Convexity Angle Research Articles

Evaluation by 3D stereophotogrammetry of facial changes in edentulous patients after rehabilitation.

To assess facial changes after oral rehabilitation with complete dentures (CDs) by 3D technology allows understanding the results of a treatment that changes facial proportions. Precise outcome parameters can improve decision making. Objective This descriptive observational research aimed to assess facial changes in completely edentulous patients after oral rehabilitation with a CD by a 3D stereophotogrammetry system.Methodology 30 edentulous patients (7 men and 23 women), aged 50 to 75, were analyzed with stereophotogrammetry at 28 previously determined anthropometric landmarks, at 2 different times: T1, before treatment, and T2, after inserting the CDs. Images were analyzed with a specific software for linear and angular measurements. The paired t-test was used to compare timestamps (α=0.05).Results Major changes were observed in 7 of the 13 linear measures and 7 of the 9 angular measures. The following linear measurements had an increase: Sn-Gn (lower third of the face), Ls-Li (height of the vermilion lip), and ChL-ChR (mouth width). Sn-Ls (nasal philtrum height) decreased. For angular measurements, Sn-St-Pg (lower facial convexity) angles increased, and the Prn-Sn-Ls (nasolabial angle) and GoR-Pg-GoL (mandible convexity) angles decreased.Conclusions Major facial changes in newly rehabilitated edentulous patients with CDs included an increase of the lower third of the face, of the vermilion lip, of mouth width, and of the lower facial convexity, and a decrease of the nasolabial angle and mandible convexity.

Effects of facemask therapy in the treatment of skeletal class III malocclusion in Vietnamese children

Sparse data are available on the effects of facemask therapy in treatment of skeletal class III malocclusion in Vietnamese children. The purpose of this study was to investigate the skeletal, dental, and soft-tissue profile changes following facemask treatment in children with skeletal class III malocclusion. Twenty-four children (7-12 years-old) with skeletal class III malocclusion treated with facemask appliance were included in this study. All lateral cephalograms taken before and after treatment had been manually traced, followed by cephalometric landmark identification and parameter measurements. Significant skeletal, dental and soft tissue profile changes after treatment were recorded and statistically evaluated by paired t test at a 0.05 significance level. After treatment, the maxilla moved forward (SNA increased 1.53 degrees and A–Y increased 1.93 mm; p<0.001). The mandible rotated backwards and downwards (SNB decreased 1.35 degrees; B–Y decreased 1.12mm; p<0.001). These movements in the maxilla and mandible caused a significant improvement in intermaxillary sagittal relationship (ANB increased 2.89degrees; the convexity angle increased 4.7 degrees; Wits appraisal increased 3.77mm; p<0.001). The maxillary incisors moved forward (4.57 degrees). The improvement in overjet was 5.83 mm. The change in Prn-Y and Ls–E measurement was 2.46mm and 2.72mm, respectively. Our results showed that facemask was highly effective for treating skeletal class III malocclusion and improving facial esthetics. Facemask treatment is a highly effective for skeletal class III malocclusion because it leads to positive changes in the jaws, teeth and soft tissue after 1-year of treatment.

Comparison of facemask therapy effects using skeletal and tooth-borne anchorage.

To investigate long-term outcomes of dentoskeletal changes induced by facemask therapy using skeletal anchorage in Class III patients and compare them to those of conventional tooth-borne anchorage. This retrospective study included 20 patients who received facemask (FM) therapy with miniplates as anchorage for maxillary protraction (Miniplate/FM group, 10.6 ± 1.1 years old [mean ± SD]) and 23 patients who were treated with facemask with rapid maxillary expander (RME/FM group, 10.0 ± 1.5 years old [mean ± SD]). Dentoskeletal changes were evaluated using lateral cephalograms at pretreatment (T1), after facemask therapy (T2), and at the post-pubertal stage (T3). Cephalometric changes were compared between groups and clinical success rates at T3 were evaluated. SNA and A to N perpendicular to FH increased significantly more in the Miniplate/FM group than in the RME/FM group when comparing short-term effects of facemask therapy (T1-T2). ANB, Wits appraisal, Angle of convexity, mandibular plane angle, and overjet decreased significantly more in the RME/FM group than in the Miniplate/FM group after facemask therapy (T2-T3). A more favorable intermaxillary relationship was observed in the Miniplate/FM group than in the RME/FM group in long-term observations (T1-T3). Clinical success rate at T3 was 95% in the Miniplate/FM group and 85% in the RME/FM group. Facemask therapy with skeletal anchorage showed a greater advancement of the maxilla and more favorable stability for correction of Class III malocclusion in the long-term than conventional facemask therapy with tooth-borne anchorage.

Mount Vernon Index vs Yen Angle for Assessment of Anteroposterior Apical Jaw Base Relationship.

Aims and objectivesThis research aimed to determine the predictability and variability of the Yen angle and Mount Vernon Index (MVI) in relation to the other four sagittal discrepancy parameters, as well as to evaluate and explain any correlations that exist. The Lateral Cephalograms of 100 Class I Indian participants aged 17–24 years were recorded. The lateral cephalograms were traced for six distinct AP characteristics, including ANB, Wits appraisal, facial convexity, and beta angle, Yen angle, and MVI. The gathered data were evaluated statistically using S.P.S.S. version 10. To determine the difference between males and females, an independent “t” test was used. The coefficient of variability and correlation methods were used to determine the correctness of the Yen angle and MVI, as well as the association between the variables.ResultsThe results of this study indicate that the most predictable and highly dependable parameter was the Yen angle (CV = 5.63), followed by the beta angle (5.63), the MVI (CV = 13.6), the ANB, Rickett's analysis, and Wit's analysis. Throughout all five analyses, the most statistically significant positive association between the MVI and the BETA angle was determined.ConclusionThe derived inferences from the study included the high reliability of the yen angle for assessing the AP skeletal patterns of a patient, followed by the beta angle and MVI.How to cite this articleDoshi JR, Jain P, Jain M, et al. Mount Vernon Index vs Yen Angle for Assessment of Anteroposterior Apical Jaw Base Relationship. Int J Clin Pediatr Dent 2021;14(S-1):S35–S38.

Interaction Between Subspinale and Two Expansion Protocols in Class III

ABSTRACT Objectives: to assess and compare skeletal,dental and soft tissue changes of three RME protocols using conventional Hyrax, Hybrid Hyrax, and four miniscrew supported Hyrax using alternated expansion and constriction. Methods: 21 patients enrolled in this study with Class III maxillary deficiency, with an average age of 10.5±6 months, and allocated into three groups of seven patients each. Maxillary expansion was done with conventional Hyrax in Group I. Group II: RME with Hybrid Hyrax. Group III: skeletal four-point supported custom-made Hyrax with four palatal micro-implants and alternating rapid maxillary expansion and contraction. A cephalometric tracing of standardized cephalometric x-ray was performed for each patient before and after expansion for various linear and angular measurements and statistically analyzed Results: SNA angle increased significantly (p ≤ 0.05) from pretreatment to post-expansion stage in all groups. There was a statistically significant difference between Groups II and III. When the three Groups were compared, a considerable forward movement of point A was detected in both Group I and Group II. The forward movement of point A, the angle of facial convexity and upper lip prominence improved considerably in GII. Conclusion: Hybrid Hyrax (Group II) showed a significant improvement in forward position of point A concomitant with a significant sagittal skeletal, dental and soft tissue profile improvement.

English

BACKGROUND Orthodontics has witnessed a paradigm shift in the perception of aesthetics. Soft tissue assessment and correction has become a greater concern when compared with dental and skeletal correction. In the current era, pleasing profile is a prime requisite. The purpose of this study is to evaluate different parameters responsible for perception of a pleasing profile. METHODS Hundred dental students with well-balanced faces were selected. Profile photographs of participants were taken by DSLR camera maintaining standardized photography protocol. The principal investigator had measured ten soft tissue parameters for each profile photograph. These profile photographs were further converted into profile silhouettes. 10 laypersons appraised each profile silhouette using visual analog scale (VAS). The obtained scores were again correlated with photographic measurements of each individual to identify role of different parameters responsible for pleasing profile. RESULTS When comparing the data statistically, significant differences were found amongst the parameters between less attractive and more attractive profile; parameters include facial convexity angle, naso-labial angle, protrusion of lip relative to each other, vertical lip to chin ratio and vertical height ratio. CONCLUSIONS It was clear from this study that, amongst individuals with normal overjet, overbite and a pleasing profile, those subjects with more obtuse facial convexity angle, obtuse nasolabial angle, slightly more protruded upper lip than lower lip, equivalent vertical height ratio, and smaller lip-chin ratio vertically, were found to be more attractive, as perceived by laypersons. KEY WORDS Parameters, Photographic Soft Tissue Analysis, Silhouette Study, Pleasing Profile

Evaluation of Cephalometric Changes and Its Relation to Changes in Patients' Quality of Life After Mandibular Setback Surgery.

To find out if a relationship exists between the different cephalometric changes and the perception of patients before and after Bilateral Sagittal Split Osteotomy (BSSO) setback surgery. Sample consisted of 28 patients (mean age 23.78 ± 1.36years), Male:Female = 1:1.3, with a median follow-up of 10 ± 1.8months, with skeletal class III malocclusion treated with BSSO setback surgery. Pre- and post-surgery lateral cephalograms were analysed. The Oral Health Impact Profile (OHIP) questionnaire was used to assess the patients' quality of life after surgery. Cephalometric data were then correlated with the questionnaire results. The psychological and social aspects of OHIP questionnaire were most affected. The most significant correlation between OHIP score change and cephalometric parameters was found with reduction of 'lower lip protrusion'; and significantly positive correlations were with increase in ANB angle and reduction in values of SND angle, N-B distance, lower lip length, lower facial height, mentolabial angle and angle of facial convexity. A significant relationship exists between the subjective and objective parameters which should be considered while planning for orthognathic surgery. Results of this study could be beneficial, helping the clinicians, to emphasise on specific cephalometric variable with the patient-specific expectations.

Tooth-borne versus tooth-bone-borne rapid maxillary expanders according to a stereophotogrammetric evaluation of facial soft tissues: A randomized clinical trial.

To evaluate the effects of tooth-borne and tooth-bone-borne rapid maxillary expansion (RME) on soft tissue with stereophotogrammetry. Thirty two patients (15 males and 17 females) who met inclusion criteria were divided into two groups. In the first group, tooth-borne RME appliance (hyrax) was applied to 16 patients (9 males and 7 females mean age 13.4±1.3years), and in the second group, tooth-bone-borne RME appliance (hybrid hyrax) was applied to 16 patients (6 males and 10 females, mean age 13.05±1.24years). Changes in soft tissues before RME (T0) and post-retention (T1) period were evaluated by stereophotogrammetry. Linear and angular measurements were performed. Independent- and dependent-sample t tests were used to compare intra- and inter-group differences at P<.05 significance level. The data revealed statistically significant changes in nasal width, mid-face width, upper lip vermillion length/lower lip vermillion length ratio and upper lip angle in hyrax group. (P<.05) Also nasal width, lower lip length, lower lip vermillion length, anterior face height, lower face height, convexity angle and mandibular angle showed statistically significant changes in hybrid hyrax group. (P<.05) In the inter-group evaluation, no significant differences were found except upper lip and mandible angle. (P<.05). Both hyrax and hybrid hyrax expanders had effects on soft tissue profile. Anterior face height and lower face height increased in both groups. Upper lip length increased by 0.36mm in the hybrid group and 0.10mm in the hyrax group. This trial was registered at Clinicaltrials.gov (Identifier: NCT04828213).

Evaluation of Cephalometric Standards for Zanjanian Population According to Downs' Analysis

Background: Following the morphological features of different races and ethnic groups, knowledge of standard dentofacial patterns of each ethnic group is essential. Therefore, this study aimed to explain cephalometric standards for the Zanjanian population according to Downs' analysis and compare them to Caucasian individuals. Methods: Seventy lateral cephalometries of Zanjanian adults (17 - 29 years old) who had been referred to a private orthodontic office in Zanjan, Iran with class I molar and canine relationship and normal overjet and overbite as well as minimum crowding/spacing/rotations were scanned and traced with the Novatech scanner and Dolphin software version 10. Next, statistical analyses were performed in order to compare the Zanjanian population to Caucasians. Results: We found a significant difference between males and females in terms of interincisal angle, incisor-occlusal angle, incisor-mandibular plane angle, upper incisor proclination, facial angle, and angle of convexity. Discussion: The analysis of six statistically significant parameters indicates that the upper and lower incisors in women of Zanjan were proclined and protruded compared with those of Caucasian subjects. Due to the statistical analysis on facial angle and angle of convexity, women also show more maxillary prognathism and skeletal class II pattern. Generally, a comparison of Zanjanian population cephalometrics based on Downs' analysis showed an increase in maxillary prognathism, maxillary and mandibular incisal protrusion and posterior rotation of the mandible. Conclusions: In conclusion, the Zanjanian population tends to have more dental and skeletal class II patterns than the Caucasians. In addition, gender comparison indicates lower and upper-incisors protrusion in women of Zanjan.

Three-dimensional soft tissue evaluation after rapid maxillary expansion and mandibular midline distraction osteogenesis.

To evaluate the effects of rapid maxillary expansion (RME) and mandibular midline distraction osteogenesis (MMDO) on facial soft tissues using three-dimensional (3D) images. A total of 20 patients (average age 15.86 ± 2.17 years) were treated with RME and MMDO using tooth-borne distractors. Three-dimensional photographs of each patient were taken with a stereophotogrammetry system at baseline (T0), at the end of the distraction period (T1), and at the end of the consolidation period (T2). All data were analyzed using a dependent-samples t-test at a significance level of 5%. Total and lower face height increased after MMDO (P < .05). Nasal and mouth width increased after RME as compared with baseline (P < .05). The labiomental angle increased at T1 and decreased at T2 (P < .05). After MMDO, the convexity angle increased while the mandibular angle decreased (P < .05). Upper and lower lip angles increased after RME (P < .05). The distance from the lower lip to the E plane increased after MMDO and decreased after RME (P < .05). The MMDO and RME procedures provide an efficient nonextraction treatment alternative for transverse maxillomandibular deficiency. MMDO may improve the facial soft tissue profile in the transverse and vertical axis of the mandibular region.

Nasal Morphology and Its Correlation to Craniofacial Morphology in Lateral Cephalometric Analysis.

Nose shape, size, and inclination influence facial appearance, but few studies concern the relationship between the nasal profile and craniofacial structures. The objective of this study was to analyze association of nasal cephalometric variables with skeletal structures, age, and sex. Cephalometric and nasal analysis was performed in 386 Polish orthodontic patients (aged 9–25 years). Student t-test and Mann–Whitney test were used to compare quantitative variables and Pearson’s or Spearman’s correlation coefficients—to find correlations. Soft tissue facial convexity angle correlates to Holdaway ratio, ANB (A-Nasion-B), and Wits appraisal. Nasal dorsum axis, nose length, nose depth (1) and nose depth (2), nose hump, lower dorsum convexity, and columella convexity increase with age. Nasal base angle, nasolabial angle, nasomental angle, soft tissue facial convexity and nasal bone angle decrease with age. Nasal base angle and nasomental angle are smaller in females. Thus, a relationship exists between nasal morphology and sagittal jaw configuration. Nasal parameters significantly change with age. Sexual dimorphism characterizes nasal bone angle and nasomental angle.

Symptoms, disc position, occluding pairs, and facial skeletal characteristics of older patients with temporomandibular disorders.

ObjectiveTo describe the proportions of different osseous diagnoses in older patients with temporomandibular disorders (TMD) and to analyze the symptoms, disc position, occluding pairs, and facial skeletal characteristics of patients with bilateral osteoarthrosis (BOA) and bilateral normal joints (BNJ).MethodsThis retrospective cross-sectional study constituted 88 older patients (age ≥60 years). The osseous diagnosis, symptoms, disc position, occluding pairs, and facial skeletal characteristics were evaluated. Variables in BOA patients and BNJ patients were compared using the t-test and chi-square test.ResultsForty-eight patients had BOA, 7 had unilateral osteoarthrosis, 11 had intermediate osteoarthrosis, and 22 had BNJ. The prevalence of disc displacement without reduction (DDw/oR) in BOA patients was significantly higher than in BNJ patients. BOA patients exhibited greater ANB angle, PP-MP, U1-NPo, L1-NPo, and facial convexity angle; shorter posterior cranial base; and decreased ramus height.ConclusionBOA patients with associated DDw/oR had more complaints of orofacial pain and exhibited a shorter posterior cranial base, and greater mandibular retrusion, anterior tooth protrusion, and protruded profile than BNJ patients.

Changes in the craniofacial structures and esthetic perceptions of soft-tissue profile alterations after distalization and Herbst appliance treatment

The purpose of this prospective clinical trial is to evaluate the changes of soft tissues and designate the esthetic perceptions of children with Class II malocclusion after Herbst appliance therapy and maxillary molar distalization using stereophotogrammetry. Thirty patients were allocated either to Herbst (6 boys and 9 girls; mean age=11.60±0.82years) or distalization (4 boys and 11 girls; mean age=11.46±1.30years) groups. Dentoskeletal and soft-tissue treatment changes were examined objectively by cephalometric analysis and stereophotogrammetry, respectively. Pre- and posttreatment profile views were evaluated subjectively by orthodontists and laypeople using the 7-point Likert scale. Intra- and intergroup comparisons for the repeated measurements were performed with 2-way variance analysis. Bonferroni test was used for multiple comparisons (P≤0.05). Greater skeletal changes were observed in the Herbst group than in the distalization group. Maxillary incisor retrusion and mandibular incisor protrusion were observed in the distalization and Herbst groups, respectively. Stereophotogrammetric measurements showed that mandibular body length and lower and anterior facial height increased in both treatment groups. Convexity angle (P=0.020) and labiomental angle (P=0.033) were greater in the Herbst group than the distalization group. The skeletal contribution to correction of maxillomandibular discrepancy was greater in the Herbst group than the distalization group. Significant profile improvements were recorded for both groups with treatment. After both treatments, orthodontists were found to have higher rates of detection in the profiles than laypeople. The esthetic contribution of treatments to the facial profile was found similar in both groups.

Reliability of mobile application-based cephalometric analysis for chair side evaluation of orthodontic patient in clinical practice.

OBJECTIVES:The purpose of this study was to evaluate the accuracy and reliability of Mobile Application-Based Software for chair side cephalometric analysis.MATERIALS AND METHOD:Pretreatment lateral cephalograms of 20 patients (10 males and 10 females) were selected randomly and were traced manually and also using Application-based software (One Ceph). 20 angular and three linear parameters were measured both manually and with the software in all the patients. Inter and intra-operator reliability of one ceph was evaluated and the measured parameters were statistically compared with the manual method (Gold Standard).RESULT:The accuracy of angular and linear values was compared for all 23 parameters and our results showed no significant difference in the two methods used for most of the measurements. Three of the measurements [Angle of convexity (N-A; A-Pog); ANB angle; Upper Incisor to NA (Angular)] did show a statistically significant difference though these were clinically irrelevant.CONCLUSION:Application-based cephalometric analysis can be an effective clinical diagnostic tool for chair-side cephalometric evaluation of orthodontic patient.

Evaluation of the effects of maxillary expansion and protraction on facial soft tissue profile in unilateral cleft lip and palate patients using cone beam computed tomography

Aim: The aim of this study was to evaluate 3 dimensionally the influence of maxillary expansion and protraction on the facial soft tissue profile in unilateral cleft lip and palate patients with skeletal Class III malocclusion. Materials and Methods: This retrospective study included 2 groups. The first treatment group included randomly selected CBCT scans of 15 unilateral cleft lip and palate patients (8 males and 7 females, mean age 8.3±1 years) with skeletal Class III treated with Hyrax expander for rapid expansion and face mask appliance for maxillary protraction. The CBCT scans for each patient were available before starting the treatment (T1) and after a positive overjet was achieved (T2). The soft tissue profile changes in the treatment group were compared with a closely matched second control group with skeletal Class I relation (7 males and 8 females, mean age of 8.5± 1.1 years). Results: Upper lip protrusion, H angle, prominence of the nose and soft tissue facial height showed statistically significant increase in the first than the second group (P < 0.001). Lower lip protrusion, angle of facial convexity, nasolabial angle and soft tissue chin prominence showed statistically significant decrease in the first than the second group (P < 0.001). Conclusions: Unilateral cleft lip and palate patients with skeletal Class III malocclusion showed significant improvement in the facial soft tissue profile when treated with hyrax expander and face mask.

IMPACT OF MALOCCLUSION OF CLASS ІІ1 ACCORDING TO ANGLE’S CLASSIFICATION METHOD ON FACIAL ESTHETICS

The aim: There is no information on the esthetic features of the face, which are typical of the patients with late mixed occlusion with maxillodental anomalies of Angle’s class II1 depending on the types of mandible growth in domestic and foreign literature. To study the esthetic peculiarities in the face profile, which are typical of the patients aged 10-13 with maxillodental anomalies of Angle’s class II1 with different types of mandible growth. Materials and methods: 55 patients aged 10-13 with maxillodental anomalies of Angle’s class II1 were examined. Teenagers were divided into five groups depending on the type of mandible growth. 82 photostatic images in profile were analyzed. Soft tissue analysis was performed using the Viasis method. Results: Face profile was studied based on the following indicators: convexity angle of the face profile Viazis (&lt;V), profile angle by Schwarz (&lt;T), the angle of the face profile shape (&lt;gl-UL -pg), Th-me / NoV angle, nasolabial angle, labial angle (&lt;L), mentolabial angle. Conclusions: Photometric study in 55 patients aged 10-13 with maxillodental anomalies of Angle’s class I and analysis of the results depending on the types of mandible growth prove the presence of a retrogenic type of the lower third of the face, convex shape of the profile, the development of posterior bite of varying severity. All patients were reported to have changes in the indicators of the lips position and non-harmonious development of their faces. The greatest esthetic changes were reported in the group of patients with a component of horizontal type of mandible growth.

Influence of skeletal class and facial type on nose dimensions in a Brazilian subpopulation: a CBCT study

Evaluating factors that may influence the nose dimensions and, therefore, contribute to the singularity of a person, is important for obtaining a precise facial reconstruction (FR) in forensic anthropology. Thus, the aim in this study was to evaluate the influence of sex, skeletal class, and facial type on nose dimensions of Brazilian individuals using cone-beam computed tomography (CBCT) scans. CBCT images of 54 males and 67 females were classified according to skeletal class (class I, II, or III) and facial type (brachycephalic, dolichocephalic and mesocephalic). Linear and angular measurements of the nose were performed using the CS 3D Imaging software. The measurements obtained for males and females were compared by one-way ANOVA. Two-way ANOVA was used to compare the measurements in the different skeletal classes and facial types. Significance level was set at 5%. All linear measurements were greater in males (p < 0.05); the angular measurements, however, did not differ between sexes (p > 0.05). Linear and angular measurements of class III males were significantly different from the other classes; the same was observed for the angular measurements in females (p < 0.05). Regarding facial types, some linear measurements were significantly greater in dolichocephalics males (p < 0.05). For females, there was no influence of facial type (p > 0.05), except for the nasal convexity angle. Nose dimensions differed in specific points among different skeletal classes and facial types, and there was sexual dimorphism in all linear nose dimensions. This information may be applicable for nose reconstructions, allowing more reliable FR.

Photographic Analysis of Aesthetically Pleasant Facial Profile in Aryan Group of Nepalese Population

Background: Facial aesthetics has been considered as the most significant factor for individual. The aim of the study was to identify the standard linear and angular measurement of facial profile in Aryan group of Nepalese population so as to set up aesthetic treatment goal.Methods: A cross-sectional observational study was done in fifty-seven subjects (27: females and 30: males, from 17-30 years). The landmarks were marked and two most commonly used lines were taken as reference lines E-line and S-line and seven facial angles were measured: Total Facial Convexity Angle (G-Prn-Pog), Facial Convexity Angle (G-Sn-Pog), Nasofacial Angle (G-Pog-N-Prn), Nasolabial Angle (Ls-Sn-Cm), Mentolabial Angle (Pog-B-Li),Nasofrontal Angle (G-N-Nd) and Nose tip Angle (N-Prn-Cm).Data was analyzed using Statistical Package for the Social Sciences (SPSS) 21. To assess anterior-posterior relationship of upper and lower lips judged by E-line and S-line were determined using correlation co-efficient (r). Likewise, to compare the angular measurement between males and females were determined using Mann-Whitney U test. Result: The anterior-posterior position of upper lip and lower lip judged by E-line were -3.78±0.67 mm and -1.92±0.61 mm respectively whereas upper and lower lips judged by S-line were 0.18±0.58 mm and 0.06±0.44 mm respectively. Statistically significant (p&lt;0.001) strong correlation(r) was found between upper lip to E-line and S-line (0.999) and between lower lip to E-line and S-line. Out of seven angular parameters, four parameters showed gender dimorphism which means statistically significant difference (p&lt;0.001) were seen in Nasofrontal Angle.Conclusion: Either one of the reference line can be used for evaluation of facial profile at the time of diagnosis. The parameters calculated by photographic analysis serve as a comparing guide for setting up aesthetic treatment plan and can be used both before and after orthodontic treatment.

Self-perception of facial esthetics by patients with different profiles compared with assessments of orthodontists and lay people

This study evaluated the perception of facial esthetics of patients with different profiles as assessed by orthodontists, lay people, and patients. The sample comprised 120 patients (81 females, 39 males; mean age, 26.3years) selected from private practices at the onset of orthodontic treatment. The patients were divided into 3 groups of 40 according to the type of facial profile. The groups were composed of straight, concave, and convex profiles, on the basis of the facial convexity angle (G.Sn.Pog') measured on the initial cephalometric tracings. Patients analyzed only their frontal (smiling and at rest) and profile facial photographs and evaluated the pleasantness of these images on a 5-point Likert scale. A group of 30 orthodontists and 30 lay people also evaluated the patients' facial pleasantness, using the same scale. Factorialanalysis of variance (convexity and sex) was used to evaluate the differences between the convexities, and analysis of variance mixed model (type of evaluator and sex) to compare the 3 categories of evaluators, using the aligned rank transform technique. The correlation between the convexity angle and facial pleasantness was assessed by the Spearman correlation coefficient. Patients and lay people assigned higher pleasantness scores than orthodontists, with statistically significant differences for all evaluations, except for the frontal analysis of the convex group. The correlation coefficients regarding profile convexity and facial pleasantness were negative, indicating a tendency that more convex or concave facial profiles received lower pleasantness scores; however, this correlation was only significant in the evaluation of profile photographs by orthodontists. Patients with different profiles were scored with acceptable faces by lay people and patients themselves. Orthodontists' perceptions were different; they attributed lower pleasantness scores. Discrepant profiles affect facial esthetics in the profile view when judged by orthodontists.

Evaluation of the facial soft tissue changes in skeletal anterior open bite patients treated with rapid molar intruder appliance using cone beam computed tomography

Aim: The aim of this study was to evaluate the facial soft tissue changes in skeletal anterior open bite patients treated with rapid molar intruder appliance using cone beam computed tomography (CBCT). Materials and Methods: This retrospective study included 2 groups. The first treatment group included randomly selected CBCT scans of 20 skeletal open bite patients (8 males and 12 females, mean age 11.6±1.1 years) who were treated with the rapid molar intruder appliance (RMI) for molar intrusion. The CBCT scans were taken before treatment (T1) and after open bite correction (T2). The facial soft tissue changes in the treatment group were compared with a closely matched second untreated control group with normal anterior overbite (9 males and 11 females, mean age 11.9± 1.2 years). Results: The first group showed significantly greater decreases in the angle of facial convexity and the H angle than the second group. The first group showed significantly greater increases in the lower lip protrusion and the soft tissue chin prominence than the second group. The upper lip protrusion and the soft tissue facial height were decreased in the first group and increased in the second one. The difference was statistically significant. The nasolabial angle was increased in the first group and decreased in the second one. The difference was statistically significant. Conclusions: Molar intrusion using the rapid molar intruder appliance (RMI) could result in significant improvement in the facial soft tissue profile in skeletal anterior open bite patients.