Evaluation of Quantitative Aspects of Craniofacial Deformities in Transfusion Dependent Beta-Thalassemia Major Patients: A Cephalometric Study

J Craniofac Surg. 2022 Nov-Dec;33(8):e848-e853. doi: 10.1097/SCS.0000000000008783. Epub 2022 Aug 10.


Purpose: To evaluate the quantitative (cephalometric) aspects of the craniofacial deformities in transfusion-dependent beta-thalassemia (TDT) patients.

Materials and methods: Sixty-five TDT patients receiving a regular blood transfusion in the Department of Pediatrics of age group 5 to 8 years (younger) and 15 years and above (older) were compared with control groups of similar age using cephalograms (lateral and posterior-anterior view).

Results and observation: The prevalence of skeletal class II tendency is higher in thalassemic patients that do not improve with age. The thalassemic patients were found to show large angle ANB i.e. Angle between points point a, nasion and point B (ANB), large flexure angle, small angle SNB i.e. Angle between points sella, nasion and point B (SNB), and normal angle SNA i.e. Angle between points sella, nasion and point A (SNA) angles suggestive of retrognathic mandible. The thalassemic patients were observed to have smaller transverse widths and thickened calvarium on the posterior-anterior view.

Conclusion: The skeletal class II malocclusion appears to be a manifestation of generalized growth retardation/delayed puberty in thalassemic patients leading to diminished mandibular growth, rather than maxillary prognathism due to marrow hyperplasia.

MeSH terms

  • Cephalometry
  • Child
  • Child, Preschool
  • Craniofacial Abnormalities*
  • Humans
  • Malocclusion, Angle Class II*
  • Mandible
  • Maxilla
  • beta-Thalassemia* / complications
  • beta-Thalassemia* / therapy