Journal of Research in Dental and Maxillofacial Sciences

en Influence of Vertical Skeletal Pattern on Ramal Morphology and Optimal Screw Insertion Angulation orthodontic orthodontic Original article Original article <div style="text-align: justify;">Background and Aim: The mandibular ramus is increasingly used as an anchorage site for orthodontic miniscrews; however, anatomical variability related to vertical skeletal growth patterns may influence placement safety and stability. This study assessed mandibular ramus morphology, buccal cortical bone density, and insertion angles across different growth patterns using cone-beam computed tomography (CBCT), aiming to propose growth-pattern specific guidelines for ramal screw insertion.    Materials and Methods: This retrospective study analyzed CBCT scans of 81 adults aged 18-35 years. Subjects were equally stratified into hypodivergent, normodivergent, and hyperdivergent growth patterns. Standardized sagittal sections taken 5 mm above the occlusal plane were used to measure ramal width, thickness, height, proximity to the inferior alveolar nerve (IAN), cortical bone density, and ramal screw insertion angle. Intergroup comparisons were performed using one-way ANOVA with Tukey’s post-hoc test (alpha=0.05).    Results: Vertical growth pattern significantly influenced all parameters (P<0.001). Hypodivergent subjects showed the greatest ramal width, thickness, and height, IAN clearance, and the highest bone density. Hyperdivergent individuals demonstrated markedly reduced dimensions and the lowest density. The modified N-angle differed significantly, being smallest in hypodivergent (8.62 degrees) and greatest in normodivergent (27.45 degrees) types. Conclusion: The results showed that vertical skeletal growth pattern significantly influences mandibular ramal morphology, cortical bone density, and screw insertion angulation. Hypodivergent individuals exhibited the most favorable anatomical characteristics, whereas hyperdivergent individuals demonstrated reduced dimensions and density, requiring steeper insertion angulations. These findings highlight the importance of growth pattern-specific planning to enhance the safety and predictability of ramal screw placement.  </div> Bone Density, Bone Screws, Cone-Beam Computed Tomography, Mandibular Nerve 185 194 http://jrdms.dentaliau.ac.ir/browse.php?a_code=A-10-3254-1&slc_lang=en&sid=1 Sinta Abraham sintaelza59@gmail.com 100319475328460017610 100319475328460017610 No Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, Telangana, India, 500087. Pradeep Raj drpradeepraj@yahoo.co.in 100319475328460017611 100319475328460017611 No Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, Telangana, India, 500087. Prasad Chitra prasadchitra@yahoo.co.uk 100319475328460017612 100319475328460017612 Yes Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, Telangana, India, 500087.