Acute Nasolabial Angle Research Articles

Management Of Skeletal Class Ii Malocclusion With Twin Block And Headgear: A Case Report

Background. The main concern of patients and their parents seeking orthodontic treatment has always been the sagittal relationship between the jaws and dentition. The most commonly observed sagittal problems are skeletal class II maxillomandibular relationship which affects about one-third of the examined patients who seek orthodontic treatment. This case report demonstrates the use of the Twinblock appliance and high-pull headgear in a skeletal Class II Division 1 patient with a prognathic maxilla and a retrognathic mandible. A 9 year old male patient reported to Department of Paediatric and Preventive Dentistry with a chief complaint of forwardly placed upper front teeth. On extraoral examination, it was found that the patient had a convex profile, incompetent lips, increased maxillary anterior teeth visibility, acute nasolabial angle, receded chin and deep mento labial sulcus. Superimposition of Post treatment with pre-treatment lateral cephalograms showed a reduction in the sagittal discrepancy. With the retraction and intrusion of maxillary anteriors by the use of head gear along with mandibular advancement by the use of twinblock gave the desired result.

Case Study: Facemask Protocol for Growing Patient

This case report describes the orthodontic treatment of a 9-year-old Egyptian male with a Class III incisor relationship and skeletal Class III base, characterized by a -3 mm reverse overjet, 70% reverse overbite, and masticatory difficulties. The patient exhibited full unit Class III molar relationship, unclassified canine relationship, lower and upper crowding, concave profile, acute nasolabial angle, and competent lips. Treatment involved two phases: Phase 1 utilized an orthopaedic appliance (facemask) with banded hyrax and posterior acrylic bite planes, while Phase 2 employed upper and lower fixed pre-adjusted edgewise appliances with MBT prescription and class III elastics. This comprehensive approach aimed to address the malocclusion effectively and achieve improved dental alignment and facial aesthetics.

Incisor and Soft Tissue Characteristics of Adult Bimaxillary Protrusion Patients among Different Skeletal Anteroposterior Classifications.

The objective of this study was to investigate the upper incisors (U1), lower incisors (L1), and soft tissue profiles of bimaxillary protrusion (BM) adult patients among skeletal Class I (BM1), II (BM2) and III (BM3). Understanding these characteristics would be useful for incisor and lip diagnostics in different skeletal classifications. Fourteen linear and twelve angular variables of the incisors and lips were evaluated in 214 lateral cephalograms (BM1 = 91, BM2 = 84, BM3 = 39). ANOVA and Bonferroni tests compared the measurements. BM1 and BM3 exhibited a greater U1 position and U1 inclination than the norms, while BM2 presented only a greater U1 position than the norms but normal U1 inclination. BM1 and BM3 had a significantly greater U1 position than BM2. BM1 and BM2 demonstrated a greater L1 position and L1 inclination than the norms, whereas BM3 displayed only a greater L1 position than the norms but normal L1 inclination. BM2 had the most anterior L1 position, whereas BM3 had the least anterior position. Only BM2 had a longer anterior dental height (ADH) than the norms, while BM1 and BM3 had a normal ADH and the significantly shortest ADH, respectively. Only BM1 had a normal upper incisor display at rest (U1R), while BM2 and BM3 displayed an increased and decreased U1R, respectively, with significant differences among the three groups. The most significantly protruded upper and lower lips were presented in BM2, but these were exhibited the least in BM3. The most significant acute nasolabial angle (NLA) was found in BM3, whereas BM2 presented the least acute NLA. A normal lip-chin-throat angle (LCTA) was observed in BM1 and BM3, while only BM2 had a greater LCTA than the norms. The most significant obtuse LCTA was found in BM2, while BM3 had the least obtuse LCTA. Therefore, both U1 and L1 in all groups presented protrusion and proclination, except for U1 in BM2, while L1 in BM3 exhibited normal inclination. The ADH and U1R were increased in BM2 but decreased in BM3. The most acute NLA was found in BM3, whereas the least acute was found in BM2. The most obtuse LCTA was in BM2, while the least was in BM3.

Binder Phenotype—Prenatal Diagnosis, Management, and Postnatal Outcome: Insights from a Case Series and Updated Review of the Literature

AbstractBinder phenotype (BP) or maxillonasal dysplasia is a developmental disorder of the anterior part of the maxilla and nasal complex and is characterized by a short nose with a flat nasal bridge, short columella, acute nasolabial angle, perialar flatness, convex upper lip, and tendency to a class III malocclusion. The etiology of BP is heterogeneous with diverse features and outcomes. The ultrasound features of BP are midfacial hypoplasia with verticalized nasal bones, short columella with flattened tip and alar wings, and the nasofrontal angle measuring >140 degrees. In this case series, we present seven cases of BP detected antenatally, their varied etiology, management, and outcomes with a 2-year follow-up. We conclude that the diagnosis of facial dysmorphisms, such as BP, brings a lot of apprehension and agony in the parents amounting to multiple tests and counseling sessions. Physiognomy which is the normal familial appearance should be considered before concluding whether the observed feature is normal or pathological. Accurate diagnosis, adequate testing, and personalized counseling will help in the prevention of needless termination of pregnancies and ensure an optimal perinatal outcome.

Facial Anthropometric Analysis of Gender-Related Characteristics in Computed Tomography.

In recent years, facial feminization surgery (FFS) has gained increasing popularity because of increases in transgender individuals and the acceptance of diversity in gender identity. However, there is still a scarcity of anthropometric research to guide evidence-based practices for FFS in Taiwan. The purpose of this study was to provide a reference for surgeons to achieve optimal outcomes for patients undergoing FFS. The anthropometric analysis could help surgeons meet patients' specific requirements and improve patients' alignment with their gender identity. The study group consisted of 100 patients (50 males and 50 females) who had undergone cranial computed tomography at Chang Gung Memorial Hospital in Taiwan because of the indication of blunt injuries to the head and face with suspected skull and facial fractures. The computed tomography images were imported into the OsiriX image software to conduct an anthropometric evaluation. The parameters used in the measurements included 2 aspects: bone and soft tissue anthropometric analysis. Anthropometric data were obtained from 50 males (age 32.6 ± 11.4 years) and 50 females (age 33.7 ± 10.3 years). The results for bone measurements showed that both the forehead bossing length and nasal bone width in the male group were significantly greater. The frontal angle in both bone and soft tissue in the male group was significantly smaller. The chin height and bigonial width in both bone and soft tissue in the male group were significantly greater. Although the average gonial angle was greater in the female group, the difference was not significant. For the measurements of lip projection, the results showed that there was no significant difference. Although this group of Asian males had more acute nasolabial angles, the difference was not statistically significant. However, the average nasofrontal angle among females was significantly more obtuse than among males. The results revealed that Asian males tend to have more prominent superior orbital rims, wider nasal bones, and wider and taller mandibles compared with Asian females. Despite showing some trends, the gonial angle and lip projections did not reveal any significant differences, which is likely because of a large amount of variation.

Correction of Skeletal Class II Malocclusion in a Growing Child Using Standard Twin Block: A Case Report

Mandibular defiiency in a Class II malocclusion is a frequently encountered condition that can be managed with myofunctional appliance in a growing child. An 11-year-old patient presented with a complaint of forwardly placed upper front teeth. The patient had a convex facial profie, acute naso-labial angle, deep mento-labial sulcus with lip trap. Clinically the patient showed positive VTO. The clinical fidings and cephalometric analysis indicated skeletal Class II jaw bases owing to prognathic maxilla and retrognathic mandible with Angle’s Class II division 1 malocclusion. CVMIshowed that the patient was in his growth phase. The treatment was done with a standard twin block appliance for 9 months followed by fied orthodontic treatment. The post functional phase showed correction of skeletal class II jaw base and marked improvement in the facial profie from convex to straight. It was later followed by fixed orthodontic treatment in the second phase upon completion of which bonded lingual retainer and wrap around retainers were given in the upper and lower arch. The total duration of the treatment was 23 months.

An innovative approach for treatment of anterior open bite in Class II Division 1 patient with VF appliance (Zygomatic Implant and Spur Assisted) - A case report

Controlling anchorage is one of the foremost necessary aspects of treatment. Moderate anchorage is comparatively simple to manage with the use of some intraoral appliances and biomechanical procedures. On the opposite hand, cases that need the most anchorage need extraoral support to strengthen the anchorage. In some instances, 100 percent anchorage has got to be maintained, such an anchorage may be termed as absolute anchorage. It's tough and not possible to get absolute anchorage by using typical ways like extraoral force application. In this case report, we describe the treatment of Open bite by using the support of Zygomatic plates and Spurs anteriorly placed with the combination of posterior bite blocks. A 20-year-old female reported to our department of orthodontics with the chief complaint of anteriorly placed upper front teeth. There was no relevant medical history; she was having tongue thrusting habit, acute nasolabial angle and incompetent lips. Overjet of 12mm and anterior skeletal open bite from canine to canine of 5mm was present associated with anterior tongue thrusting habit, and constricted upper arch. The molar relation was end-on on the right side and class II on left side. Canine relation is end-on, on both the side. Growth pattern is vertical. Upper arch is well aligned with constriction in premolar region; lower arch has crowding of 6 mm. The treatment plan was selected as alignment of the teeth with fixed mechanotherapy and impaction of the maxillary posteriors using zygomatic anchorage with posterior bite block and spurs soldered to the anterior part of the appliance. The sutures were removed after 7 days, the appliance was inserted into the patient’s mouth and secured with a power chain to the hooks of the appliance and the hook of zygomatic implant, 400gms of force was applied on both the sides.

An innovative approach for treatment of anterior open bite in Class II division 1 patient with zygomatic implant and spur assisted appliance - A case report

Controlling anchorage is one of the foremost necessary aspects of treatment. Moderate anchorage is comparatively simple to manage with the use of some intraoral appliances and biomechanical procedures. On the opposite hand, cases that need the most anchorage need extraoral support to strengthen the anchorage. In some instances, 100 percent anchorage has got to be maintained, such an anchorage may be termed as absolute anchorage. It's tough and not possible to get absolute anchorage by using typical ways like extraoral force application. In this case report, we describe the treatment of Open bite by using the support of Zygomatic plates and Spurs anteriorly placed with the combination of posterior bite blocks.A 20-year-old female reported to our department of orthodontics with the chief complaint of anteriorly placed upper front teeth. There was no relevant medical history; she was having tongue thrusting habit, acute nasolabial angle and incompetent lips. Overjet of 12mm and anterior skeletal open bite from canine to canine of 5mm was present associated with anterior tongue thrusting habit, and constricted upper arch. The molar relation was end-on on the right side and class II on left side. Canine relation is end-on, on both the side. Growth pattern is vertical. Upper arch is well aligned with constriction in premolar region; lower arch has crowding of 6 mm. The treatment plan was selected as alignment of the teeth with fixed mechanotherapy and impaction of the maxillary posteriors using zygomatic anchorage with posterior bite block and spurs soldered to the anterior part of the appliance. The sutures were removed after 7 days, the appliance was into the patient’s mouth and secured with a power chain to the hooks of the appliance and the hook of zygomatic implant, 400gms of force was applied on both the sides.

Photogrammetrics and clinical features of nasal siliconoma in Asians

BACKGROUND Nasal silicone injections have been a common procedure among Asians. However, this procedure can lead to severe complications. Unfortunately, there are limited data available on the distortive characteristics of nasal siliconoma in the Asian population. This study aimed to provide objective data on the distortive characteristics of nasal siliconoma to be a reference for a treatment outcome.
 METHODS This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from June 2017 to March 2018. The study included 30 Asian females with nasal siliconoma, and nasal photogrammetric measurements were taken using a portable mirror stand device and analyzed to formulate the distortive characteristics.
 RESULTS The mean (standard deviation) of intercanthal width was 3.33 (0.25) cm, nasal root width was 2.70 (0.30) cm, alar width was 4.48 (0.31) cm, two tip-defining points (TDP) distance was 2.09 (0.22) cm, nasofrontal angle was 141.10 (8.40)°, length of the nose was 3.10 (0.48) cm, nasofacial angle was 32.94 (4.51)°, nasion projection was 0.64 (0.36) cm, pronasion projection was 2.00 (0.25–2.46) cm, tip angle was 122.7 (4.52)°, nasolabial angle was 78.81 (15.93)°, columella length (n = 20) was 0.64 (0.20) cm, tip lobular portion length was 1.12 (0.20) cm, the extend of extended columella was 0.47 (0.31) cm, and base of the nasal width was 3.98 (0.25) cm.
 CONCLUSIONS Nasal siliconoma in Asians had certain characteristics such as a wider nasal root, wider two TDP distance, wider nasion projection, acute nasolabial angle, hanging columella, and a long lobular portion of the tip.

Surgical-Orthodontic Treatment of Class III Malocclusion with Anterior Open Bite

A 21-year-old female came with chief complaints of inability to incise food and poor esthetics. The patient presented with a concave facial profile, long face with a steep mandibular angle, incompetent lip closure, and acute nasolabial angle. Intraorally, she had negative 6 mm overjet, 3 mm open bite and dental crowding. She was diagnosed as severe skeletal Class III malocclusion and anterior open bite. The treatment plan included orthodontic treatment with orthognathic surgery and extraction of maxillary second molars, which were supra-erupted and tipped buccally. The pre-operative orthodontic alignment took 11 months. The surgical correction included maxillary Le Fort I osteotomy with 4 mm advancement, mandibular intraoral vertical ramus osteotomy with 6.5 mm setback and genioplasty. The total surgical-orthodontic treatment time was 16 months. The final result presented a straight profile with stable occlusion. The patient’s facial and dental esthetics, masticatory function, and quality of life were all significantly improved after surgical-orthodontic treatment.

Ortho-Surgical Management of An Adult Patient with Gummy Smile

Aim: This case report represents the clinical management of a Skeletal Class II adult patient with gummy smile treated by Orthognathic surgery. Background: Vertical maxillary excess (VME) is the most common skeletal deformity in Skeletal Class II which is treated by Anterior Maxillary Osteotomy (AMO) and Gummy Smile is the characteristic feature of VME in which the anterior part of maxilla is superiorly repositioned. Case Description: A 19-year-old patient reported our clinic with the complaint of forwardly placed upper front teeth. On extra oral examination, she had convex profile with posterior divergence and interlabial gap of 10mm and everted upper lip. The patient had a gummy smile of 8mm. Intra orally, she had Class II canine relationship on both sides with missing irt 16, 36, 46. Cephalometric values showed Class II skeletal base with protrusive upper and lower incisors and acute nasolabial angle. Initially orthodontic treatment was done and extraction of upper first premolars was planned during surgery. AMO was done with superior impaction of 4mm and posteriorly by 6mm. After 4 weeks of post surgery, the settling of occlusion using intermaxillary elastics was done. At the end of the treatment, the patient had Class I canine relationship on both sides with Skeletal Class I and overjet and overbite was 2mm. The patient gummy smile was reduced to 4mm which was accepted by the patient. Fixed retention was given in both the arches. The total treatment time was around 30 months. Conclusion: The proper diagnosis and appropriate treatment planning is the main key to achieve stable results in Orthodontics. An interdisciplinary approach with the orthodontist and surgeon will lead to achieve stable, functional and esthetic results.

Current Trends in Ideal Nasal Aesthetics Show Younger Patients Have a Preference Toward Longer Augmented Noses.

Aesthetic norms fluctuate over time and often result in generational differences in preferred ideal nasal aesthetics. While some traditional concepts of the ideal nasal aesthetic have been suggested in our literature, there has been no study to date that has identified contemporary preferences across different age groups. To understand the general population's current perception of ideal nasal profiles. Two-dimensional images of female noses (n = 10) of varying ethnicities were simulated to alter either the radix height or nasolabial angle (NLA) independently. Radix height was manipulated by increasing or decreasing the height by 5 mm relative to baseline. For NLA, 3 images were created with the following measurements: (1) 90°, (2) 100°, and (3) 110°. Groups were categorized by generation and age at the time of completing the study: Generation Z (Gen Z; age 18-23), Millennial 20s (age 24-30), Millennial 30s (age 31-39), and Generation X (Gen X; age 40-55). Each figure consisted of either 3 variations in radix height (n = 10) or 3 variations in NLA (n = 10). Within each figure, volunteers were asked to choose their preferred nose. The younger generations, Gen Z and Millennial 20s and 30s, preferred a more augmented radix compared to Gen X which preferred a baseline radix height. Gen Z, Millennial 20s, and Gen X preferred a 90° NLA, while Millennial 30s preferred an NLA of 100°. The authors found that younger populations (Gen Z, Millennial 20s, and Millennial 30s) preferred a more augmented appearance to the nasal radix and, on average, a more acute NLA than published data suggest.

Correlation of vertical dimension with lip position, nasolabial angle and incisal display at rest and at smile in young adults

Introduction: Photography has been given a great importance in diagnosis in orthodontics, the study of certain aesthic parameter on digitilzed photographs can provide an additional diagnostic tool. This study is designed to compare facial parameters and various photographic parameters among patients with long, average, short faces in central Indian population. Also an alternative method to cephalometric analysis needs to be worked upon which is reliable, easily assessable and convenient for multiple usage by the orthodontist to direct his/her treatment. Materials and Methods: 150 subjects (75 males and 75 females) selected and examined by two methods clinical examination and photographic examination by using ImageJ software. Results: The results of this study shows there is significant correlation between vertical dimension, incisal display upper lip length, lower lip length and nasolabial angle and there is no significant difference between clinical examination and photographic examination done with Image J software. Conclusion: This study concluded that the vertical proportions of facial soft tissue follow the underlying vertical skeletal pattern, high vertical dimension is associated with short upper lip, more incisal display and high clinical FMA. The low vertical dimension is associated with acute nasolabial angle and low clinical FMA. Photogrammetry was found to be a quick easy, cost effective and reliable diagnostic tool which can reduce radiation exposure and reduce the number of cephalograms during treatment

McNamara analysis cephalometric parameters in White-Brazilians, Japanese and Japanese-Brazilians with normal occlusion.

ABSTRACTIntroduction: McNamara’s Jr. cephalometric analysis is a tool to diagnose dental and skeletal discrepancies and is widely used, guiding diagnosis for surgical procedures to be performed or for the use of functional devices. Few studies have shown that different ethnic groups have different cephalometric patterns. Thus, single characteristics should be respected to support the diagnosis and to help the treatment plan for different ethnic groups and their different patterns of miscegenation. Objective: Obtain normal values for McNamara’s cephalometric analysis for adolescent Japanese-Brazilian descents with normal occlusion, as well as to compare this sample with similar samples of White-Brazilian and Japanese. Methods: Lateral headfilms from 40 White-Brazilian, 33 Japanese and 32 Japanese-Brazilian descents were selected. The three groups were composed by individuals with normal occlusion, well-balanced profiles and were separated by sex. The data were statistically analyzed with ANOVA, t-test, ANCOVA and MANCOVA tests. Results: White-Brazilian males had significantly greater nasolabial angle than Japanese males. Japanese-Brazilian displayed an intermediate value between White-Brazilian and Japanese. Conclusion: White-Brazilian, Japanese and Japanese-Brazilian present different cephalometric characteristics of McNamara analysis. Japanese males have a significantly more acute nasolabial angle than White-Brazilian subjects.

Nasal Analysis of Classic Animated Movie Villains versus Hero Counterparts.

Opposing facial features between animated villains and heroes have historically been used to demonstrate contrasting morality between characters, and this could have an impact on how humans view someone as good or evil in everyday life. Studies have been done investigating classic dermatologic features of villainous characters. This principle can be applied to nasal features as well. A search for "top animated characters" was performed. Characters were chosen from American Film Institute's "The Top Tens," Rolling Stone's "25 Best Pixar Movie Characters," and Screenrant's "The 30 Best Animated Movie Characters of All Time." Twenty villains and twenty hero counterparts from respective films were chosen. Classic nasal features were analyzed. Twenty villains (14 male, 6 female) and 20 heroes (12 male, 8 female) were analyzed. Sixteen villains (80%) had greater than normal nasal frontal angle versus 18 heroes (90%). Thirteen villains (65%) had an acute nasolabial angle versus two heroes (10%). Two villains (10%) had excess columellar show versus seven heroes (35%). Seven villains (35%) and one hero (5%) had a dorsal hump. Twelve villains (60%) had an overprojected chin versus three heroes (15%). Villains in pre-2000s films more frequently had a dorsal hump, overprojected chin, ptotic tip, pollybeak deformity, and bulbous tip. Heroes in pre-2000s films more frequently had an overrotated tip. Villains and heroes commonly have a greater than normal nasofrontal angle. Villains more commonly have an acute nasolabial angle, underrotated tip, overprojected chin, dorsal hump, and pollybeak deformity. Heroes more commonly have a large nasolabial angle and overrotated tip. Further research in conjunction with psychologists is required to obtain concrete data on how this affects whether an individual in real life is seen as good or evil, and the impact this has on interactions in society, including in the medical field.

Pretreatment dentoskeletal comparison between individuals treated with extractions in the 1970s and in the new millennium.

This retrospective study aimed to compare the occlusal and dentoskeletal initial features of patients treated with four first premolar extractions in the 1970s and after 2000. Group 70' was composed by 30 subjects with Class I malocclusion (mean age of 12.8years, 10 male, 20 female) treated in the 1970s with four first premolar extractions and comprehensive orthodontic treatment. Group NM comprised 30 subjects with Class I malocclusion (mean age of 13.4years, 13 male, 17 female) treated in the new millennium, similarly to Group 70'. Initial dental models and lateral cephalograms were digitized and measured using OrthoAnalyzerTM 3D software and Dolphin Imaging 11.0 software, respectively. Initial occlusal and dentoskeletal features were analyzed and compared. Intergroup comparison was performed using t tests (p < 0.05). Holm-Bonferroni correction for multiple comparison was applied. Group NM showed significantly greater maxillary and mandibular effective lengths and greater maxillary and mandibular incisor protrusion in comparison with Group 70'. Group NM presented a significantly greater lower anterior facial height. Group NM also showed significantly smaller nasolabial angle and protruded inferior lip. Patients with Class I malocclusion treated with four first premolar extractions in the new millennium present a greater degree of dental and labial protrusion, increased lower anterior facial height, and more acute nasolabial angle compared with patients treated similarly in the 1970s. Greater dental and labial protrusion determines first premolar extractions in the new millennium. Despite the decrease of tooth extraction frequency, four first premolar extractions may be justified in cases with severe dental and skeletal protrusions.

Management of a Skeletal Class II Malocclusion Using 2-Phase Treatment: An Indian Board of Orthodontics Case Report

PK, a 12-year-old female patient, was diagnosed with skeletal Class II due to retrognathic mandible, average growth pattern, Angle’s Class II, Division I malocclusion with Class II canine relation, mild upper anterior spacing, upper anterior proclination, uprighted lower anterior, lingually tipped 35, increased overjet and overbite, scissor bite Irt 24, 25, acute nasolabial angle, tongue thrust habit, incompetent lips, and lower lip trap. The nonextraction approach to orthodontic treatment was involved. The skeletal malocclusion was corrected using the twin-block appliance, followed by upper and lower pre-adjusted edgewise appliances (0.022 × 0.028 slot) with the MBT prescription.

Premaxillary Deficiency: Techniques in Augmentation and Reconstruction.

Progressive premaxillary retrusion is a common sequela of the facial aging process. In most cases, this manifests with central maxillary recession. Central maxillary insufficiency is also commonly encountered within certain ethnic communities, or in cleft lip nasal deformity, and may represent a challenge for the plastic and reconstructive surgeon attempting correction in the setting of facial contouring, rhinoplasty, or reconstruction following oncologic resection or trauma. Aesthetically, premaxillary retrusion may be coincident with an acute nasolabial angle and ptotic nasal tip. Minor deformities may be addressed with use of either alloplastic implants, autogenous tissue, lipotransfer, or injectable filler. Larger composite defects may require reconstruction with implementation of free tissue transfer. Herein, we describe techniques that aim to augment, or reconstruct, the premaxillary region in the context of nasal deformity, osseous resorption, or composite maxillofacial defects.

Soft tissues cephalometric norms for a sample of Sudanese adults. Part I: Legan and Burstone analysis

ABSTRACT Purpose: To establish soft tissues cephalometric norms for orthognathic surgery in a sample of Sudanese adults. Materials and Methods: A total of 106 lateral cephalograms of Sudanese adults (55 females and 51 males) aged between 18 and 25 years (mean 22.8 years) were manually traced and analysed using Legan and Burstone Cephalometric analysis for orthognathic Surgery (COGS). Results: Sudanese sample, in comparison to Caucasian, had a more convex profile with larger angle of convexity and more prognathic maxillae, obtuse lower face-throat angle, more acute nasolabial angle, protrusive upper and lower lips with deeper labiomental sulci and greater maxillary incisors exposure with larger interlabial gap. Males had greater maxillary and mandibular prognathism, more obtuse lower face-throat angle and vertical height depth ratio than females. Females had larger vertical lip chin ratio, maxillary incisor exposure and interlabial gap. Conclusion: Considerable differences between the soft tissue profile configuration of Sudanese and Caucasian adults exist and also between Sudanese and other populations. These variations should be taken into account during diagnosis and treatment planning of orthognathic surgery.

Correction of Anterior Vertical Dysplasia by using Tongue Crib Therapy in An Adult Patient -A Case Report

A female patient of 26 years reported to the Department of Orthodontics, with a chief complaint of spacing between upper and lower front teeth. Patient has a habit of thumb sucking during night time since last 24 years. On extra oral examination she has mesoprosopic facial form, competent lips, bilaterally asymmetric face, convex profile, acute nasolabial angle, high clinical FMA. Intra oral examination reveals anterior open bite with Angle’s Class I molar relation and class I canine relation, proclined upper and lower anterior teeth slightly crowded. Cephalometrically skeletal class II malocclusion, vertical growth pattern with bidental proclination with 10 mm openbite. Detailing treatment strategies such as bracket repositioning, occlusal adjustment,and elastics were used