Original Article

Cephalometric Variability Among Siblings: A Pilot Study


  • Katharine L. Marcks
  • Yihong Zhao
  • Melih Motro
  • Leslie A. Will

Received Date: 06.12.2021 Accepted Date: 27.02.2022 Turk J Orthod 2022;35(4):239-247


To determine whether multiple siblings resemble one another in their craniofacial characteristics as measured on cephalometric radiographs.


This study was conducted retrospectively using the Forsyth Moorrees twin sample. A total of 32 families were included, each with ≥4 postpubertal siblings, totaling 142 subjects. Only 1 monozygotic twin was included per family. Headfilms were digitized, skeletal landmarks were located, and 6 parameters that indicated sagittal jaw relationships and vertical status were measured. Diverse statistical approaches were used. Dixon’s Q-test detected outliers in a family for a given parameter. Manhattan Distance quantified similarity among siblings per parameter. Scatter plots visually displayed subject’s measure relative to the mean and standard deviation of each parameter to assess the clinical relevance of the differences.


A total of 11 families (34.4%) had no outliers on any parameter, 13 families (40.6%) had outliers on 1 parameter, and 8 families (25%) had outliers on ≥2 parameters. We identified 29 individuals with at least 1 outlying measure (20.4%). Among these, only 2 individuals (1.4%) were significantly different from their siblings for more than 1 measurement. Although the majority of the families did not demonstrate any statistical outlier, the ranges of the measurements were clinically relevant as they might suggest different treatment. For example, the mean range of SNB (Sella-Nasion-B point) angles was 7.23°, and the mean range of MPA was 9.42°.


Although families are generally not dissimilar in their craniofacial characteristics, measurements from siblings cannot be used to predict the measurements of another sibling in a clinically meaningful way.

Keywords: Sibling relations, facial bones, growth, craniofacial, cephalometry