Comparison of facial soft tissue thickness, pharyngeal airway widths in different skeletal Patterns

Introduction: Understanding the variations in the thickness of facial soft tissue is important in forensic medicine, dentistry, and plastic surgery. This study aimed to evaluate the thickness of the facial soft tissue in adolescents with different maxillary skeletal patterns and compare them between both sexes, by using digital lateral cephalometric radiographs. Methods: 97 patients over 18 years of age referring to a private radiology center for digital lateral cephalometric radiographs participated in this study. Standard digital lateral cephalometric radiographs of patients were categorized based on the ANB angle to three Skeletal jaw classes ( I, II, and III). Then, in each of the lateral cephalometric radiographs, the Soft tissue landmarks including glabella, nasion, subnasale, labrale superius, stomion, labrale inferius, labiomental, pogonion, menton, and the vertical distance of each landmark to the bone surface were determined. Soft tissue thickness landmarks at each site were measured separately in males and females and in three different skeletal class groups. Statistical analysis of multivariate multiplicative variance was used to compare the data. Results: The results of the study showed that soft tissue thickness in Glabella and Labiomental points were not significantly different between men and women (P-value >0.05). Other landmarks in men were significantly higher than women(P-value<0.05). As for the relationship between soft tissue thickness and skeletal classes, subnasale, labrale superius, stomion, labrale inferius had significant association with skeletal classification (P-value<0.05). Conclusion: These findings point to the importance of sex and cranial morphology in soft facial tissues for accurate facial reconstruction

ObjectiveThe purpose of this study was to determine the soft tissue thickness of male and female orthodontic patients with different skeletal malocclusions.MethodsSoft tissue thickness measurements were made on lateral cephalometric radiographs of 180 healthy orthodontic patients with different skeletal malocclusions (Class I: 60 subjects, Class II: 60 subjects, Class III: 60 subjects). Ten measurements were analyzed. For statistical evaluation, one-way ANOVA and Kruskal-Wallis tests were performed. Least significant difference (LSD) and Dunnet T3 post hoc tests were used to determine the individual differences.ResultsSoft tissue thicknesses were found to be greater for men than for women. Statistically significant differences among the skeletal groups were found in both men and women at the following sites: labrale superius, stomion, and labrale inferius. The thickness at the labrale superius and stomion points in each skeletal type was the greatest in Class III for both men and women. On the other hand, at the labrale inferius point, for both men and women, soft tissue depth was the least in Class III and the greatest in Class II.ConclusionsSoft tissue thickness differences among skeletal malocclusions were observed at the labrale superius, stomion, and labrale inferius sites for both men and women.

Introduction: Variations in facial soft tissue thickness have been established previously by studies conducted in different population. Hence, it is essential to obtain facial soft tissue thickness measurement data specific to a population and develop individual standards. The objective of this research is to obtain facial soft tissue thickness data of Nepalese adult male and female subjects seeking orthodontic treatment with different sagittal skeletal malocclusion and evaluate variations in facial soft tissue thickness.&#x0D; Materials &amp; Method: Facial soft tissue thicknesses was measured manually on ninety pretreatment lateral cephalogram at eleven points (Glabella, Nasion, Rhinion, Subnasale, Labrale superius, Stomion, Labrale inferius, Labiomentale, Pogonion,Gnathion and Menton). One-way Analysis of variances [one-way ANOVA] followed by Least significant difference (LSD) post hoc test was used to determine difference in facial soft tissue thickness measurements among three sagittal skeletal group for both sexes. In addition, Student’s t-test was used to find difference in facial soft tissue thickness between the male and female subjects in each skeletal Class.&#x0D; Result: Statistically significant differences were found at points Rhinion, Subnasale, Labrale superius, Stomion and Gnathion in males and at Subnasale, Labrale superius, Stomion and Labrale inferius in females while comparing facial soft tissue thickness among three sagittal skeletal classes. Also, it was observed that mean facial soft tissue thickness was greater for males as compared to female subjects with significant differences at Subnasale, Labrale superius, and Labrale inferius in each skeletal Class.&#x0D; Conclusion: Facial soft tissue thickness varies considerably among different population group, sex and sagittal relationship of jaws.

Resorption of hard and soft tissues following immediate implant insertion is frequently reported. Data regarding the influencing factors on facial tissue thickness are rare. This retrospective study investigated the impact of connective tissue grafting, the orofacial angulation and position of immediately inserted and provisionalized implants on the facial hard and soft tissue thickness in the anterior maxilla within a 1- to 5-year follow-up. Implants with the prerequisite of having preoperative and postoperative cone beam computed tomography (CBCT) and a follow-up of 1 to 5 years were included. Facial bone deficiencies were grafted flaplessly with autogenous bone in all sites. In a subgroup of implants additional connective tissue grafting was performed, whereas the remaining implants were not grafted with soft tissue. The orofacial tooth and implant angulation, the change of horizontal position and the facial bone thickness were measured by CBCT, the facial mucosa thickness by an ultrasonic device. In total, 76 implants were placed in 55 patients. Sixty-nine sites showed a facial bone defect. Thirty-eight received a connective tissue graft additionally. All implants were still in function after a mean follow-up of 36 months. The mean thickness of the facial mucosa was 1.72 mm at 1 mm, 1.63 mm at 4 mm, 1.52 mm at 6 mm, and 1.66 mm at 9 mm apically to mucosal margin. The bone thickness was 0.02, 0.25, and 0.36 mm initially and 1.32, 1.26, and 1.11 mm finally at 1, 3, and 6 mm apically to implant shoulder level. Mixed model analysis revealed an impact of the preoperative bone status on the facial bone increase. The facial soft tissue thickness was significantly influenced by the gingival biotype. The results indicate that an initial severe hard tissue defect allows for significant bone regeneration. The facial soft tissue thickness is primarily influenced by the gingival biotype.

Background: The anatomical assessment of the arrangement of facial soft tissues has important applications in different fields from orthodontics to plastic surgery. One of the issues concerns the relationship between facial soft tissue thickness and skeletal class. Literature mainly deals with adult populations, whereas very few studies have been focused on children. Objective: This study aims at investigating the relationship between midline facial soft tissue thickness and skeletal classes in Italian pre-treatment orthodontic child patients. Methods: Lateral cephalometric X-ray films were obtained from 220 healthy Caucasoid children (91 males and 129 females), aged between 6 and 18 years (Class I: 41 males and 70 females; Class II: 18 males and 25 females; Class III: 32 males and 34 females). All the films were digitized and 14 soft tissue thicknesses were measured on the midface; in addition, the skeletal class was assessed according to the corrected ANB angle (ANBc). Differences in facial soft tissue thickness according to sex and skeletal class were assessed through two-way ANOVA test (p&lt;0.01). Results: Statistically significant differences according to sex were found for labrale superius, stomion and labrale inferius, with thicker soft tissues in males than in females (p&lt;0.01). Only measurements at labrale superius and gnathion showed statistically significant differences according to skeletal class, with thicker soft tissues in Class III children and thinner ones in Class II children (p&lt;0.01). Conclusion: The limited number of investigations, as well as the differences in protocols, renders the comparison of results from different studies difficult, suggesting further investigations to enlighten this complex and debated anatomical issue.

Different facial reconstruction methods rely on the average facial soft tissue thickness values provided in previous studies. Facial soft tissue thickness is influenced by the age, sex, and ethnicity of the individual. The aim of the present study was to determine facial soft tissue thickness of adult Pakistani subjects with different facial morphology. A total of 166 subjects were categorized into three skeletal classes (based on convex, straight, or concave facial profile) employing the classification system used in orthodontics. Facial soft tissue thickness was determined at ten midline points on lateral cephalograms. Significant differences in facial soft tissue thickness were present at glabella, labrale superius, stomion, and labiomentale in males and at labrale superius, labrale inferius, labiomentale, and pogonion in females among different skeletal classes. The current study suggests that the skull morphology-related variations in facial soft tissue thickness should be considered during facial reconstruction to achieve accurate results.

The purpose of this retrospective study was to assess the alteration in the facial soft tissue thickness after rapid maxillary expansion with facemask treatment in bilateral cleft lip and palate (BCLP) Class III patients and noncleft Class III patients. Case records including lateral cephalograms of 30 patients (19 females, 11 males) treated using a rapid maxillary expansion with facemask treatment were analyzed. Group I (age: 11.4 ± 1.02 years) (10 females, 5 males) consisted of noncleft skeletal Class III patients, and group II (age: 10.8 ± 0.84 years) (9 females, 6 males) comprised skeletal Class III patients with bilateral cleft lip and palate. Fifteen hard tissue and 10 soft tissue measurements were made at the beginning and at the end of the treatment to evaluate the change with rapid maxillary expansion combined facemask treatment. The bilateral cleft lip and palate group displayed a statistically significant increase in the thickness of the subnasale, labrale superius, labrale inferius, labiomentale, and pogonion, whereas the thickness of the stomion was found to be significantly decreased. The noncleft group demonstrated a statistically significant decrease in the thickness of the stomion and gnathion. There was a statistically significant difference between the bilateral cleft lip and palate and noncleft groups in the facial soft tissue thickness measurements at labrale superius, gnathion, and subnasale points and in Y axis, U1-SN, U1-NA in the hard tissue measurements. The results of the study indicated that the rapid maxillary expansion with facemask treatment produced diverse alterations in the facial soft tissue thickness of bilateral cleft lip and palate patients and noncleft Class III patients.

In this study the authors aimed to evaluate craniofacial morphology and facial soft tissue thickness of the patients with cleft lip and palate.(CLP), and to compare the results with a sex and age-matched noncleft healthy control group. Craniofacial and soft tissue thickness measurements of 20 patients with unilateral cleft lip palate (UCLP) and 20 patients with bilateral cleft lip palate (BCLP) were compared with 20 noncleft control subjects. Angles between Sella-Nasion-A point, Sella-Nasion-B point, Nasion-A and Nasion-B line, Sella-Nasion line and Gonion-Gnation line, and linear (glabella, rhinion, subnasale, labrale superius, stomion, labrale inferius, labiomentale, pogonion, and gnathion) measurements were assessed on lateral cephalometric radiographs. Group differences were evaluated with 1-way analysis of variance and post hoc Tukey test. Unilateral cleft lip palate and BCLP groups demonstrated lower values of skeletal measurements than control group except for Sella-Nasion line and Gonion-Gnation line value (P < 0.01). Maxillary incisors were retruded in BCLP group compared with the other groups (P < 0.001). Thickness of the rhinion, subnasale, and stomion demonstrated no significant difference between UCLP and BCLP groups (P > 0.05). Thickness of rhinion and stomion was found significantly higher in both groups, and thickness of the subnasale was found significantly lower than the healthy group (P < 0.05). Findings of the study suggested that patients with CLP showed differences on craniofacial morphology and facial soft tissue thickness. Before planning orthodontic treatment and esthetic surgeries, soft tissue thickness should be taken into consideration in addition to skeletal measurements in CLP patients.

Facial characteristics are determined by the thickness of facial soft tissue and parameters of the dentoskeletal system. The aim of the study was to compare the soft tissue thickness in individuals with different malocclusions, based on their lateral cephalograms. In this retrospective study, 285 lateral cephalograms of 141 males and 144 females aged between 18 and 40 years were evaluated in the following 4 groups of malocclusions: class I (n = 72); class II division 1 (n = 71); class II division 2 (n = 72); and class III (n = 70). Linear measurements of the soft tissue thickness were obtained at 9 facial midline landmarks. Angular measurements were made by calculating the ANB angle and the inclination angle of upper central incisors. The data was statistically analyzed using the χ2 test, the Shapiro-Wilk test, the t-test, analysis of variance (ANOVA), Tukey's test, and Pearson's correlation. A comparison of the soft tissue thickness revealed that male subjects demonstrated greater thickness than female subjects. This difference was statistically significant at all points in the skeletal class III individuals (p < 0.05). Different skeletal classes demonstrated significant differences in the soft tissue thickness at the subnasale, stomion, labrale inferius, labiomentale, and menton (p < 0.05). Males exhibited a greater facial soft tissue thickness than females. A statistically significant difference in the soft tissue thickness was observed among the different skeletal classes, particularly at regions located farther from the underlying bone. The class III individuals revealed an increased upper lip thickness and a decreased lower lip thickness. A decrease in the upper lip thickness and an increase in the lower lip thickness were observed in the class II individuals. This pattern suggests that the underlying skeletal discrepancy is being concealed.

BackgroundThe facial soft tissue thickness [FSTT] is a prominent factor in orthodontic diagnoses and treatment planning. The variance in FSTT measurements then gives orthodontists a better understanding of how to shape their treatment (based on classification of skeletal deformity and sex). This study aimed to assess the FSTT differences in a population of Cambodian adults aged 18–25 (in skeletal classes I, II, and III) and between genders.MethodA retrospective audit of 300 lateral cephalometric radiographs was undertaken through UP Dental Hospital. The sample was stratified equally by sex and skeletal class (n = 100 per class; 50 males, 50 females) based on Steiner analysis SNA, SNB and ANB. Linear FSTT measurements were carried out at 11 points using the software Webceph.ResultsSignificant FSTT differences were measured at the various cephalometric landmarks; in males, significant difference is noted at Rhinion, Subnasale, Labrale superius, and Stomion. In females, significant differences exist at Subnasale, Labrale superius, Stomion, and Labrale inferius. Males had a thicker soft tissue than females when evaluated collectively among the 11 points and skeletal Classes.ConclusionFSTT helps in determining individualized treatment plans. Of the modalities of imaging that are available, lateral cephalometric radiography still represents the gold standard for determining facial soft tissue. This study provides a baseline reference for orthodontists, maxillofacial surgeons, and dental surgeons in Cambodia for treatment planning. Knowledge of the differences in FSTT could contribute to more customized treatment plans.

Facial approximation techniques used in forensic anthropology are based on soft-tissue thickness databases. A potentially relevant application concerns the facial reconstruction of children in cases where only the skull can be recovered. Although several databases concerning facial soft tissues thicknesses already exist [1-3], no study has so far taken into consideration the Italian population. This study aims at providing data concerning facial thickness on the midline in a population of Italian children. Diagnostic cephalometric X-ray films were obtained from 222 healthy Caucasoid children (91 boys and 131 girls), aged between 6 and 18 years. After setting the Frankfurt plane horizontal, 15 measurements were taken at the mid-facial landmarks: supraglabella, glabella, nasion, nasale, subnasale, nasal tip, superior labial sulcus, labrale superius, stomion, labrale inferius, inferior labial sulcus, suprapogonion, pogonion, gnathion, menton. Mean and standard deviation of soft-tissues thickness at each point were calculated. A two-way analysis of variance (ANOVA) was performed to test the modifications of facial parameters with age and sex (p<0.01). The results demonstrated that there is an increase in tissue thickness as individuals grow; in most occasions, males showed thicker soft tissues than females of the same age, especially after the adolescent growth spurt. Facial thicknesses at subnasale, nasal tip, superior labial sulcus, labrale superius, labrale inferius, inferior labial sulcus, suprapogonion, pogonion and gnathion significantly modified with age, whereas the same parameters at subnasale, superior labial sulcus, labrale superius, labrale inferius, stomion and suprapogonion were significantly sexually dimorphic. In addition, a database for soft-tissue thicknesses in children aged between 6 and 18 years was created, which may be of interest in cases of facial approximation of Italian minors.

Background: The soft tissue thickness is affected by anterior posterior skeletal relationship. This study has been designed to evaluate the soft tissue thickness among different anterior posterior skeletal classifications. Material and Methods: In this cross-sectional study, 206 digital lateral cephalometric radiographs from patients undergoing treatment at several orthodontic clinics were evaluated. The skeletal group was determined by the ANB angle. The planned points were determined on digital radiographs using the Digimizer.V4.1.1.0 and then the measurements were done. Data were analyzed by Kruskal-Wallis, Mann-Whitney, Pearson Correlation and Spearman tests. Results: Significant difference showed between soft tissue thickness at Subnasale between class I and II, at Subnasale, Labrale Superius, Stomion Superius, Stomion Inferius between class I and III and at Subnasale, Labrale Superius, Stomion Superius, Stomion Inferius, between class II and III. Among the women, soft tissue thickness at subnasale were higher in class I group compared to class II, Subnasale, Labrale Superius, Stomion Superius, Stomion Inferius were higher in class III compared to class I and at Labrale Inferius was higher in class II compared to class III. Among the men, soft tissue thickness at Stomion Superius, Stomion Inferius and Labrale Superius were higher in class III group compared to class I and II. Conclusion: We established that soft tissue thickness in some landmarks were significantly different between skeletal groups and gender. There is a correlation in soft tissue thickness and skeletal relationship at Stomion Inferius, Subnasale, Labrale Superius, Stomion Superius. Keywords: Soft Tissue, Skeletal Classification, Cephalometry

Radiographic assessment of facial soft tissue thickness in South Indian population – An anthropologic study

To evaluate and compare the soft tissue thickness values at the lower anterior face among adult patients with different vertical growth patterns using cone-beam computed tomography. The study sample consisted of 105 adult patients (54 women and 51 men) with a normal sagittal skeletal pattern divided into three groups according to the vertical growth pattern: high-angle (women/men, 22/13; mean age, 24.54 ± 4.45years), low-angle (women/men, 14/21; mean age, 24.62 ± 5.08years), and normal-angle (women/men, 18/17; mean age, 24.22 ± 5.40years) groups. The soft tissue thickness measurements at the lower anterior face in each group were done and analyzed using the one-way analysis of variance and Tukey tests. Soft tissue thickness values were the lowest in the high-angle group for both women and men. For women, the thickness values at the labrale superius, labrale inferius, and pogonion were found to be statistically significantly smaller in the high-angle group (11.49 ± 1.05mm, 12.70 ± 1.92mm, and 11.64 ± 2.65mm, respectively) compared with the values in the normal-angle group (13.31 ± 2.01mm, 15.08 ± 1.94mm, and 14.69 ± 3.08mm, respectively) (P < .05, P < .05, and P < .01, respectively). For men, however, no statistically significant differences were found among the vertical growth patterns (P > .05). Women had statistically significantly thinner thickness at the labrale superius, labrale inferius, and pogonion in the high-angle group compared with the normal-angle group.

Background Facial esthetics depend on the skeletal and dental structures underlying variable facial soft tissue thickness. In this social context, determining the relationship between external soft tissue and underlying skeletal and dental hard tissue is essential for detailed orthodontic diagnosis and treatment planning. Objective This study aims to measure facial soft tissue thickness in different sagittal and vertical skeletal patterns. Methodology This is an observational study utilizing pre-existing cone-beam computed tomography (CBCT) images of 170 subjects (110 females and 60 males) with a mean age group of 37.45 ± 13.83 years. CBCT images were then classified sagittally based on the point A-Nasion-point B (ANB) angle from Steiner's analysis into skeletal Class I, Class II, and Class III. Furthermore, vertical patterns were grouped based on the Frankfort-mandibular plane angle (FMA) from Tweed's analysis into hyperdivergent, hypodivergent, and normodivergent facial types. One-way ANOVA was used to compare the means of facial soft tissue thickness between the skeletal groups, followed by Tukey's post-hoc test for individual comparison. Multinomial logistic regression analysis was used to test the association between gender, age, and skeletal groups. The significance level was 0.05. Results One-way ANOVA revealed statistically significant differences in both sagittal and vertical groups (p≤0.05).Tukey's post hoc analysis showed that the skeletal Class III group has increased soft tissue thickness in the subnasale, upper lip, and mention compared to Class I and Class II subjects. Moreover, the hypodivergent group demonstrated increased soft tissue thickness in gnathion and mentioned landmarks in relation to the other groups. Multinomial logistic regression analysis showed significant differences between groups according to both gender and sagittal skeleton patterns (p≤0.05), with males less likely to be in Class II. Conclusions Skeletal Class III and hypodivergent groups have thicker soft tissue in specific facial landmarks. Sexual dimorphism was marked in soft tissue measurements.