Original Article

Assessment of β Angle among the various Facial Types

in Garhwali Population - A Cephalometric Evaluation

Dr P Narayana Prasad,1 Dr Rubina Ansari,2 Dr Tarun Rana,3 Dr Nimme Rawat4

1
Professor & Head, Postgraduate student, 3Senior lecturer
2,4

Department of Orthodontics, Seema Dental College, Rishikesh, India

Correspondence: [email protected]

ABSTRACT
Objective: The purpose of the study was to evaluate Beta (β) angle variation in different facial types among
Garhwali population and also to evaluate the differences in Beta angle in male and female subgroups.

Materials & Method: The sample included pre-treatment lateral cephalograms of 90 native Garhwali subjects
(age 16-24 years) who were divided into three groups: normodivergent, hypodivergent and hyperdivergent; of 30
subjects of each group 15 were male and 15 were female.

Result: In Garhwali population subjects with a β angle between 28° to 32° have a normodivergent facial type
(ANOVA p < 0.01).

Conclusion: There is a significant difference in the mean values of β angle in Garhwali population among various
facial types.

Key words: Beta angle, hyperdivergent, hypodivergent, normodivergent

Introduction and linear measurements have been incorporated

into various cephalometric analyses to help the
Over the years diagnosis and treatment planning in clinician diagnose antero-posterior discrepancies
orthodontics and dentofacial orthopaedics have relied and establish the most appropriate treatment plan.2,3,4
substantially on technological and mechanical aids. Any cephalometric analysis based on either angular
These technological aids include imaging, articulators, or linear measurements has various shortcomings.
jaw tracking and functional analyses. The goal in using Reliability of these parameters is questionable due to
these techniques is to accurately replicate or portray problems encountered in identification, reproducibility
the “anatomic truth” to show the three dimensional and effects of changes in occlusion and rotation of
anatomy in both static and dynamic function as it jaws during growth.5
exists in nature. Imaging is one of the most ubiquitous
tools orthodontists use to measure and record the A measurement was developed by Baik and
size and form of craniofacial structures. Imaging has Ververidou in the year 2004 named as the β angle in
traditionally been used to record the status quo of an attempt to overcome the shortcomings of various
limited or grouped anatomic structures.1 other reference parameters used.5 This angle does not
depend on any cranial landmarks or dental occlusion
An accurate antero-posterior (AP) measurement of and reflects true antero-posterior changes as a result of
jaw relationships is critically important in orthodontic growth and orthodontic intervention. Furthermore, it is
diagnosis and treatment planning. Both angular not influenced by changes in occlusion thus it would be

Orthodontic Journal of Nepal, Vol. 3, No. 1, June 2013

37
 Prasad NP, Ansari R, Rana T, Rawat N. : Assessment of β Angle among the various Facial Types in Garhwali Population - A Cephalometric Evaluation

especially valuable whenever previously established Cephalometric points used were:

cephalometric measurements such as ANB angle and
Wits appraisal cannot be accurately used.5 Sella Nasion

Porion Orbitale
Hence this study was undertaken with the aim and
objective of evaluating the β angle variations in Pterygo maxillary fissure Anterior Nasal Spine
Garhwali population. Posterior Nasal Spine Point A

J point Centre of Condyle

MATERIALS AND METHOD
Ramus point Articulare
The present study was based on lateral cephalograms
Point B Pogonion
of 90 native Garhwali subjects who visited the out-
patient department of Seema Dental College & Gnathion Menton
Hospital, Rishikesh, India for orthodontic alignment of Gonion
teeth. The pre-treatment lateral cephalograms were
obtained in the natural head position. According to Reference planes used were:
their facial pattern the subjects were divided into three
groups of 30 samples each comprising 15 males and • Sella–Nasion Plane (SN)
15 females using four parameters. The subjects were • Frankfort Horizontal Plane (FHP)
within the age range of 16–24 years, with the mean
• Palatal Plane (PP)
age of 18 years for female and 20 years for male.
• Mandibular Plane (Go-Gn) (Steiner’s)
The four parameters that were used to segregate
Various parameters used were (Figure 1):
the facial types into three groups were Jarabak ratio
(Rakosi), mandibular plane angle (Steiner’s), Y-axis of • Mandibular plane angle – (Go – Gn to SN)
growth (Down’s) and ALFH/AUFH (Di Paolo’s). • Y axis of growth - (S – Gn to FH)
• ALFH/AUFH - N - Pt A (PP); Pt A on PP to Pt B on Go-Gn
The three groups were as follows: 6
• Jarabak ratio – S Go / N Me x 100
Group A- Normodivergent: The subjects in this group • β angle - pt. A ┴ CB - AB
had normal mandibular plane angle, average anterior
lower face height equal to the upper face height,
normal Y-axis of growth, Jarabak ratio between 62%
and 65%.

Group B- Hyperdivergent: The subjects in this group

had steep mandibular plane angle, long anterior lower
Apparent axis of
face height, increased Y-axis of growth, Jarabak ratio condyle C
< 62%.
A
Group C- Hypodivergent: The subjects were grouped
β
as hypodivergent on the basis of low mandibular plane
angle and short lower facial height, decreased Y-axis
of growth, Jarabak ratio > 65%. B

Each radiograph was scanned into an X–Y co-ordinate

system using Epson perfection V700 photo scanner Figure 1: Beta angle
and was digitized by a single investigator using
specific points required by the software. Linear and
angular hard tissue measurements; skeletal and dental The data was summarized by finding mean and
parameters were calculated electronically using the standard deviation. 1-way analysis of variance
Dolphin Imaging® 11.0 software (Dolphin Imaging (ANOVA) was used followed by student t-test. A-P value
and Management Solutions, Chatsworth, Calif.) and < 0.01 was considered to be statistically significant.
recorded in print.

38 Orthodontic Journal of Nepal, Vol. 3, No. 1, June 2013

 Prasad NP, Ansari R, Rana T, Rawat N. : Assessment of β Angle among the various Facial Types in Garhwali Population - A Cephalometric Evaluation

RESULTS
Table 1 shows mean, standard deviation and variance of β angle among three groups for males. There is highly
significant difference between the measurements of β angle among the males of these three groups (p<0.01).

Table 2 shows mean, standard deviation and variance of β angle among three groups for females. There is highly
significant difference between the measurements of β angle among the males of these three groups (p<0.01).

Table 3 shows the comparison of mean β angle value of the gender within the group, which shows non-significant
difference.

Table 1: Descriptive statistics of β angle and difference between the groups among male samples

Groups Mean Standard deviation Variance p-value

Normodivergent 28.63 4.41 19.44 <0.01*
Hyperdivergent 33.88 4.28 18.35 <0.01*
Hypodivergent 24.26 4.72 22.32 <0.01*
* Statistically significant

Table 2: Descriptive statistics of β angle and difference between the groups among female samples

Groups Mean Standard deviation Variance p-value

Normodivergent 30.69 2.87 8.27 <0.01*
Hyperdivergent 32.29 4.28 18.32 <0.01*
Hypodivergent 25.98 4.20 17.61 <0.01*
* Statistically significant

Table 3: Comparison of β angle between gender in each group

Groups Mean Standard deviation p-value

Normodivergent 28.63 30.69 (NS) 0.14
Hyperdivergent 33.88 32.29 (NS) 0.31
Hypodivergent 24.26 25.98 (NS) 0.3
NS Not significant

DISCUSSION parameter ANB angle can also be affected by various

factors thus it is often misleading. The other alternative
An accurate antero-posterior measurement of jaw is Wits appraisal but it has a problem in encountering
relationship is critically important in orthodontic the functional occlusal plane.5
treatment planning.5 Both angular and linear variables
have been proposed to analyze sagittal jaw relationship In the present study, β angle was proposed as a stable
and jaw position. However the angular measurements measurement as all the reference points are located
are erroneous as changes in facial height and jaw on the jaws and it is reliable to measure sagittal
inclination could lead to an alteration in these values discrepancy. β angle reflects true changes in the jaws
and the linear measurements can be affected by the and it can be used for consecutive comparisons.5
inclination of the reference line.7,8 The most popular It is also useful for planning orthognathic surgeries as

Orthodontic Journal of Nepal, Vol. 3, No. 1, June 2013

39
 Prasad NP, Ansari R, Rana T, Rawat N. : Assessment of β Angle among the various Facial Types in Garhwali Population - A Cephalometric Evaluation

it helps to discriminate between patients of different CONCLUSION

facial types.
According to the results of the cephalometric study
Thus the present study was undertaken to evaluate β on β angle among the various facial types of Garhwali
angle in Garhwali population and it was concluded population; following conclusions can be drawn:
1. Previously established measurements for assessing
that, for male samples in Group A (normodivergent) this
sagittal jaw relationship can often be inaccurate.
angle was seen to be at an average of 28.63°; for female
2. A new angle; the Beta angle was developed
samples the β angle was found to be at an average of
as a diagnostic aid to evaluate the sagittal jaw
30.69° for Group A (normodivergent) population.
relationship more consistently.
3. Garhwali population with a β angle between 28°
In Group B (hyperdivergent) population, because
and 32° have normodivergent facial pattern; β
of steep mandibular plane there is a downward
angle less than 28° indicates hypodivergent facial
and backward rotation of the mandible9,10 due to pattern, and β angle greater than 32° indicates
which there is an increase in β angle. In Group C hyperdivergent facial pattern.
(hypodivergent) population, because of the upward 4. There is no statistically significant difference
and anterior rotation of the mandible, there is a between mean β angle values between male and
reduction in β angle.11 female samples.

OJN

REFERENCES
1. Quintero JC, Trosien A. Craniofacial imaging in orthodontics: historical perspective, current status, and further developments.
Angle Orthod 1999; 69(6):491-3.
2. Moyers RE, Bookstein FL, Guire KE. The concept of pattern in craniofacial growth. Am J Orthod 1979; 76:136-148.
3. Steiner: Cephalometrics in clinical practice. Angle Orthod 1959: 29: 8-29.
4. Chang HP. Assessment of antero-posterior jaw relationship. Am J Orthod Dentof Orthop 1987; 92:117-122.
5. Baik CY, Ververidou M: A new approach of assessing sagittal discrepancies: the Beta angle. Am J Orthod Dentofac Orthop
2004; 126:100-105.
6. Rana T, Khanna R, Tikku T, Sachan K: Relationship of maxilla to cranial base in different facial type: A cephalometric evaluation.
JIOBCR 2012; 2(1):30-35.
7. Sachdeva K et al. Comparison of different angular measurements to assess sagittal skeletal discrepancy: A cephalometric
study. IJODS 2012; 4(2):27-30.
8. Nanda R, Merrill RM. Cephalometric assessment of sagittal relationship between maxilla and mandible: Am J Orthod Dentofac
Orthop 1994; 105:328-44.
9. Sassouni V. Classification of skeletal facial types. Am J Orthod1969; 55:109–23.
10. Schendel SA, Bell WH, Epker. The long face syndrome: Vertical maxillary excess. Am J Orthod 1976; 70:398–408.
11. Opdebeeck H, Bell WH. The short face syndrome. Am J Orthod Dentof Orthop 1978; 73:499–511.

40 Orthodontic Journal of Nepal, Vol. 3, No. 1, June 2013