Balanced Facial Profile Research Articles

Three-dimensional evaluation of facial asymmetry and its association to occlusal and muscular imbalance in young women.

Diagnosing asymmetries and restoring functional balance are challenges in facial rehabilitation and aesthetic procedures. This cross-sectional observational study aimed to evaluate whether occlusal imbalance and the electromyographic activity of the masseter and temporalis muscles in young women may be associated with facial asymmetry. Fifty women (mean age ± standard deviation: 22.5 ± 2.7), without temporomandibular dysfunction and with balanced facial profiles, were divided into two groups categorized by receiver operating characteristic analysis: symmetric (n=25) and asymmetric (n=25). The variables included the evaluation of asymmetry through clinical examination, quantification of asymmetry using stereophotogrammetry through the root mean square method, asymmetry of occlusal contacts, and electromyographic activity of the masseter and temporal muscles in both latero-lateral and antero-posterior directions. The mean asymmetry indices were compared using Welch's t-test and the Mann-Whitney test. The impact of occlusal and muscular imbalance on facial asymmetry was assessed through linear regression analysis. A significant difference was observed between the groups in the asymmetry of occlusal contacts, with a considerable effect size (p<0.01 - Cohen's d=0.73). The imbalance in the electromyographic activities of the masseter and temporal muscles was considered a predictor of facial asymmetry (F=4.00, p<0.02, R²=0.15). Occlusal imbalance and electromyographic activity of the masseter and temporal muscles are associated with facial asymmetry. Key words:Facial asymmetry, masticatory muscles, stereophotogrammetry, occlusion, electromyography.

Bimaxillary dentoalveolar protrusion associates with labially angulated mandibular canine and mesial inclined mandibular first premolars—Based on CBCT image measurements

BackgroundBimaxillary dentoalveolar protrusion is a frequent complain in orthodontic clinic. The incisor angulation and inclination have been largely discussed. The present purpose was to assess the involvement of the teeth distal to incisors. MethodsIn this cross-sectional study, 63 patients with Class I occlusion and an average sagittal relationship between the maxilla and mandible were enrolled. Twenty-two cases (20.14 ± 7.32 years old) who had protrusion profile and flaring upper and lower incisors were diagnosed as bimaxillary dentoalveolar protrusion. The other 41 cases (21.87 ± 7.15 years old) who had a balanced facial profile and mild anterior crowding were taken as controls. The buccolingual angulation and the mesiodistal inclination of the canines and premolars, which had single root, revealed on the cone-beam computed tomography (CBCT) images were measured. The values of the angulation and inclination were compared between the two groups by using Student t-test methods (α = 0.05). ResultsThe bilateral mandibular canines were more labially angulated (P＜0.001) but the bilateral mandibular first premolars were more mesial inclined in the bimaxillary dentoalveolar protrusion group than that in the control group (for tooth 34,P < 0.002; for tooth 44, P < 0.010). ConclusionsMore labial angulated mandibular canine and more mesial inclined mandibular first premolars associate with bimaxillary dentoalveolar protrusion. The labial-lingual angulation of the mandibular canines and the mesial-distal inclination of the mandibular first premolar should be paid a specially attention during the development, thus, the early intervention of the bimaxillary dentoalveolar protrusion.

Cephalometric Evaluation of Soft-tissue Profile Changes in Class-II Division 1 Patients with Varied Growth Patterns Treated with all First Premolar Extractions: A Cross-sectional Study

Introduction: Knowledge of the facial skeleton and its overlying soft-tissue is essential in determining facial harmony. Additionally, an individual’s growth pattern may influence posttreatment facial profiles and needs to be considered during treatment planning. Aim: To evaluate the soft-tissue profile changes in treated Class-II malocclusion patients with varied mandibular growth patterns and to compare these changes with patients having a skeletal Class-I relationship and a balanced facial profile. Materials and Methods: The present cross-sectional cephalometric study was conducted in the Department of Orthodontics, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India, from June 2021 to December 2022. The study included 210 lateral cephalograms of 120 patients. The cephalograms were divided into four groups based on the Frankfort horizontal Mandibular plane Angle (FMA): Group-1 (control, n=30): skeletal Class-I (FMA=22°-28°); Group-2 (n=30): skeletal Class-II with a horizontal growth pattern (FMA&lt;22°); Group-3 (n=30): skeletal Class-II with an average growth pattern (FMA=22°-28°); and group-4 (n=30): skeletal Class-II with a vertical growth pattern (FMA&gt;28°). All patients in the groups2,3, and 4 were treated with all first premolar extractions using a 0.022˝ McLaughlin, Bennett and Trevisi (MBT) appliance. The student’s t-test and post-hoc test was used to analyse skeletal, dental and soft-tissue parameters using Statistical Package for the Social Sciences (SPSS) software (version 22.00 for Windows; SPSS Inc., Chicago, USA). Results: Of the total, 120 patients, 52 were males and 68 females with an age range of 18-28 years. On intergroup analysis, significant changes (p-value&lt;0.05) in the Sella, Nasion and A point (SNA) and Sella, Nasion and B point (SNB) angles were observed in group-3. Clinically insignificant changes were found in the A point, Nasion and B point (ANB) angle across all experimental groups. However, a significant change (p-value&lt;0.001) in the post-treatment ANB angle was observed in group-2, followed by group-3 and 4 when compared with group-1. The soft-tissue profile angle showed a significant change in Group-2 when compared with Group-1 (p-value=0.012). Conclusion: The post-treatment soft-tissue profiles of the experimental groups were comparable to the balanced profile of the control group patients.

Esthetic preferences of orthodontists, dentists, and plastic surgeons for balanced facial profiles.

The aim of this investigation was to determine whether the facial esthetics of subjects rated as "attractive" can be related to specific cephalometric soft tissue parameters. The profile silhouettes of 100 subjects (45 males and 55 females) were rated by 60 esthetics specialists (20 orthodontists, 20 dentists, and 20 plastic surgeons) using a Likert scale, and 30 of the subjects were selected as being "attractive". The cephalometric measurements of the attractive group were then compared with norms for the general Caucasian population. The effects of specific measured parameters on profile beauty grades were assessed using the median test, and the following variables were found to show significant correlations between the Caucasian norms and the attractive profile group: the ratio of the upper to lower face height (P = 0.011), the ratio of the subnasale - labrale inferius (Sn-Li) and labrale inferius - menton (Li-Me`) lines (P = 0.011), the distance between the chin and the subnasale perpendicular (P = 0.002), upper lip thickness (P = 0.021), soft tissue chin thickness (P = 0.021), vertical height ratio (P = 0.021), and nasolabial angle (P = 0.021). A straight profile with a fuller and more protruded upper lip, a higher nasal tip, and a smaller lower facial third are considered to be the most attractive facial features, and may be useful for improvement of facial esthetics.

Facial profile preferences: Perception difference among Indian population

It is a prospective, in-vivo randomized cross sectional questionnaire based study to determine general esthetic preference of Indian population and to find out whether this preference was affected by sex, age, education, social status and geographic location. Toward these aims, 30 well balanced facial profiles are selected (15 males and 15 females) in the age group of 18-30 years. The most attractive facial profile of 1 male and 1 female subject is selected by three panel of Judges. Profile selected for each sex were morphed by an Adobe Photoshop version cs2 technique and then scored by 200 participants. Subjects were asked to rank the profiles in ascending order of attractiveness on scoring scale 1 to 10. Morphing is done in 2 dimensions Sagittal and Vertical. Profile digital photographs were altered by 2mm and 4mm increments to produce different combinations of mandibular sagittal positions and vertical facial heights and to assess whether interactions and magnitude of the sagittal and vertical facial dimensions influence perception of facial attractiveness. Analysis of variance (ANOVA) and independent sample t-tests were used to compare the preferences of the groups. The orthognathic profile and straight profile in both sexes was selected as the most preferred profile whereas the convex profile with a prognathic maxilla and a retrognathic mandible were the least preferred. The public also admired fuller and protrusive lips in females and retrusive lips in males. Sex, age, education, social status and geographic location were also shown to affect the public’s profile preferences. Keywords: ANOVA, facial perception morphing questionnaire study ttests.

Estimation and comparative evaluation of tip and torque values of Saudis for bracket prescription

ObjectivesThe present study aimed at determining the tip and torque values of the teeth of Saudi adults with normal occlusion to develop orthodontic bracket prescription. In addition, we proposed to compare the results with published data of varied geographical distribution. Materials and MethodsThe study sample consisted of 60 upper and lower study models of Saudi adults (30 males and 30 females) with normal occlusion and a balanced facial profile. Evaluated by experts, the torque and tip of teeth were measured using a torque angulation device. The collected data was analyzed using SPSS (IBM SPSS Inc., version 20, Chicago, IL, USA). The mean, and standard deviation were obtained for each measurement. Paired t-test, Independent t-test and student t-test were used for the comparison at a significant level of (p ≤ 0.05). ResultThe results of torque and tip of teeth for the Saudi adult population showed no significant differences between the right and the left quadrants of the analyzed study sample. In general, there was no significant observed difference between male and female samples, accordingly, the Saudi tip and torque data were combined. However, the comparisons of the combined Saudi data to the published data showed significant differences (p ≤ 0.05). ConclusionStatistically Significant differences were found between the combined Saudi data when compared to North American, Italian, African, Japanese, and Indian data. We inferred, that racial differences should be considered when presenting bracket prescriptions.

Surgery-First Approach in a Case of Mandibular Asymmetry

AbstractThis case report describes the orthodontic and surgical treatment of an adult patient aged 25 years 10 months, who had a skeletal Class I and Angle Class III subdivision malocclusion, with mild mandibular crowding and facial asymmetry. The chief complaint was a deviated chin to the left. Treatment was performed using a surgery- first approach that included maxillo-mandibular advancement, followed by orthodontic fixed appliances. After 12 months, the treatment has addressed the chief complaint of facial asymmetry and resulted in an attractive smile, functional occlusion, passive lip seal, balanced facial profile, and esthetic improvement. After 2 years 5 months of follow-up, the patient showed a stable surgical-orthodontic outcome with increased airway space.

Treatment of a Class I Malocclusion with Severe Crowding using Passive Self-Ligating Brackets Passive Self-Ligating Brackets

Presently, dental crowding is the most common problem among orthodontic patients. The prevalence of crowding in the dental arch is significantly increased in modern dentitions, and it is the most common reason why patients pursue orthodontic treatment. Objective: To report an advanced bracket systems, namely self-ligating brackets, to increase the efficacy of orthodontic treatment especially in patients with severe crowding. Case Report: A 22-year-old female patient presented with severe crowding of the maxillary and mandibular arches. In the upper arch, both second premolars were palatally positioned; in the lower arch, the lower right canine was lingually positioned and the lower left second premolar was extracted. The patient had a balanced facial profile with a straight profile and skeletal Class I relationship. Treatment was initiated using passive self-ligating brackets followed by extraction of the upper second premolars and the lower right first premolar. Conclusion: The use of passive selfligating brackets proved to be effective and resulted in a significant improvement in the patient’s dental and smile esthetics. The active treatment time was 11 months; this resulted in successfully alleviating the crowding of the maxillary and mandibular arches and significant improvement in the occlusal relationship.

Computer-Aided Planning in Orthognathic Surgery: A Comparative Study with the Establishment of Burstone Analysis-Derived 3D Norms.

Three-dimensional (3D) computer-aided simulation has revolutionized orthognathic surgery treatment, but scarce 3D cephalometric norms have been defined to date. The purposes of this study were to (1) establish a normative database of 3D Burstone cephalometric measurements for adult male and female Chinese in Taiwan, (2) compare this 3D norm dataset with the two-dimensional (2D) Burstone norms from Caucasian and Singaporean Chinese populations, and (3) apply these 3D norms to assess the outcome of a computer-aided simulation of orthognathic surgery. Three-dimensional Burstone cephalometric analysis was performed on 3D digital craniofacial image models generated from cone-beam computed tomography datasets of 60 adult Taiwanese Chinese individuals with normal occlusion and balanced facial profile. Three-dimensional Burstone analysis was performed on 3D image datasets from patients with skeletal Class III pattern (n = 30) with prior computer-aided simulation. Three-dimensional Burstone cephalometric measurements showed that Taiwanese Chinese males had significantly (p < 0.05) larger anterior and posterior facial heights, maxillary length, and mandibular ramus height than females, with no significant (p > 0.05) difference for facial soft-tissue parameters. The 3D norm dataset revealed Taiwanese Chinese-specific facial characteristics, with Taiwanese presenting (p < 0.05) a more convex profile, protrusive maxillary apical bases, protruding mandible, protruding upper and lower lips, and a shorter maxillary length and lower facial height than Caucasians. Taiwanese had significantly (p < 0.05) larger maxillary projection, vertical height ratio, lower face throat angle, nasolabial angle, and upper lip protrusion than Singaporean Chinese. No significant (p > 0.05) difference was observed between 3D norms and computer-aided simulation-derived 3D patient images for horizontal skeletal, vertical skeletal, and dental measurements, with the exception of two dental parameters (p < 0.05). This study contributes to literature by providing gender- and ethnic-specific 3D Burstone cephalometric norms, which can assist in the multidisciplinary-based delivery of orthodontic surgical care for Taiwanese Chinese individuals worldwide, including orthodontic management, computer-assisted simulation, and outcome assessment.

Dorsal Augmentation in Facial Profiloplasty.

Nasal profile line has central importance in forming an aesthetically balanced facial profile. Thus, rhinoplasty is a critically necessary surgery in shaping ideal profile line. For successful rhinoplasty, meticulous preoperative evaluation and proper planning should be performed before surgery. The nasal dorsum is the broadest and most prominent part of the nose; any minor imperfection is readily appreciated by an observer. Thus, dorsal augmentation is one of the most challenging areas in rhinoplasty as there is virtually no single ideal graft material and method for the nasal dorsum, which is free of aesthetic complication The surgeon should be able to discern the pattern of the abnormal nasal profile and to strategize the best possible surgical option to create a long-lasting, aesthetically pleasing dorsal line in good harmony with the overall facial profile. This study addresses our strategy to deal with various types of aesthetically unpleasant nasal profile line. The characteristics of augmentation materials and considerations in surgical technique are also addressed.

Evaluation of conformity of preformed orthodontic archwires and dental arch form.

ABSTRACTIntroduction: The alterations in the arch form during treatment are dictated by the dimensions of the archwires. Objective: This study aimed to determine the mean arch dimensions of a sample of Pakistani subjects and to evaluate the conformity of preformed archwires with mandibular arch form. Methods: The dental records of 1,500 adult subjects were evaluated. The mandibular casts of 42 subjects (males = females = 21) with balanced facial profile, Class I occlusion, ideal overjet and overbite were included. Brackets were bonded on all teeth. Arch dimensions were evaluated at canines, first premolars, second premolars, first and second molars, with digital vernier calipers. The arch widths at the level of aforementioned teeth were evaluated on the digitized archwires, using the mean arch depths of the subjects.Results: In males, the archwires were found to be wider at canines and premolars, and significantly narrower at first (p< 0.001, 95% CI = 2.03 - 5.74) and second molars (p< 0.001, 95% CI = 2.29 - 7.73) as compared to the arch dimensions of the mandibular casts. In females, the archwires were significantly narrower at canines (p< 0.001, 95% CI = 1.4 - 3.97), and first (p= 0.02, 95% CI = 0.402 - 4.41) and second molars (p< 0.001, 95% CI = 1.76 - 6.13).Conclusion: No single commercially available archwires evaluated in the present study conformed to the arch dimensions of our subjects. Utilization of the currently available archwires may result in unwarranted modification of arch form, which may lead to unstable post-treatment teeth position.

Revision malarplasty guided by strategic categorization

Esthetic reduction malarplasty is popular in East Asia, where a small and balanced facial profile is considered a desirable characteristic. Various surgical techniques have been applied; however, several complications can impact the bony structure and final esthetic appearance. We examined the outcomes of revision malarplasty with regard to strategic assessments to achieve facial balance and skeletal stability. This retrospective study reviewed 97 patients who underwent revision malarplasty between December 2014 and November 2016. We analyzed the indications of revision and categorized the patients into three surgical groups. Dual bone flap procedures utilizing new osteotomies were performed to achieve a natural malar contour in certain cases. In addition, zygomatic arches were fixed in a lifted position to revise both bony dehiscence and soft tissue drooping. Postoperative results were assessed using medical records, photographs, and facial bone computerized tomography images. The major reason for revision malarplasty was undercorrection that required additional repositioning. The zygomatic body and arch with a bony gap (5-7mm) necessitated additional osteotomy and repositioning to achieve zygomatic continuity and natural curvature. Significant bony defects and segmental resorption were addressed with reconstructive bone grafts. The causes of complications after malarplasty should be cautiously evaluated before revision procedures. We categorized patients on the basis of strategic analysis considering reposition vector and the necessity of additional osteotomy. Unstable zygomatic segments were revised to obtain structural stability, and the zygomatic arch lifting technique using an intraoral approach can be used to achieve promising and predictable outcomes in revision malarplasty.

Analysis of facial pattern among 12–16-year-old students in Lagos, Nigeria

Background: Facial patterns or biotypes have been known to influence the treatment plan of orthodontic patients and analyze the facial patterns described by Ricketts. Determining the facial type is extremely important for orthodontic diagnosis and planning since the muscular and skeletal configuration of each facial type responds differently to the orthodontic treatment. Materials and Methods: A sample of 100 individuals was recruited by multistage sampling from three schools in Ikeja local government, Lagos State. Those aged between 12 and 16 years who met the inclusion criteria were enrolled in the study after obtaining informed consent and assent from the parents and participants. Lateral cephalometric radiographs were taken for all participants, and the final sample after analysis of the radiographs was 84. The error of the cephalometric method was assessed using the intraclass correlation coefficient. Facial axis angle (Ptm-Gn/Ba-N) was used to classify the facial pattern into brachyfacial ( 93°) Results: Out of the 84 participants, 60 (71.4%) had mesofacial facial pattern which consisted of 27 (32.1%) males and 33 (39.3%) females. 10 (11.9%) had brachyfacial pattern out of which 9 (10.7%) were male and 1 (1.2%) was a female. This difference between the males and females in the brachyfacial pattern was statistically significant with a P value of 0.014 (P ≤ 0.05). 14 (16.67%) participants had dolichofacial pattern with 5 (6.0%) males and 9 (10.7%) females. Conclusion: The mesofacial pattern had the highest frequency among the facial pattern types studied in this Nigerian population and was found to be more predominant among females. The brachyfacial pattern was seen more frequently in males while the dolichofacial pattern was more prevalent among females. The facial pattern assessment should guide the orthodontist in the use of appropriate mechanics to achieve an overall balanced occlusion and facial profile following orthodontic treatment.

The facial profile in brazilian adults

AIM: To investigate if there is agreement between measurement values obtained for Brazilian adults and the values recommended by Holdaway, Merrifield, Burstone, Steiner and Ricketts, for facial profile soft tissue analysis. METHODS: A sample of 30 cephalometric radiographs was used, consisting of 15 women and 15 men, aged 18 to 31 years, all exhibiting excellent occlusion and balanced facial profile. Comparisons were made with the measurement values proposed by the aforementioned authors using Student’s t-test and to determine the correlation between the ANB and Â-H measurement values described by Holdaway, using Pearson's correlation coefficient. RESULTS: Among the measures evaluated, 4 showed statistically significant differences: Â.Z (Merrifield), S-LS and S-LI (Steiner), and E-LI (Ricketts) relative to the standards recommended by the authors. The measurement values advocated by Merrifield, Steiner and Ricketts showed statistical differences, and as for the Z-angle, Brazilians feature a slightly more convex profile, which appeared slightly concave according to Steiner, and according to the E-Plane (Ricketts), it meant an increased protrusion of the lower lip. CONCLUSION: It could be asserted that adult Brazilians have a slightly more convex facial profile than US standards, but these differences should be viewed with caution, as they are clinically unimportant.

Treatment duration and gingival inflammation in Angle’s Class I malocclusion patients treated with the conventional straight-wire method and the Damon technique: a single-centre, randomised clinical trial

To compare the duration of orthodontic treatment and Gingival Index (GI) scores in Class I malocclusion patients treated with a conventional straight-wire method (CG) or the Damon technique (DT). Two-arm, parallel, randomised clinical trial Setting: A postgraduate orthodontic clinic Participants: Patients with a balanced facial profile, a full permanent dentition and Angle's Class I malocclusion with moderate crowding. The primary outcome was the duration of orthodontic treatment in months. GI scores throughout treatment were secondary outcomes and the PAR index was also assessed. Randomisation was accomplished using a table of random numbers and the allocation was concealed in sequentially numbered and opened, opaque, sealed envelopes. Blinding was applicable for PAR assessment only. Comparison of data between groups was performed with appropriate tests for independent samples. Twenty-two patients were randomly allocated to treatment in a 1:1 ratio to either CG or DT group. Age at the start of treatment, initial PAR index and GI scores were similar between groups. All patients completed the study, but the total duration of orthodontic treatment was almost half of the initial assumption. No statistically significant differences were observed in treatment duration (CG: Mean ([Formula: see text]) = 14.5 months, Standard Deviation (SD) = ±3.03; DT: [Formula: see text] months, SD = ±2.93; 95% Confidence Interval: -0.40 to 4.90; P = 0.093; t-test). The two groups did not differ statistically regarding the GI scores during the observational period. No serious harms were observed other than gingival inflammation associated with oral biofilm accumulation. The present study did not reveal statistically significant differences between the compared, conventional straight-wire method and Damon technique-treated, Angle's Class I malocclusion groups regarding total treatment duration and GI scores.

Cephalometric analysis for functional occlusion

BackgroundVarious elements contributing to good functional occlusion have not been clearly assessed with cephalometrics for the diagnosis of functional problems and their application in clinical practice. The aim of this study, therefore, was to analyze different components of functional occlusion to formulate concise functional cephalometric analysis.Materials and MethodsEighty-two cases (38 males and 44 females), with class I occlusion and balanced facial profile, were examined based on the selection criteria, and cephalograms were taken in natural head position. All the radiographs were then analyzed using various functional parameters.ResultsThe mean values of condylar path angle and incisal path angle were 55.83° and 65.67°, respectively, with large deviations. However, both showed positive correlation. The value of the angle of long axis of mandibular incisor with respect to the line joining center of condyle and lower incisor tip was 88.04°. Moreover, the angle between the occlusal plane and horizontal plane was 12.88°. In vertical plane, lower face height (LFH) was found to be slightly less than the upper face height. Maxilla contributed around 45% of the LFH while mandible formed about 60%. Furthermore, upper alveolar component (maxillary alveolar height) formed more than half of the maxilla (53.79%) whereas lower alveolar component (mandibular alveolar height) was 74.8% of the mandible.ConclusionThis study has analyzed various components of functional occlusion and formulated a concise functional cephalometric analysis for diagnosis, treatment planning, and assessment of treatment results.

Cephalometric Hard and Soft Tissue Norms for Sudanese Adults

Introduction: Cephalometric norms of various populations show differences between diverse ethnic and racial groups. Thus, numbers of cephalometric norms have been established for different ethnic groups.Objective: To assess skeletal, dental and soft tissue features in a sample of well-balanced face of Sudanese university students.Materials &amp; method: Lateral cephalographs were taken from 18-25 years old 35 male and 38 female Sudanese university students with balanced facial profile and Class I occlusion with no previous orthodontic treatment. Fourteen angular and five linear measurements, and facial index were recorded according to Husund analysis. Male and female mean values were compared statistically using Student t-test.Result: Statistically significant differences were noted between both genders especially in skeletal variables SNA˚, SNB˚, SNPg˚, ML- NSL˚, NL-NSL˚, UFH, LFH and dental variable I -Ī. Holdaway angle showed no significant difference between the genders. Skeletally, maxilla and mandible of the Sudanese sample were more prognathic compared to Caucasians and Arabs but less prognathic than the Africans. Dentally, maxillary and mandibular incisors were more proclined compared to Arabs and Caucasians. Soft tissue analysis showed more lip protrusion in Sudanese adults.Conclusion: The study offered normative cephalometric standards for Sudanese adults, which were specific for each gender group. The normative values showed that the Sudanese sample lied between African and Arab values which might suggest that the studied sample had an Afro-Arabian mixture.

Facial profile esthetic preferences: perception in two Brazilian states

OBJECTIVE: The aim of this study was to assess the regional influence on the perception of facial profile esthetics in Rio de Janeiro state (RJ) and Rio Grande do Sul state (RS), Brazil. METHODS: Two Caucasian models, a man and a woman, with balanced facial profiles, had their photographs digitally manipulated so as to produce seven different profiles. First year dental students (laypeople) assessed the images and classified them according to their esthetic preference. RESULTS: The result of the t test for independent samples showed differences among states for certain facial profiles. The female photograph identified with the letter 'G' (mandibular retrusion) received higher scores in RS state (p = 0.006). No differences were found for male photographs (p > 0.007). The evaluators' sex seemed not to influence their esthetic perception (p > 0.007). Considering all evaluators together, ANOVA/Tukey's test showed differences among the profiles (p ≤ 0.05) for both male and female photographs. The female photograph that received the highest score was the one identified with the letter 'F' (dentoalveolar bimaxillary retrusion/ straight profile). For the male profiles, photograph identified with the letter 'E' (dentoalveolar bimaxillary protrusion/ straight profile) received the best score. CONCLUSION: Regional differences were observed regarding preferences of facial profile esthetics. In Rio de Janeiro state, more prominent lips were preferred while in Rio Grande do Sul state, profiles with straight lips were favored. Class III profiles were considered less attractive.

Two-dimensional to three-dimensional: A new three-dimensional cone-beam computed tomography cephalometric analysis

Objectives of the Study: were (1) to develop a three-dimensional cephalometric analysis scheme applicable to assessing dentofacial deformities; and (2) to create a normative database of three-dimensional cephalometric measurements for adult North Karnataka population. Materials and Methods: A cross-sectional study was conducted on 40 male and 40 female adults with normal balanced facial profile and occlusion. Cone-beam computed tomography (CBCT) images obtained in digital imaging and communications in medicine format and the anatomic Cartesian three-dimensional cephalometric reference system according to Swennen et al. was used to standardize the reference planes. Cephalometric analysis was performed using various landmarks. New three-dimensional cephalometric analyses appropriate for orthognathic surgery as well as new parameters were used in this study. Results: The cephalometric norms generated in this study were comparable with those reported in the literature for conventional two-dimensional cephalometric analysis and unique features of North Karnataka population. The results showed significant differences between males and females in most of the facial measurements (P < 0.0001). Conclusion: This is the first database of three-dimensional cephalometric norms based on CBCT of the North Karnataka population. Norms generated were comparable with those reported in the literature with the conventional two-dimensional cephalometry: More accurate and reliable. Moreover, three-dimensional cephalometric analysis has the potential of incorporating new measurement methods that are difficult if not impossible in two-dimensional cepholmetric analysis. This method of cephalometric analyses can be useful in diagnosis and treatment planning for patients with dentofacial deformities.

Orthodontic camouflage via total arch movement in a Class II with idiopathic condylar resorption

Idiopathic condylar resorption (ICR), also known as idiopathic condylysis or condylar atrophy, is multifactorial pathology leading to severe mandibular retrognathism. The etiology has been shown to be multifactorial, such as avascular necrosis, traumatic injuries, hormone and autoimmune disease and it is largely difficult to distinguish the exact cause in each individual. In spite of the remarkable morphological alteration, surgical intervention is not readily recruited due to the possibility of recurrence of resorption. In order to restore balanced facial profile and occlusion. In this report, we present a camouflage treatment for skeletal Class II with ICR and facial asymmetry involving total arch movement, for the improvement facial profile and reconstruction of occlusion.