Prevalence of long face pattern in Brazilian individuals of different ethnic backgrounds

Mauricio De Almeida Cardoso,Leopoldino Capelozza Filho,Tien Li An,Renata Cristina Faria Ribeiro De Castro,David Normando,Daniela Gamba Garib

doi:10.1590/1678-7757201302270

Abstract

Objective:The long face pattern is a facial deformity with increased anterior total facial height due to vertical excess of the lower facial third. Individuals with long face may present different degrees of severity in vertical excess, as well as malocclusions that are difficult to manage. The categorization of vertical excess is useful to determine the treatment prognosis. This survey assessed the distribution of ethnically different individuals with vertical excess according to three levels of severity and determined the prevalence of long face pattern. Material and Methods:The survey was comprised of 5,020 individuals of Brazilian ethnicity (2,480 females and 2,540 males) enrolled in middle schools in Bauru-SP, Brazil. The criterion for inclusion of individuals with vertically impaired facial relationships was based on lip incompetence, evaluated under natural light, in standing natural head position with the lips at rest. Once identified, the individuals were classified into three subtypes according to the severity: mild, moderate, and severe. Then the pooled sample was distributed according to ethnical background as White (Caucasoid), Black (African descent), Brown (mixed descent), Yellow (Asian descent) and Brazilian Indian (Brazilian native descent). The Chi-square (χ2) test was used (p<0.05) to compare the frequency ratios of individuals with vertically impaired facial relationships in the total sample and among different ethnicities, according to the three levels of severity. Results:The severe subtype was rare, except in Black individuals (7.32%), who also presented the highest relative frequency (45.53%) of moderate subtype, followed by Brown individuals (43.40%). In the mild subtype, Yellow (68.08%) and White individuals (62.21%) showed similar and higher relative frequency values.Conclusions:Black individuals had greater prevalence of long face pattern, followed by Brown, White and Yellow individuals. The prevalence of long face pattern was 14.06% in which 13.39% and 0.68% belonged to moderate and severe subtypes, respectively.

Highlights

Long face pattern consists of facial deformities with increased anterior total facial height1,17 as a consequence of vertical excess of the lower facial third1,4,11,25, which results in an oval10 or taper1 facial appearance
34.94% of the pooled sample presents vertical excess and 65.06% belong to other patterns, either pattern I, II, III or short face
Considering that long face pattern consists of moderate and severe subtypes, 14.06% of individuals showed long face pattern, in which 0.68% belonged to the severe subtype (Table 3)

Summary

Introduction

Long face pattern consists of facial deformities with increased anterior total facial height as a consequence of vertical excess of the lower facial third, which results in an oval or taper facial appearance. In this pattern, lip incompetence is mandatory and when the lips seal, contraction of the perioral musculature can EH HYLGHQFHG ZKLFK DFFHQWXDWHV WKH GH¿FLHQF\ of the chin contour and the appearance of a more retrognathic mandible. The nose is long, and the nostrils are narrow with prominent nasal dorsum in lateral view. The orthodontic treatment alone is very limited, and an orthodontic-surgical approach would be more appropriate

Methods

Results

Conclusion