Lip Prints and Dermal Prints as a Tool to Detect the Skeletal Malocclusion: A Clinical Study.

Introduction: For the study's purposes, the researchers are looking to examine if there is a correlation between the skeletal base connection and lip and dermal prints, as well as whether there is a significant variation between genders. Materials and Procedures: Participants in the study numbered 120: Based on Reidel's Malocclusion categorization, There were 40 each of Class I, Class II, and Class III samples. The cellophane technique was used to obtain lip, finger, and palm prints from each of the 120 participants, and the data was analysed using SPSS 22.0. Intergroup comparisons were made using the Chi square test. Atd angle and a-b ridge count were both shown to be statistically significant via the use of an ANOVA test. Class III skeletal malocclusion individuals have a vertical lip pattern, as opposed to the branching lip pattern seen in Class I and II. All three research populations, including the South Indian population, have a right loop pattern. Class I individuals exhibited a greater number of a-b ridges and a greater atd angle. The majority of males and females had branching lip patterns.
Conclusion: Dermatoglyphics and cheiloscopy can be used to investigate the genetic correlations of malocclusion and to prevent malocclusion at an early stage. They are simple, affordable, and noninvasive. However, they are not totally dependable because to other ethnic and environmental factors. Copyright:

INTRODUCTION

When it comes to creating a complete orthodontic treatment plan, diagnostic methods and data interpretation are critical. Lips play a critical part in a range of diagnostic soft tissue studies.[1] Between the labial mucosa and the outer skin, there are many lines and fissures, as well as numerous wrinkles and grooves. It is the scientific study of lip prints that is called cheiloscopy. It does not alter at all from the sixth week of intrauterine life till death. As with lipstick, it is visible to the naked eye, although latent prints can not be detected this way.[2]

It's all about epidermal ridges and how they're arranged on the fingers, palms, and soles.[34] Many researchers have been attracted by investigations examining the pattern of skin ridges and finger impressions. Dermatoglyphics has been studied in forensic medicine, genetics, and anthropology, among other subjects.[5] Embryonic development anomalies due to hereditary or environmental factors are consistently captured by changes in ridge form throughout this time.[67]

There are no changes to the dermatoglyphic patterns that have already been established during pregnancy. This embryonic period is also considered to be when finger and palm impressions as well as the lip alveolus and palate are formed. As a consequence, finger and palm prints may take on a different appearance if anything happens to the lips, alveoli, or palate. It is well accepted that skeletal malocclusions may be traced back to genetic expression.[8]

Dermal ridge variations may be used to examine genetically-influenced illnesses since they can be seen as a sign of abnormalities in the DNA. Malocclusion is a type of developmental abnormality that can range from minor to serious dental or skeletal deformities, as well as systemic syndromic defects.[9] Consequently, the study's primary goal is to examine diverse dermatoglyphic patterns and their relationship to skeletal malocclusions, which may be used in the prevention and treatment of high-risk individuals, as well as in parental counselling.

MATERIALS AND METHODS

STUDY SAMPLE SIZE: Riedel's skeletal Class I, II, and III malocclusion categories led to the selection of 120 human subjects ranging in age from 21 to 25 years old for the study. The samples were divided into three categories.

The study comprises of 3 groups

Group I - Class I (ANB 20-40) – Sample size 40 Group II - Class II (ANB ≥40) – Sample size 40 Group III - Class III (ANB 00) – Sample size 40.

INCLUSION CRITERIA

Individuals with Skeletal Class I, II, III Malocclusion

Individuals under the age range of 21-25 years

Samples willing to participate in the study.

EXCLUSION CRITERIA

Subjects with any lesions on the lips

Subjects with any congenital facial clefts and cleft lip and palate

Subjects with any wounds or cuts in the fingers and palms

It is important to exclude those who are allergic to lip sticks and those who have had orthodontic treatment or face surgery.

RESULTS

The following are the clinical features of the study participants:

A sum of 120 people were examined, including 40 examples of class I skeletal malocclusion, 40 examples of class II skeletal malocclusion, and 40 examples of class III skeletal malocclusion. Patient ages went from 21 to 25 years of age, with the normal being 23.2 years old.

Class I skeletal malocclusion samples are shown in Table 1 and Figure 1.

Table 1

Clinical characteristics of the study group

Category	Gender		Age
	Male	Female	21	22	23	24	25
Class I	20 (50%)	20 (50%)	9 (22.5%)	8 (20%)	11 (27.5%)	9 (22.5%)	3 (7.5%)
Class II	20 (50%)	20 (50%)	4 (10%)	5 (12.5%)	9 (22.5%)	10 (25%)	12 (30%)
Class III	20 (50%)	20 (50%)	1 (2.5%)	6 (15%)	15 (37.5%)	14 (35%)	4 (10%)

Figure 1

Cephalometrics along with lip prints

Comparing the research groups' lip prints is done in Table 2. 120 patients showed branching lip patterns, with 33 (27.5 percent) having vertical lip patterns, 19 (15.8 percent) having intersected patterns, 12 (10) having reticular patterns, and 12 (10) having undetermined patterns of branching lips.

Table 2

Comparison of lip prints in the study groups

n value	Vertical	Branched	Intersected	Reticular	Undetermined	P
Class I
Within group	11 (27.5%)	13 (32.5%)	4 (10%)	6 (15%)	6 (15%)	0.108
Within lip print	33.3%	29.5%	21.1%	50%	50%
Class II
Within group	7 (17.5%)	19 (47.5%)	10 (25%)	1 (2.5%)	3 (7.5%)
Within lip print	21.2%	43.2%	52.6%	8.3%	25%
Class III
Within group	15 (37.5%)	12 (30%)	5 (12.5%)	5 (12.5%)	3 (7.5%)
Within lip print	45.5%	27.3%	26.3%	41.7%	25%
Total
Within group	33 (27.5%)	44 (36.7%)	19 (15.8%)	12 (10%)	12 (10%)
Within lip print	100%	100%	100%	100%	100%

When looking at a group of 120 patients, this research discovered a vertical lip pattern in 33.3% of individuals with Class I malocclusion, 21.2% in Class II malocclusion, and 45.5% in Class III malocclusions.

About 29.5% of patients in class I, 43.2% in class II, and 27.3% in class III have malocclusions. A total of 21.1% of Class I malocclusions, 52.6% of Class II malocclusions, and 26.3% of Class III malocclusions had intersecting lip patterning. It was identified in 50 percent of Class I malocclusions, 8 percent of Class II malocclusions, and 41.7 percent of Class III malocclusions. Unknown lip patterns were detected in 50% of Class I malocclusions; 25% of Class II malocclusions; and 25% of Class III malocclusions, a total of 55%. Lip patterns are not statistically significant since the P value is very low (0.108).

Table 3a compares the fingerprints of the research groups. More than half (48.6 percent) of the patients had right loops, 45 had left loops, 93 had whorls, 54 had a center-pocket-whorls, 24 had two-loops, and 20 had unintended loops, according to the study, which examined 120 patients in total.

Table 3a

Comparison of finger prints in the study groups

n Value	Right loop	Left loop	Whorl	Central pocket whorl	Double loop	Accidental loop	Arches
Class I
40	100 (50%)	6 (3%)	23 (11.5%)	24 (12%)	9 (4.5%)	8 (4%)	31 (15.5%)
Class II
40	109 (54.5%)	5 (2.5%)	31 (15.5%)	9 (4.5%)	8 (4%)	6 (3%)	32 (16%)
Class III
40	71 (35.5%)	34 (17%)	39 (19.5%)	21 (10.5%)	7 (3.5%)	6 (3%)	22 (11%)
Total
120	280 (46.6%)	45 (17.5%)	93 (15.5%)	54 (9%)	24 (4%)	20 (3.3%)	85 (14.2%)

In Group I, 25% of people exhibited right loop patterns on all five fingers, whereas 25% had right loop patterns on just two of the five fingers [Table 3b].

Table 3b

Comparison of finger print count in the fingers of left hand

GROUP	n value	R L	L L	W	C P W	D L	A L	A
CLASS I	0	2 (5%)	34 (18.0%)	27 (67.5%)	25 (60%)	31 (77.5%)	33 (82.5%)	24 (60%)
	1	8 (20%)	6 (15.0%)	8 (20%)	10 (25%)	9 (22.5%)	7 (17.5%)	8 (20%)
	2	10 (25%)	0 (0%)	2 (5%)	4 (10%)	0 (0%)	0 (0%)	4 (10%)
	3	9 (22.5%)	0 (0%)	1 (2.5%)	2 (5%)	0 (0%)	0 (0%)	1 (2.5%)
	4	10 (25%)	0 (0%)	2 (5%)	0 (0%)	0 (0%)	0 (0%)	3 (7.5%)
	5	1 (2.5%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)
CLASS II	0	1 (2.5%)	38 (95%)	16 (40%)	32 (80%)	32 (80%)	36 (90%)	21 (52.5%)
	1	7 (17.5%)	1 (2.5%)	18 (45%)	7 (17.5%)	8 (20%)	2 (5%)	9 (22.5%)
	2	8 (20%)	0 (0%)	5 (12.5%)	1 (2.5%)	0 (0%)	2 (5%)	7 (17.5%)
	3	11 (27.5%)	0 (0%)	1 (2.5%)	0 (0%)	0 (0%)	0 (0%)	3 (7.5%)
	4	12 (30%)	1 (2.5%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)
	5	1 (2.5%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)
CLASS III	0	8 (20.0%)	23 (57.5%)	19 (47.5%)	26 (65%)	34 (85%)	35 (87.5%)	27 (67.5%)
	1	8 (20.0%)	8 (20%)	8 (20%)	8 (20%)	5 (12.5%)	4 (10%)	7 (17.5%)
	2	13 (32.5%)	5 (12.5%)	9 (22.5%)	5 (12.5%)	1 (2.5%)	1 (2.5%)	3 (7.5%)
	3	6 (15%)	1 (2.5%)	3 (7.5%)	1 (2.5%)	0 (0%)	0 (0%)	3 (7.5%)
	4	5 (12.5%)	2 (5%)	1 (2.5%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)
	5	0 (0%)	1 (2.5%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)

The a-b ridge count and atd angle in the study groups are compared in Table 4:

Table 4

Comparison of palm prints in the study groups

	n	Mean	Std.deviation	Std.error
a-b ridge count
Class I	40	42.95	4.063	0.642
Class II	40	40.28	4.512	0.713
Class III	40	39.28	5.402	0.854
Total	120	40.83	4.906	0.448
Atd angle
Class I	40	42.95	5.491	0.868
Class II	40	41.45	4.326	0.684
Class III	40	40.75	3.794	0.600
Total	120	41.55	4.607	0.421

For Class I, the average a-b ridge count was 42.95, followed by Class II with a mean of 40.28, and Class III with a mean of 39.28. While Class II and III had somewhat lower mean atd angles, Class I had a 42.45 mean atd angle.

DISCUSSION

The interplay and synergistic impact of hereditary and environmental variables lead to the development of occlusion.

Tsuchihashi found that the most prevalent lip pattern in a study of the Japanese population was the intersection of the lips. A vertical lip design was found to be the most prevalent by Aggarwal et al.[9] in their analysis. A study by Sivapathasundharam et al.[10] indicated that the intersecting lip pattern was the most prevalent among Indo-Dravidians. The reticular lip pattern was found to be the most common by Verghese et al.[11] in Kerala. It is estimated that around half of the study population (46.6%), the other half of the population (17.5%), the centre pocket whorls (9.5%), the double loops (4.3%), as well as the unintentional loops (3.3%), were all found to be present. One in every fourteen arches is made up of an arch, making up 14.2% of all arches. As with Eslami et al.,[7] but not with Reddy et al.,[12] or Trehan et al.,[13] our results were in line with the previous research on the topic. Tikare et al.,[14] found no significant association was observed between fingerprint patterns and malocclusion. In our research, all three groups showed a preponderance of the right loop pattern, proving that dermatoglyphics and malocclusion are unrelated. overall statistical association was observed between fingerprint patterns and malocclusion Dhivyashree et al.[15] revealed Class I with a majority of whorls and Class II with a majority of Loops, which is verified by Rajput,[16] Tiwari et al.[17] Class I had the highest mean a-b ridge count, at 42.95, followed by Class II, at 40.28, and Class III, at 39.28, but in Eslami et al.,[7] the mean a-b ridge count was 30.5, 32.1, and 33.1 in Class I, II, and III, respectively. However, in Eslami et al. research.'s the mean atd angle was found to be 40 degrees in all three groups, even though ours was 42.45 degrees in Class I, followed by Class II, and then Class III with a mean of 39.75 degrees. Many studies have shown a substantial link between vertical lip patterns and class III malocclusion, which might be explained by the fact that lip prints, like skeletal class III malocclusion, are inherited. ANB angle selection was made based on the absence of substantial differences in lip patterns between persons with skeletal class I and skeletal class I malocclusion, and we did not take into account inherited or environmental variables that could have a role in the development of this condition. With dermatoglyphics, you do not have to go to the hospital or risk any injury since scanning or recording may be done quickly and cheaply at the clinic. This method likewise requires little equipment, and the data it collects may be kept for future reference.

CONCLUSION

As a result of the research, the following conclusions might be drawn: Investigations into the genetics of malocclusion and early intervention to avoid it may both be accomplished via the use of dermatology and cheiloscopy. Studies of a wide range of people's ethnic and racial backgrounds must be conducted before any conclusions can be drawn.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.