Impact of Saddle Angle on Skeletal Class II Division 1 Malocclusion in Libyan Patients: A Retrospective Cephalometric Analysis

Abstract

Cranial base morphology plays a key role in determining maxilla-mandibular relationships. The saddle angle (N–S–Ar) reflects cranial base flexure and has been linked to sagittal discrepancies such as Class II Division 1 malocclusion. However, its role in Libyan populations remains insufficiently defined. This study was conducted to investigate the relationship between saddle angle and skeletal parameters (SNA, SNB, ANB, SN–MP) in Libyan patients with Class II Division 1 malocclusion. A retrospective cephalometric study was conducted on 116 Libyan patients. Standard angular measurements were obtained, compared to Libyan normal values, and correlations between saddle angle and skeletal variables were analyzed using Pearson correlation and simple regression analysis. The saddle angle was significantly higher than Libyan normal values. It showed a positive correlation with SNA, ANB, and SN–MP, and a negative correlation with SNB. The strongest correlation was observed with ANB. Increased saddle angle is significantly associated with the skeletal characteristics of Class II Division 1 in Libyan patients, particularly through mandibular retrusion and vertical growth tendency. Its effect on SNA is minimal, which indicates more impact on mandibular retrusion than maxillary protrusion.