Zealand ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Adult Population ◽  
Diagnostic Category ◽  
Class Ii ◽  
Adverse Outcomes ◽  
Class I ◽  
Class I Obesity

OBJECTIVE: The apparent survival benefit of being overweight or obese in critically ill patients (the obesity paradox) remains controversial. Our aim is to report on the epidemiology and outcomes of obesity within a large heterogenous critically ill adult population. DESIGN: Retrospective observational cohort study. SETTING: Intensive care units (ICUs) in Australia and New Zealand. PARTICIPANTS: Critically ill patients who had both height and weight recorded between 2010 and 2018. OUTCOME MEASURES: Hospital mortality in each of five body mass index (BMI) strata. Subgroups analysed included diagnostic category, gender, age, ventilation status and length of stay. RESULTS: Data were available for 381 855 patients, 68% of whom were overweight or obese. Increasing level of obesity was associated with lower unadjusted hospital mortality: underweight (11.9%), normal weight (7.7%), overweight (6.4%), class I obesity (5.4%), and class II obesity (5.3%). After adjustment, mortality was lowest for patients with class I obesity (adjusted odds ratio, 0.78; 95% CI, 0.74– 0.82). Adverse outcomes with class II obesity were only seen in patients with cardiovascular and cardiac surgery ICU admission diagnoses, where mortality risk rose with progressively higher BMIs. CONCLUSION: We describe the epidemiology of obesity within a critically ill Australian and New Zealand population and confirm that some level of obesity is associated with lower mortality, both overall and across a range of diagnostic categories and important subgroups. Further research should focus on potential confounders such as nutritional status and the appropriateness of BMI in isolation as an anthropometric measure in critically ill patients.

Regulation of mouse CYP1A1 gene expression by dioxin: requirement of two cis-acting elements during induction

1989 ◽  
Vol 9 (6) ◽  
pp. 2378-2386
Author(s):  
L A Neuhold ◽  
Y Shirayoshi ◽  
K Ozato ◽  
J E Jones ◽  
D W Nebert
Keyword(s):  
Gene Expression ◽  
Simian Virus 40 ◽  
Class Ii ◽  
Simian Virus ◽  
Class I ◽  
Ah Receptor ◽  
Class Iii ◽  
Cis Acting ◽  
Cyp1a1 Gene ◽  
Sv40 Dna

The mouse cytochrome P1450 (CYP1A1) gene is responsible for the metabolism of numerous carcinogens and toxic chemicals. Induction by the environmental contaminant tetrachlorodibenzo-p-dioxin (TCDD) requires a functional aromatic hydrocarbon (Ah) receptor. We examined the 5'-flanking region of the CYP1A1 gene in mouse hepatoma Hepa-1 wild-type cells and a mutant line having a defect in chromatin binding of the TCDD-receptor complex. We identified two cis-acting elements (distal, -1071 to -901 region; proximal, -245 to -50 region) required for constitutive and TCDD-inducible CYP1A1 gene expression. Three classes of DNA-protein complexes binding to the distal element were identified: class I, found only in the presence of TCDD and a functional Ah receptor, that was heat labile and not competed against by simian virus 40 (SV40) early promoter DNA; class II, consisting of at least three constitutive complexes that were heat stable and bound to SV40 DNA; and class III, composed of at least three constitutive complexes that were thermolabile and were not competed against by SV40 DNA. Essential contacts for these proteins were centered at -993 to -990 for the class I complex, -987, -986, or both for the class II complexes, and -938 to -927 for the class III complexes. The proximal element was absolutely essential for both constitutive and TCDD-inducible CYP1A1 gene expression, and at least two constitutive complexes bound to this region. These data are consistent with the proximal element that binds proteins being necessary but not sufficient for inducible gene expression; interaction of these proteins with those at the distal element was found to be required for full CYP1A1 induction by TCDD.

Prevalence of Malocclusions in Autistic Patients in Isfahan

2021 ◽  
Author(s):  
Zahra Ali Mehtari ◽  
Mehdi Rafiei ◽  
Saeed Azarbayjani ◽  
Neda Ahmadi Rouzbehani ◽  
Amir Hossain Moeini
Keyword(s):  
Class Ii ◽  
Autism Spectrum ◽  
Open Bite ◽  
Class I ◽  
Dental Student ◽  
Class Iii ◽  
Cross Sectional ◽  
Deep Bite ◽  
Normal Occlusion ◽  
Age Range

Introduction: Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders diagnosed by impairments in social interaction and communication with repetitive and restrictive stereotyped behavioral patterns. The Prevalence of autism has been reported to be increased in recent years. This study aimed to assess the prevalence of different types of malocclusion among ASD patients in Isfahan in 2018. Materials & Methods: In a descriptive and cross-sectional trial, 92 ASD patients were studied in the age range of 7-18 years at the center for autism patients in Isfahan. Clinical oral examinations of patients are taken to assess the involved malocclusions (Cl I, Cl II and Cl III malocclusions) and malocclusion traits (deep bite, open bite and cross bite) by an educated dental student under the supervision of an orthodontist under natural light. The data are reported using frequency and percentage indices. Results: Class I malocclusion had the highest prevalence 54.3% (50) among ASD patients and the prevalence of class II and class III were found to be 19.6% (18) and 7.6% (7) respectively. The frequency of malocclusions traits of deep bite, cross bite and the open bite were 27.2% (25), 18.5% (17) and 7.6% (7) respectively. Among of the total patients, 65.2% (60) showed normal bite and 18/5% (17) showed Normal occlusion. Conclusion: ASD patients showed class I, class II and class III malocclusions from the most to least frequency and the most frequent malocclusion traits were also deep bite, cross bite and open bite respectively.

Prevalence of Malocclusion among School Children of Biratnagar, Nepal

2021 ◽  
Vol 11 (1) ◽  
pp. 46-48
Author(s):  
Nidhi Giri ◽  
Anand Acharya ◽  
Kanika Yadav
Keyword(s):  
School Children ◽  
Class Ii ◽  
Cross Sectional Study ◽  
Class I ◽  
Class Iii ◽  
Cross Sectional ◽  
Total Study Population ◽  
Medical College ◽  
Normal Occlusion ◽  
Study Population

Introduction: Various forms of malocclusion are a matter of serious concern in Nepalese population. This study was carried out to understand the prevalence of malocclusion among the school children of Biratnagar. The objective of this research is to find out the prevalence of malocclusion of children from different schools of Biratnagar visiting the Pedodontics and Orthodontics department of Nobel Medical College and Teaching Hospital, Biratnagar. Materials and Method: A descriptive cross sectional study method was used in this research. Data was collected by using direct observation of the subjects and occlusal assessment was done according to Angle’s classification and Dewey’s modification types of class I, class II and class III malocclusion. Result: Subjects with normal occlusion was found to be 39 % and with malocclusion was found to be 61%. Among them, class I malocclusion (60%) and angles class II div I subjects (88.33%) were in majority of the total study population. Conclusion: The present study helps to determine the prevalence of malocclusion and need of orthodontic treatment for the school children of Biratnagar

scholarly journals Evaluation of Occlusal Contacts among Different Groups of Malocclusion using 3D Digital Models

2014 ◽  
Vol 15 (1) ◽  
pp. 46-55 ◽  
Author(s):  
Naim Z Al-Rayes ◽  
Mohammad Y Hajeer
Keyword(s):  
Class Ii ◽  
Sexual Differences ◽  
Class I ◽  
Stepwise Multiple Regression ◽  
Regression Equations ◽  
Class Iii ◽  
Digital Models ◽  
Arch Width ◽  
Division 1 ◽  
3D Digital Models

ABSTRACT Objectives (1) To evaluate the applicability of using 3D digital models in the assessment of the magnitude of occlusal contacts by measuring occlusal contact surface areas (OCSAs) and 3D mesh points in ‘contact’ (OCMPs) in a sample of orthodontic patients; (2) To detect any sex differences in the magnitude of occlusal contacts in all malocclusion groups; (3) To detect intergroup differences; (4) To assess possible correlations between occlusal contacts and other dental characteristics. Materials and methods Study casts of 120 malocclusion patients were selected and divided into 4 groups (class I division 1, class II division 1, class II division 2, class III) with equal numbers for both sexes. 3D digital models were produced using O3DM™ technology. Occlusal contacts were quantified using two methods of measuring. Results (1) No significant sexual differences were detected for OCMPs (mesh points) and OCSAs (mm2) in all groups. (2) There were statistically significant differences among malocclusion groups for OCMPs and OCSAs (p < 0.001). Tukey's HSD posthoc tests showed that class III patients had significantly less occlusal contacts than other malocclusion groups. (3) Stepwise multiple regression equations showed that overjet, lower arch width and overbite could explain approximately 19.5% of the total variance of OCSAs and OCMPs. Conclusion Sexual differences in occlusal contacts were not detected. Class I division 1 patients had the highest amount of occlusal contacts among all groups of malocclusion. Overjet, overbite and lower dental arch width were best predictors of occlusal contacts in the current sample. How to cite this article Al-Rayes NZ, Hajeer MY. Evaluation of Occlusal Contacts among Different Groups of Malocclusion using 3D Digital Models. J Contemp Dent Pract 2014;15(1):46-55.

scholarly journals Anatomical characteristics of mandibular bone in skeletal Class I, II and III patients by using cone beam computed tomography images in an iranian population

2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Mohammad Zandi ◽  
Abbas Shokri ◽  
Vahid Mollabashi ◽  
Zahed Eghdami ◽  
Payam Amini
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Class Ii ◽  
Class I ◽  
Cone Beam ◽  
Class Iii ◽  
Anatomical Characteristics ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Ramus Height

Objetive: This study aimed to compare the anatomical characteristics of the mandible in patients with skeletal class I, II and class III disorders using cone beam computed tomography (CBCT). Material and Methods: CBCT scans of patients between 17 to 40 years taken with NewTom 3G CBCT system with 12-inch field of view (FOV) were selected from the archive. Lateral cephalograms were obtained from CBCT scans of patients, and type of skeletal malocclusion was determined (Class I, II or III). All CBCT scans were evaluated in the sagittal, coronal and axial planes using the N.N.T viewer software. Results: The ramus height and distance from the mandibular foramen to the sigmoid notch in class II patients were significantly different from those in skeletal class I (P < 0.005). Distance from the mandibular canal to the anterior border of ramus in class III individuals was significantly different from that in skeletal class I individuals (P < .005). Conclusion: Length of the body of mandible in skeletal class I was significantly different from that in skeletal class II and III patients. Also, ramus height in skeletal class I was significantly different from that in skeletal class II patients. CBCT had high efficacy for accurate identification of anatomical landmarks.   Keywords Prognathism; Retrognathism; Mandible; Anatomy; Cone beam computed tomography.

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