Measurement of three‐dimensional facial changes after orthodontic extraction: a retrospective longitudinal study

BackgroundThe profound influence of orthodontic treatments on facial aesthetics has been a topic of increasing interest. This study delves into the intricate interplay between orthodontic treatments, facial feature alterations, and aesthetic perceptions.MethodsA total of 73 patients who had undergone orthodontic treatment were included in this study. Facial photographs were taken before and after treatment. Ten orthodontists provided facial aesthetic ratings (FAR) for each patient's frontal, profile, and overall views. 48 facial landmarks were manually placed by the orthodontists and normalized using Generalized Procrustes analysis (GPA). Two types of phenotypes were derived from facial landmarks. Global facial phenotypes were then extracted using principal component analysis (PCA). Additionally, 37 clinical features related to aesthetics and orthodontics were extracted. The association between facial features and changes in FAR after orthodontic treatment was determined using these two types of phenotypes.ResultsThe FAR exhibited a high correlation among orthodontic experts, particularly in the profile view. The FAR increased after orthodontic treatment, especially in profile views. Extraction of premolars and orthognathic surgery were found to result in higher FAR change. For global facial phenotypes, the most noticeable changes in the frontal and profile views associated with FAR occurred in the lip area, characterized by inward retraction of the lips and slight chin protrusion in the profile view, as well as a decrease in lip height in the frontal view. The changes observed in the profile view were statistically more significant than those in the frontal view. These facial changes were consistent with the changes from orthodontic treatment. For clinical features, two profile features, namely pg.sm.hori and pg.n.ls, were found to be associated with FAR following orthodontic treatment. The highest FAR scores were achieved when pg.sm.hori was at 80° and pg.n.ls was at 8°. On the other hand, frontal clinical features had a subtle effect on FAR during orthodontic treatment.ConclusionsThis study demonstrated that orthodontic treatment improves facial aesthetics, particularly at lip aera in the profile view. Profile clinical features, such as pg.sm.hori and pg.n.ls, are essential in orthodontic treatment which could increase facial aesthetics.

BackgroundThe abnormal facial features in maxillary transverse deficiency (MTD) are minimal and limited to a deficiency of the middle facial third, narrow nares and nasal base, and deepened nasolabial folds. The surgical expansion of the narrow maxilla has most obvious effects on widening of the maxillary dental arch and expansion of the maxillary and palatal structures in the transverse plane, however sagittal changes also occurs. The purpose of this observational study was to evaluate the three-dimensional (3D) facial soft tissue changes following surgically assisted rapid maxillary expansion (SARME).MethodsIn 15 skeletally mature patients with severe maxillary transverse deficiency, the planned maxillary expansion (on average 8.8 mm ± 2.3 mm) was achieved with a bone-borne palatal distractor. The 3D optical scans of the facial surface were obtained before and six months after SARME. In the first part, we defined different anatomical landmarks on both scans and compared cephalometric measurements. In the second part, we registered both 3D scans in the same workplace using the regional best-fit method (forehead, supraorbital and nasal root regions were selected for the superimposition) and conducted surface analysis.ResultsThe largest differences between the pre- and post-operation scans were observed in the paranasal and cheek area (1.4 ± 1.0 mm). Significant differences occurred for an increased nasal width, a decreased upper-face height with an unchanged lower height, an increased vertical philtrum height and an increased nasolabial angle. A significant increase in the facial profile angle was also observed, resulting in an increased facial convexity and anterior displacement of the upper-lip area.ConclusionsThe widening of the nose and increased projection in the cheek and paranasal area in the lateral direction after maxillary expansion were confirmed; moreover, facial convexity increases, reflecting the underlying advancement of the maxilla.

BackgroundThe aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology.MethodsThe samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program Ondemand™. Paired and independent t tests were performed for statistical analysis.ResultsLandmarks in the mouth corner (cheilion, Ch) moved backward and downward (p < .005, p < .01). However, cheilion width was not statistically significantly changed. Landmark in labrale superius (Ls) was not altered significantly. Upper lip prominence angle (ChRt-Ls-ChLt °) became acute. Landmarks in stomion (Stm), labrale inferius (Li) moved backward (p < .005, p < .001). Lower lip prominence angle (ChRt-Li-ChLt °) became obtuse (p < .001). Height of the upper and lower lips was not altered significantly. Length of the upper lip vermilion was increased (p =< 0.01), and length of the lower lip vermilion was decreased (p < .05). Lip area on frontal view was not statistically significantly changed, but the upper lip area on lateral view was increased and change of the lower lip area decreased (p > .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm (°) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li (°) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion.ConclusionsThe lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.

Lack of sleep is a problem in today's society, and many people are concerned about changes in their outward appearance due to lack of sleep. People generally come up with some noticeable skin attributes as symptoms of sleep deficiency including rough, dull, and dry skin as well as droopy eyelids and dark eye circles. Several previous reports also suggested that poor sleep could affect the skin condition. The purpose of this study was to evaluate the effect of one night of sleep deprivation on various skin biophysical properties. Twenty four healthy females participated in a study of one night of sleep deprivation. Subjects were kept awake for one night in a laboratory with controlled temperature and relative humidity. The skin condition of each subject was evaluated after normal sleep pattern and after one night of sleep deprivation. The measured skin biophysical parameters included transepidermal water loss, facial pore size, and skin tone, hydration, elasticity, desquamation, translucency, and blood flow. The cheek, eye, and lip areas were evaluated. After one night of sleep deprivation, multiple skin biophysical parameters showed changes when compared to the baseline measurements. A significant decrease in skin hydration and impaired barrier function were observed (p < 0.05). Decreased hydration led to decreased skin elasticity and translucency and increased skin scaling (p < 0.05). Facial pores were more conspicuous, and skin lightness decreased significantly (p < 0.05). Furthermore, skin blood flow decreased prominently (p < 0.05). The results demonstrated that the skin features that are recognized as symptoms of sleep deficiency actually showed remarkable differences after a period of sleep deprivation, and some of these features were confirmed in the eye, lip, as well as the cheek areas. This study revealed a significant association between sleep deprivation and skin biophysical properties by scientific measuring.

Facial morphological changes following complete mouth rehabilitation with implant-supported fixed dental prostheses designed using digital virtual patients: A pilot study.

BackgroundHyaluronic acid (HA) injectable fillers have been used for restoring tissues volume or for rejuvenating facial wrinkles. Even though injection is normally well tolerated, vascular complications are the main immediate...

Introduction: Self-inflicted traumatic ulcers are oral lesions caused by the patient himself, that can be caused to intentional bad habits, accidents or habits thatoccur without realizing it. Self-inflicted lesions are present in about 75% of the head and neck area, and can be caused by biting tissue in the oral cavity or inserting foreign bodies and nails into the oral mucosa. Case: It is reported a case of traumatic self-inflicted ulcer in a 4-year-old child. This patient was diagnosed with intra-abdominal tumors and plan-ned to undergo surgery. During the preoperative treatment, the patient experienced anxiety and repeatedly bit and sucked the lip and cheek area. Clinically, white plaques and ulcers were seen with a wide elevation in the lip and cheek area. Management: Against patients conducted 0.9%NaCl compress 3 times a day and were given positive suggestions to reduce anxiety. Conclu-sion: In addition to topical medication for treatment of self-inflicted traumatic oral lesion, it is also necessary to give adequate care from health personnel and positive suggestion to reduce preoperative anxiety in pediatric patient who will undergo surgery.

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.

Photograph-based visual scoring has been used for evaluation of facial morphological changes. Here, we describe a three-dimensional computed tomography (3D-CT) method for objective analysis of facial and intra-facial (subcutaneous) changes. The effects of facial massage were examined using both methods. Subjects were 12 healthy female volunteers without facial scars or deformation (age 30-54 years, mean 39.4 years). Photograph-based scoring of massage-induced morphological changes was done at the nasolabial folds, upper, lower and lateral cheeks and lower eyelids. For 3D-CT evaluation, the virtual center axis (VCA) was set as the cranio-caudal longitudinal line, and the VCA-skin surface distances (VSDs) were measured. Massage-induced changes of VSD were calculated (facial massage-induced change rate, FMCR). Intra-facial (subcutaneous) changes were also evaluated. Photograph-based scoring revealed marked morphological changes of the nasolabial folds after facial massage, and changes of the lower, upper and lateral cheeks and lower eyelid were also observed in more than half of the subjects. FMCR values were significantly changed in the paranasal area, nasolabial fold area and cranial part of the mandibular area. Photograph-based scores at the lower cheek and lower eyelid were well correlated with FMCR in the inferior part of the nasolabial fold and the mandibular area, respectively. Massage-induced changes of subcutaneous fat tissues and facial expression muscles were also apparent on CT images. 3D-CT imaging is useful for objective evaluation of the effects of facial massage, including anatomical changes in subcutaneous structures.

Effect of setback Le Fort I osteotomy on midfacial soft-tissue changes as evaluated by cone-beam computed tomography superimposition for cases of skeletal Class III malocclusion

Variations of midfacial soft-tissue thickness in subjects aged between 6 and 18years for the reconstruction of the profile: A study on an Italian sample.

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.

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.

This study investigated the correlation between the 3-dimensional changes in midfacial soft tissues, including the parasagittal area and maxilla-mandible complex, after Le Fort I maxillary posterior impaction and bilateral intraoral vertical ramus osteotomy (B-IVRO), using cone-beam computed tomography (CBCT). This retrospective study included 22 skeletal Class III patients (6 men and 16 women; mean age 21.6 years) who underwent orthognathic surgery. Three-dimensional CBCT images taken before and 1 year after surgery were superimposed based on the cranial base. Midfacial soft tissues, including those in the parasagittal area (paranasal area, anterior cheek area, lateral cheek area) and midsagittal areas of the face, were evaluated using reconstructed CBCT images. Correlations and the ratios between soft tissue and hard tissue movement were calculated. After surgery, both paranasal areas showed significant forward movement (about 2.0 mm) and the largest upward movement (about 0.15 mm) among the 3 areas. The paranasal areas moved forward with a ratio of 0.5, according to vertical movement of B. Orthognathic surgery using Le Fort I maxillary posterior impaction with B-IVRO mandibular setback results in forward movement of midfacial soft tissues, even though sagittal movement of the maxilla is limited because facial muscles and retaining ligaments pull the redundant soft tissues, which are caused by vertical movement of the maxilla-mandible. This midfacial soft tissue change with maxillary posterior impaction could be advantageous to patients who have paranasal depression and protrusion of the upper lip owing to proclined upper incisors, which are prevalent among Asian Class III patients.

The aesthetics of a smile have been shown to be related to the symmetry of the smile, the curvature of the upper lip, and the arc of curvature of the lower lip to the incisal edges of the upper teeth. The present study quantitatively compares the magnitude of facial animation (as determined by the Johnson Maximal Static Response Assay) to the aesthetics of a smile in 25 subjects. The assay (software) calculates two-dimensional facial movement changes from the frontal view, as measured by the relative change in position of seven facial landmarks. Smile shape and lip fullness were also categorized. Lip fullness was the only variable found to correlate with the aesthetics of a smile. The magnitude of facial movement, smile shape, and gender did not correlate with aesthetic ratings.