Mandibular Symphysis Dimensions Across Different Sagittal and Vertical Skeletal Relationships: A Comparative Cephalometric Study
DOI:
https://doi.org/10.52206/jsmc.2026.16.1.1289Abstract
Background: The mandibular symphysis (MS) is a critical anatomical structure influencing facial aesthetics, orthodontic diagnosis, and treatment planning. Variations in MS morphology may reflect underlying sagittal and vertical skeletal discrepancies, thereby affecting orthodontic biomechanics and treatment limits.
Objective: To compare mandibular symphysis dimensions among different sagittal and vertical skeletal patterns in non-growing adults, with additional consideration of gender-based differences.
Methodology: A comparative cross-sectional study was conducted at the Armed Forces Institute of Dentistry, Rawalpindi. Lateral cephalograms of 230 non-growing adult patients aged 16–40 years with skeletal Class I, II, or III malocclusions were analyzed. Sagittal skeletal relationships were determined using the ANB angle with Wits appraisal as an adjunct, while vertical skeletal patterns were classified using the SN–mandibular plane angle. Mandibular symphysis parameters assessed included dentoalveolar length, skeletal symphysis length, chin length, total symphysis length, vertical symphysis dimension, symphysis convexity, and symphysis concavity.
Results: Females comprised 53.04% of the sample and males 46.96%. Significant differences in mandibular symphysis dimensions were observed across vertical skeletal patterns. High vertical patterns demonstrated significantly greater skeletal symphysis length, total symphysis length, and vertical symphysis dimensions (p < 0.001), along with a shorter chin length (p = 0.008) and increased symphysis concavity angle (p = 0.002). Sagittal skeletal patterns showed no significant differences in most symphysis parameters, except for symphysis convexity, which was significantly greater in skeletal Class II subjects (p = 0.02). Gender-specific analysis revealed distinct morphological variations, particularly in high vertical patterns.
Conclusion: Mandibular symphysis morphology is significantly influenced by vertical skeletal pattern, whereas sagittal skeletal relationship has a limited effect, except on symphysis convexity. These findings underscore the importance of vertical growth assessment in orthodontic diagnosis and treatment planning.
Keywords: Cephalometry, Facial Skeleton, Mandibular Symphysis, Malocclusion, Orthodontics.
References
Bagheri S, Shokuhifar M, Moradinejad M, Razavi M, Hashemi Ashtiani A, Baratvand B, et al. Associations between the 3D position of the mental foramen with sagittal skeletal relationships: a retrospective cohort study of 360 CBCTs. BMC Oral Health. 2023;23(1):968. https://doi.org/10.1186/s12903-023-03719-z
Chen H, Liu Z, Hu X, Wu B, Gu Y. Comparison of mandibular cross-sectional morphology between Class I and Class II subjects with different vertical patterns: based on CBCT images and statistical shape analysis. BMC Oral Health. 2021;21(1):238. https://doi.org/10.1186/s12903-021-01591-3
Evangelista K, Silva M, Normando D, Valladares-Neto J. Factors associated with the morphology of the mandibular symphysis and soft tissue chin. Dental Press J Orthod. 2021;26(4):e2119347. https://doi.org/10.1590/2177-6709.26.4.e2119347.oar
Torgut AG, Akan S. Mandibular symphysis morphology in different skeletal malocclusions and its correlation with uvulo-glossopharyngeal structures. Cranio. 2021;39(6):533-40. https://doi.org/10.1080/08869634.2019.1677311
Nobre R, de Castro SM, Ponces MJ, Lopes JD, Ferreira AP. The relation between mandibular symphysis and the Angle class in orthodontic treatment. Med Pharm Rep. 2022;95(4):446-54. https://doi.org/10.15386/mpr-2416
Sendyk M, Cevidanes LHS, Ruellas ACO, Fattori L, Mendes FM, Paiva JB, et al. Three-dimensional evaluation of dental decompensation and mandibular symphysis remodeling on orthodontic-surgical treatment of Class III malocclusion. Am J Orthod Dentofacial Orthop. 2021;159(2):175-83.e3. https://doi.org/10.1016/j.ajodo.2019.12.020
Marghalani HYA, Guan G, Hyun P, Tabbaa S, Linjawi AI, Al-Jewair T. Relationship between mandibular symphysis dimensions and skeletal pattern in adults. Folia Morphol (Warsz). 2022;81(2):464-71. https://doi.org/10.5603/FM.a2021.0045
Gómez Y, García-Sanz V, Zamora N, Tarazona B, Bellot-Arcís C, Langsjoen E, et al. Associations between mandibular symphysis form and craniofacial structures. Oral Radiol. 2018;34(2):161-71. https://doi.org/10.1007/s11282-017-0292-x
Gul M, Ahmad N, Tajik I, Bahadur K, Shahabi SI. Correlation of symphysis morphology with different vertical growth patterns. Egyptian Orthod J. 2023;64(1):154-64. https://doi.org/10.21608/eos.2023.207911.1070
Oh J, Ham LK, Shin H, Han SH, Kim Y. Assessment of hard and soft tissue thickness at mandibular symphysis in skeletal Class III patients with different vertical patterns. Orthod Craniofac Res. 2024;27(6):886-92. https://doi.org/10.1111/ocr.12829
Hardin AM, Valiathan M, Oh H, Knigge RP, McNulty KP, Leary EV, et al. Clinical implications of age?related change of the mandibular plane angle. Orthod Craniofac Res. 2020;23(1):50-8. https://doi.org/10.1111/ocr.12342
Al-Taai N, Persson M, Ransjö M, Levring Jäghagen E, Fors R, Westerlund A. Craniofacial changes from 13 to 62 years of age. Eur J Orthod. 2022;44(5):556-65. https://doi.org/10.1093/ejo/cjac011
Linjawi AI, Afify AR, Baeshen HA, Birkhed D, Zawawi KH. Mandibular symphysis dimensions in different sagittal and vertical skeletal relationships. Saudi J Biol Sci. 2021;28(1): 280-5. https://doi.org/10.1093/ejo/cjac011
Uengkajornkul P, Mahatumarat K, Panmekiate S. Relationship between symphysis dimensions and mandibular incisors’ alveolar bone thickness in different vertical skeletal patterns. J Dent Assoc Thai. 2020;70(2):140.
Syed ST, Mahmood A, Nazir R. Comparison of symphysis morphology in normodivergent patients of short and normal mandible. Pak Orthod J. 2017;9(2):87-92.
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 The authors retain the copyrights. Authors are permitted and encouraged to post their work online (e.g. in institutional repositories or on their website), as it can lead to productive exchanges, as well as greater citation of published work.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Readers may “Share-copy and redistribute the material in any medium or format” and “Adapt-remix, transform, and build upon the material”. The readers must give appropriate credit to the source of the material and indicate if changes were made to the material. Readers may not use the material for commercial purpose. The readers may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.



