OBJECTIVES:Malocclusion and the treatment process can affect the person's quality of life, which includes physical and psychological effects. Classifying the patient accurately is critical to achieving the desired output. This study aimed to improve the current diagnostic process with artificial-intelligence algorithms using the lateral cephalogram. MATERIALS AND METHODS:The study sample consisted of 1014 Arab patients diagnosed with skeletal class I, II, or III. In this study, we used linear discriminant analysis (LDA), random forest (RF), decision tree (DT), K-nearest neighbors (KNN), support vector machine (SVM), and naive Bayes (NB) as classification models. In addition, we calculated the parameters' importance using two techniques-the impurity decreases and the leave-one-feature-out (LOFO) technique. Finally, we applied an artificial neural network (ANN) to classify the patients accurately. RESULTS:One of the influential models presented in this study was the model that included only the parameters Wits appraisal, SNB, SNA, and ML-NSL angles. It could classify the patients with an accuracy of 0.98. In addition, we applied the leave-one-feature-out technique (LOFO) for multiple random forest models and found that the Calculated_ANB (ANB angle-individualized ANB) and Wits appraisal were the most important parameters in the random forest models. Besides, age and gender were in 8th and 21st places (out of 26 variables). Furthermore, the decision tree results demonstrated the distinct characteristics of this ethnic group, which were presented by different ranges of ANB angles that define every skeletal class. The results showed that the tree's root classified the patient as skeletal class III when the ANB angle is less than 0.084 degrees, and skeletal class II if the ANB angle is greater than 1.23. CONCLUSIONS:In summary, this research presented a model enabling orthodontists to precisely classify orthodontic patients. Further research should include different ethnic groups to validate our findings.

Objectives the aim of this study was to clarify the biocompatibility of different tooth repositioning splints (aligners). This included a genotoxicity evaluation and the simulation of leachable compounds using ethanol and cyclohexane as well as the quantitation of bisphenol A and bisphenol S. Methods four different aligners were characterized in this study, these included two printable splints with novel shape memory properties: Tera Harz TC-85 DAC (Graphy Inc., South Korea) and LuxCreo (San Francisco Bay Area, USA). The other two aligners were conventional, thermoformable aligners: CA® Pro Clear Aligner (Scheu Dental GmbH, Germany) and Erkodur-al (Erkodent Erich Kopp GmbH, Germany). For their toxicological testing, the HPTLC-umuC (High-Performance Thin-Layer Chromatography) bioassay was used. Bacterial cultures of Salmonella typhimurium were prepared and extracts were applied to preconditioned HPTLC plates. After chromatographic development, plates were sprayed with bacterial suspension and substrate solutions, followed by incubation. In addition, the two bisphenols A and S were quantified after extraction. Results regarding the HPTLC-umuC Assay, a specific genotoxic response could not be observed in any of the aligner extracts. Furthermore, neither Bisphenol A nor Bisphenol S was detectable in the samples above the analytical detection limit. Conclusions assessing the genotoxic potential of orthodontic aligner materials using the UmuC assay demonstrated no detectable genotoxicity in the tested materials and therefore supporting their biocompatibility and safe clinical use. Clinical relevance: the current data strengthen the biological safety profile of aligners, support informed material selection and contribute to minimizing long-term patient risk in contemporary orthodontic therapy.

OBJECTIVES:Self-etching primers have simplified the process of direct bonding of dental resins and orthodontic brackets. The aim of this study was to evaluate the cytotoxic impact of the leached components to L-929 fibroblast cultures. METHODS:Transbond™ Plus self-etching primer (3M Unitek, 2724 South Peck Road, Monrovin CA 91016 USA) was applied to enamel pieces in three different conditions and the specimens were added to L-929 fibroblast cultures. The incubation time was 72 h and the cells were counted by flow cytometry. Statistics was carried out using descriptive and explorative data analyses. RESULTS:In direct contact assays, the self-etching primer without bracket exhibited mild to moderate cytotoxicity. The application of primer, composite and bracket showed no relevant decrease of cell viability. After seven days, the cytotoxic effects had largely disappeared. Overall, the combination of self-etching primer, composite, bracket exhibits no significant cytotoxicity during the observation period. CONCLUSIONS:When self-etching primers are used according to the recommended clinical protocols in orthodontics, the method is regarded as safe and the release of leachables seems to have no adverse clinical effect.

The aim of this study was to investigate the association between third molar agenesis and mesiodistal crown dimensions in individuals from Germany. The sample consisted of 314 (156 males and 158 females) orthodontic patients, divided into two groups: one group with individuals presenting at least one congenitally missing third molar and a control group with individuals having a full complement of 32 teeth. The mesiodistal crown width of each fully erupted permanent tooth was measured at its maximum dimension. The t-test was used to compare mesiodistal width between groups, with additional analyses according to gender and dental arch. A chi-square test evaluated the distribution of third molar agenesis among genders, and odds ratios (OR) with 95% confidence intervals (CI95%) were calculated. Pearson correlation assessed the relationship between the number of missing third molars and mesiodistal crown size. A total of 89 patients with third molar agenesis and 225 controls were included. Forty-three males and 46 females presented agenesis; with no significant association between gender and third molar agenesis (p = 0.760; OR = 1.08; 95% CI = 0.66-1.73). Mesiodistal dimensions were significantly different between males and females (p < 0.05). Patients with third molar agenesis exhibited a significant reduction (p < 0.05) in mesiodistal size across all teeth, most notably in second molars and maxillary lateral incisors. In males, all teeth in the agenesis group showed smaller dimensions compared to controls, with differences ranging from -0.43 to -0.15, the largest observed in the second maxillary molars (-0.43). In females, 18 of 28 teeth showed significant reductions, ranging from -0.42 to 0.00, with the largest difference in the left second mandibular molar (-0.42). The correlation between the number of missing third molar and mesiodistal size showed some negative moderate correlations, especially for lower canines (left r = -0.459, and right r = -0.534). In conclusion, third molar agenesis is associated with reduced mesiodistal crown dimensions in individuals from Germany, with this effect being more pronounced in males than in females.

Background/Objectives: Autophagy is a key degradative pathway involved in orthodontic tooth movement. DNA damage-regulated autophagy modulator 1 (DRAM1), a protein that plays a central role in the degradation of autophagic cargo, exhibits differential regulation in human periodontal ligament (hPDL) fibroblasts under compressive force. Single-nucleotide polymorphisms (SNPs) may influence force-induced gene expression. Therefore, this study investigated the impact of DRAM1 SNPs on its expression in hPDL fibroblasts under compression force. Methods: The hPDL sample comprised cells of 59 patients. A physiological compressive strain of 2 g/cm3 was used to simulate orthodontic tooth movement. Total RNA from hPDL fibroblasts was isolated to determine DRAM1 relative gene expression under loaded conditions and in a physiological control. Furthermore, a genotyping analysis of six SNPs within the DRAM1 gene (rs756534 (G/T), rs2138257 (C/T), rs2176092 (C/T), rs4622329 (A/G), rs10860812 (A/G), and rs4764657 (A/G)) was performed using real-time polymerase chain reaction. DRAM1 expression was com-pared among genotypes of each SNP using an alpha of 5%. Linear regression analysis was then employed to evaluate SNP-SNP interaction. Results: The relative DRAM1 gene expression was not statistically significantly different (p > 0.05) according to the geno-types. The SNP-SNP interaction did not demonstrate any statistically significant associ-ation either. Conclusions: DRAM1 gene expression in hPDL fibroblasts under orthodontic compression may not be regulated by the studied intronic SNPs in the gene encoding DRAM1.

PURPOSE:This study aimed to investigate the association between skeletal malocclusions and dental maturity in a German population. METHODS:A retrospective cross-sectional study was conducted with 542 patients (274 males, 268 females) aged 6-16 years from Germany. Skeletal sagittal malocclusions were classified as class I, II, or III according to the ANB, and vertical growth patterns of the mandible were determined using the Articulare-Gonion-Menton angle. Dental maturity was estimated using the Demirjian method on panoramic radiographs, and the deviation between dental age and chronological age (delta) was calculated. RESULTS:Among the sample, 43.9% presented skeletal class I, 41.5% class II, and 14.6% class III malocclusions. In our study population, mandibular vertical growth patterns were distributed as 53.5% normodivergent, 43.4% hyperdivergent (vertical), and 3.1% hypodivergent (horizontal). The mean chronological age was 11.6 years, while the mean dental age was 11.7 years, with an average delta of 0.08 (standard deviation = 1.2) years. No significant correlations were found between dental age deviation and the chosen cephalometric variables (p > 0.05). No significant associations were found between dental age deviation and sagittal and vertical malocclusions (p > 0.05). CONCLUSION:Skeletal malocclusions were not associated with deviations in dental maturity in this German sample. These findings indicate that dental development occurs independently of skeletal discrepancies, supporting the reliability of the Demirjian method across clinical and research contexts.

Zusammenfassung Der vorliegende Übersichtsartikel beleuchtet die zentrale Rolle der Zunge im Kontext der neuroanatomisch hochkomplexen Steuerung respiratorischer und schluckbezogener Funktionszustände. Dabei spielt der Kontakt der Zunge zum Hart- und Weichgaumen eine entscheidende Rolle.

Abstract Background Studies on animal models and fibroblast growth factor receptor (FGFR2)-associated craniosynostosis syndromes suggest that FGFR2 plays a crucial role in craniofacial development. Therefore, the present exploratory study aims to investigate the relationship between functional genetic polymorphisms of FGFR2 and variations in facial morphology. Methods Frontal and lateral photographs of healthy boys (aged 9 to 14 years) and girls (aged 9 to 13 years), taken before the start of orthodontic treatment, were used for the study. Saliva samples from the patients were also analyzed. Patients with syndromes, skull trauma, or cleft lip and palate were excluded from the study. The measurements and determinations of proportions were performed using the Image J image processing program. DNA was extracted from the saliva samples to investigate seven genetic polymorphisms in FGFR2 using real-time PCR (rs2162540, rs2981578, rs10736303, rs1078806, rs11200014, rs1219648, and rs4752566). ANOVA and t-tests were used to investigate the relationship between the genotypes and the horizontal as well as lateral facial proportions. Results A total of 102 children (60 boys and 42 girls) were included in the analysis. No significant sex-related differences in relative facial dimensions or angles were observed. FGFR2 polymorphisms were significantly associated with distinct facial parameters. The rs10736303 variant was associated with frontal facial proportions related to the eye and midface region, with larger relative dimensions observed in carriers of the AA genotype compared to the AG genotype. The rs2162540 polymorphism was associated with lateral profile measurements, including the relative vermilion height of the lower lip and the mentolabial angle. In addition, rs11200014 showed a significant association with the mentolabial angle, with larger angles observed in AA genotype carriers. Conclusion This exploratory study suggested that FGFR2 polymorphisms may be involved in specific facial parameters, supporting a role of FGFR2 in facial development.

One of the standard methods for classifying skeletal malocclusion patients is based on the individualized ANB (ANBindv.), which was established in 1977 by Panagiotidis and Witt. However, this method was based on a limited sample size and on one ethnic group. Therefore, the primary objective of this study was to develop a new equation based on multiple ethnic groups and a larger sample size, which would enhance the metrics of the traditional equation by Panagiotidis and Witt (r = 0.80/ R2 = 0.64). This study included 300 Arab patients and 623 German patients' lateral cephalogram images, with skeletal class I occlusion, and applied machine-learning regression models to predict the ANBindv. In the analysis of each population separately, the results showed that using SNA and ML-NSL angles led to a lower correlation coefficient among the Arab patients' formula (R2 = 0.59) and a higher correlation coefficient among the German patients' formula (R2 = 0.73) compared to Panagiotidis and Witt's research (r = 0.80). Additionally, our results showed that the addition of the SN-Pg angle can significantly improve the r and adjusted R2 (R2 (Arab) = 0.78, R2 (German) = 0.88). In the validation analysis, which included SNA, ML-NSL, and SN-Pg angle, the sensitivity of Calculated_ANB (ANB-ANBindv.) was 78.4% for the Arab equation and 92.97% for the German equation. Our study demonstrates that the relatively large sample size included in this analysis enhanced the ability to predict and explain the ANB angle. Furthermore, this study established a new equation including the two ethnic groups, that improved the sensitivity of the Calculated_ANB by up to 89.85%.

Objectives The objective of this investigation was to assess and contrast cephalometric parameters in German individuals undergoing orthodontic treatment for skeletal class II and III anomalies, while examining how these measurements vary according to age and gender. Materials and Methods A total of 386 German orthodontic patients (ages 5.3–53 years) were studied, with an even distribution by gender. Participants were classified as having a skeletal class II (n = 210, 54.4%) or class III (n = 176, 45.6%) using the individualized ANB method of Panagiotidis and Witt. Lateral cephalograms were digitally analyzed to compare cephalometric differences between groups and subgroups. Results Significant differences were observed between classes II and III, as well as among the subgroups. Skeletal deformities were more pronounced at older ages (> 21 years). Class III patients had a more prognathic mandible (SNB angle) and a greater skeletal discrepancy (as assessed by the Wits appraisal). Males with class III malocclusion exhibited a more open vertical configuration (NL/ML angle, NL-NSL angle, Gonion angle). Dental compensation increased with age, with being more proclined and lower incisors being more retroclined in class III patients. Correlations among sagittal, vertical, and dental variables were identified. Conclusions The differences in cephalometric parameters between various malocclusion classes and subgroups, particularly in terms of gender and age, underscore the potential influence of these factors.

Background: Anterior open bite (AOB) is a complex malocclusion characterized by different vertical craniofacial growth and heterogeneous skeletal patterns, making objective diagnosis challenging using conventional cephalometric assessment alone. Recent advances in machine learning offer new opportunities to improve phenotypic characterization and diagnostic accuracy in orthodontics. Methods: This retrospective study analyzed lateral cephalometric records from 1056 orthodontic patients, comprising 621 patients with an anterior open bite and 435 healthy controls, all of whom were from the Arab population in Israel. Five clinically relevant cephalometric parameters related to vertical skeletal relationships were evaluated: the mandibular plane angle (ML-NSL), palatal plane angle (NL-NSL), posterior to anterior facial height ratio (PFH/AFH), gonial angle, and the facial axis. Statistical comparisons were made between the open bite and healthy subgroups, and these analyses were conducted in an exploratory framework to support hypothesis generation. A decision tree classifier was developed to distinguish AOB from healthy subjects using these features, and model performance was evaluated on a hold-out test set. Additionally, agglomerative hierarchical clustering was applied to explore latent craniofacial phenotypes. Results: Significant differences in vertical skeletal parameters were observed between open-bite and healthy subjects across various subgroups. The decision tree classifier achieved a test accuracy of 96.2%, with a precision, recall, and F1-score of approximately 0.97. ML-NSL emerged as the most influential feature, followed by facial axis and PFH/AFH. Unsupervised clustering identified ten distinct craniofacial clusters, including pure open bite and pure healthy phenotypes, as well as mixed clusters representing borderline or intermediate skeletal patterns. Clusters dominated by open bite cases exhibited steep mandibular planes, reduced PFH/AFH ratios, increased gonial angles, and decreased facial axis values, consistent with known vertical dysplasia patterns. Conclusions: Machine learning applied to cephalometric data enables accurate classification and meaningful phenotypic stratification of anterior open bite malocclusion. Beyond binary diagnosis, clustering analysis reveals clinically relevant subgroups that reflect varying degrees and types of vertical skeletal imbalance. These findings support the potential role of interpretable machine learning models as decision-support tools in orthodontic diagnosis and personalized treatment planning.

BACKGROUND:Patients suffering from stage IV periodontitis are often characterized by pathologic tooth migration, drifting, flaring, posterior bite collapse, and secondary occlusal trauma (case type 2). Many times, these patients seek treatment because of functional and esthetic demands. The majority of these patients could benefit from an integrated, interdisciplinary approach combining periodontal therapy and orthodontics. MATERIALS AND METHODS:This narrative review aimed to update the scientific evidence on current treatment approaches for patients with stage IV case type 2, presenting with intrabony defects and pathological tooth migration. The strategic sequencing and timing of periodontal-regenerative surgery and orthodontic tooth movement are emphasized. RESULTS:Managing these patients is complex and requires careful coordination between periodontal and orthodontic specialists. Until recently, the timing of periodontal regeneration and orthodontic tooth movement has been unclear. However, new treatment guidelines and results from ongoing clinical research have provided new information. Based on the currently available evidence, it can be recommended that following a successful completion of steps 1 and 2 of periodontal therapy and regenerative periodontal surgery of intrabony defects using biomaterials according to current guideline recommendations at the migrated teeth, orthodontic tooth movement can be initiated as early as 4 weeks postoperatively. Provided patients maintain excellent oral hygiene and strictly adhere to an individualized supportive care program, favorable periodontal outcomes with significant improvements of their periodontal status can be expected with long-term stability up to 10 years. Moreover, this approach also leads to favorable orthodontic outcomes and does not increase the risk of external root resorption. These results were consistent regardless of the type of movement (translation, intrusion/extrusion, or buccal/lingual) or the type of biomaterial used. CONCLUSIONS AND CLINICAL RELEVANCE:Patients suffering from stage IV periodontitis with pathologic tooth migration requiring periodontal-regenerative therapy and orthodontic treatment can be successfully managed in the long term. The synergistic effects of a combined periodontal-regenerative and early orthodontic therapy have been demonstrated to result in a significantly improved oral health-related quality of life for patients, with restoration of function and esthetics.

Dentally worn mandibular advancement devices (MAD) represent a second-line treatment option in patients with mild to moderate obstructive sleep apnea (OSA). Greater MAD adherence is associated with improved treatment success, but with increasing wearing time (WT) dental side effects might become more pronounced. Thus, objective assessment of WT and sophisticated methods for early detection of resulting adverse effects are necessary. In this cross-sectional study 29 patients (8 female and 21 male) showing mild to moderate OSA were treated with Thornton Adjustable Positioners (TAP-T) modified with an intraoral sensor to objectively assess WT. Prior to (T0) and after 12 months of treatment (T1) cephalometric X-rays and intraoral scans (IOS) were obtained. IOS were superimposed by using iterative closest point algorithm to analyze dental changes within specific subregions in relation to individual WT. X-rays were taken to assess potential skeletal changes. Linear mixed-effects modelling (LMM) and Spearman’s Rho were utilized for statistical analyses. The present cohort showed a mean nocturnal WT of 5.52 h (± 1.75 h). Scan superimposition revealed minor dental side effects in all regions, with a greater percentage of adverse effects in the mandible. Along with labial displacement of lower and oral movement of upper incisors, we also found elongations and transverse widening of posterior teeth. WT showed significant influence on the magnitude of dental side effects, whereas Spearman’s Rho revealed correlations of specific dental side effects with craniofacial morphology. Dental adverse effects increase with treatment duration necessitating early detection. Greater susceptibility might appear in hyperdivergent craniofacial phenotypes, as well as more antero-positioned, horizontally oriented, prognathic mandibles. It is well known that strict case selection and careful MAD titration reduce the risk of dental side effects. However, monitoring of WT enables reliable observation of adherence to treatment instructions, such as reduction of application time or intermittent use, to avoid severe occlusal changes.

ABSTRACT Objectives This prospective observational study aims to accurately classify individuals as skeletal class II/III by applying several machine‐learning algorithms. Furthermore, using the k‐means clustering analysis deepened our understanding of the characteristics of skeletal class II/III malocclusion (SCIIMO/SCIIIMO) patients. Materials and Methods This multicenter study consisted of 379 German orthodontic patients. Following their distribution to SCIIMO (n = 208, 54.8%) or SCIIIMO (n = 171, 45.1%) by the individualized ANB of Panagiotidis and Witt. Machine‐learning analysis was performed using different models (KNN, RF, LDA, SVM, CART) to find the model with the highest accuracy in correctly classifying skeletal class II/III. After determining the ideal number of clusters using the Elbow approach, k‐means clustering was finally used. Results The KNN machine learning model demonstrated the ability of reduced cephalometric parameters to capture much of the same sagittal discriminatory information as the predefined class construct. The results showed that Wits‐appraisal only leads to achieving high accuracy in determining skeletal class (accuracy = 94.72%), while adding SN‐Pg angle improved the accuracy slightly to 95.86%. The clustering analysis showed that three or four clusters were optimal for SCIIMO and SCIIIMO patients and revealed interesting characteristics for each cluster and significance between the differences in all parameters except S‐N and age. Conclusions A reduced parameter set that included only the Wits appraisal and SN‐Pg angle enabled a correct classification. In the exploratory clustering analysis, three or four distinct clusters emerged as optimal when analyzing the differences among SCIIMO/SCIIIMO patients, emphasizing the complexity and diversity of malocclusion phenotype.

OBJECTIVE:Mandibular retrognathism (MR) is a skeletal malocclusion in which patients have a deficient mandibular length, resulting in a more posterior position of the mandible. We aimed to investigate the association between Single nucleotide polymorphisms (SNPs) in Fibroblast Growth Factor Receptor 2 (FGFR2) gene and MR in germans. MATERIALS AND METHODS:Genomic DNA and lateral cephalometric radiographs were obtained from orthodontic patients. Patients were allocated into the 'Retruded' group (SNB angle < 78°) and into the 'Well-positioned' group (SNB 78°-82°). The rs4752566, rs10736303, rs11200014, rs1078806, rs1219648, rs2981578 and rs2162540 SNPs were genotyped using real-time PCR. Allele, genotype and haplotype frequencies were compared (α = 5%). RESULTS:A total of 142 patients were included, 93 (65.5%) allocated into the 'Retruded' group and 49 (34.5%) into the 'Well-positioned' group. The allele T in rs2981578 SNP was statistically more frequent in the 'Retruded' group in both univariate (PR = 1.22; 95% CI, = 1.02-1.47) and multivariate (PR = 1.55; 95% CI, = 1.07-2.25) analyses (p < 0.05). The CT + TT genotypes were statistically more frequent in the 'Retruded' group in univariate (PR = 1.58; 95% CI, = 1.03-2.41) and multivariate (PR = 1.59; 95% CI, = 1.11-2.26) analysis (p < 0.05). All studied SNPs were associated with MR establishment in haplotype analysis (p < 0.05). CONCLUSION:SNPs in the FGFR2 are associated with MR and have the potential to serve as genetic biomarkers to early diagnosis and prediction of mandible growth.

Objectives The aim of this study was to clarify the applied initial forces and moments by different aligners of various materials and manufacturing methods.Methods The finite-element-method was used to analyze the forces and moments generated by the aligners on a maloccluded tooth. Plaster models of dental arches with a mesiorotated tooth 11 were fabricated, digitized and virtually analyzed. Four types of aligners with various layer thicknesses were selected: two splints with novel shape memory properties: a printable aligner made of the resin Tera Harz TC-85 DAC (Graphy Inc., South Korea) and a self-manufactured aligner consisting of the components polypropylene carbonate and thermoplastic polyurethane. The other two aligners were conventional, thermoformable aligners: CA (R) Pro Clear Aligner (Scheu Dental GmbH, Germany) and Erkodur-al (Erkodent Erich Kopp GmbH, Germany).Results The force and moment analyses showed that the thermoformable CA (R) Pro Clear Aligner exhibited the highest values. The thermoformed Erkodur-al aligner showed the lowest force loads for all layer thicknesses. The Graphy printed splint showed similar results compared to Erkodur-al at layer thicknesses of 0.40 mm and 0.50 mm.Conclusions To avoid periodontal overloading, aligners with lower force and moment delivery should be chosen for this type of tooth movement.

Objectives: The correct classification of orthodontic patients is essential in individualized diagnostics and treatment planning. However, due to the complexity of the craniofacial skeleton and differences related to gender, age, and ethnicity, cephalometric analysis can be prone to errors. This multicenter, cross-sectional study aimed to compare cephalometric measurements between skeletal class I and II in German orthodontic patients and analyze the effect of gender/age subgroups. Materials and Methods: In total, 556 German orthodontic patients were included and stratified into skeletal class I (n = 210) and II (n = 346), based on the individualized ANB of Panagiotidis and Witt (Calculated_ANB). Both classes presented a mean age of 13 with a range of 6.6-41 years and 5.4-53 years in classes I and II, respectively. Regarding the gender variations, most participants were females, n = 194 (56%) among class I, and n = 125 (60%) among class II. Cephalometric parameters were compared between classes and among age and gender-specific subgroups, followed by identifying correlations and performing principal component analysis (PCA). Results: Class II patients presented a more considerable sagittal discrepancy between jaw bases than class I cases (Calculated_ANB 2.8° vs. 0.025°), a more horizontal growth pattern (Gonion angle 119° vs. 123°), and compensated inclinations of the incisors in the upper (+ 1/NL 71° vs. 68°) and lower jaw (-1/ML 84° vs. 80°). Correlations were found between sagittal, vertical, and dental cephalometric parameters, which were strongest in adult class II males. Finally, ML-NSL angle, SNPg angle, PFH/AFH ratio, and SNB angle are related to the variations of the first four components. Conclusions: The differences in cephalometric parameters between skeletal class I and II demonstrate certain configurations in vertical, sagittal, and dental parameters, and identifying these marks precisely will enable accurate diagnosis. In addition, the variations concerning gender and age highlight the possible influence of these factors on orthodontic diagnostics and treatment planning. Future studies with equal sample sizes among subgroups must validate these findings. Finally, the PCA results highlighted that the mandible's vertical and sagittal position has a strong influence on the diagnosis of skeletal class I/II, which highlights the importance of identifying the corresponding reference marks.