Cephalometric Measurements Research Articles

Lateral cephalometric characteristics in individuals with Down Syndrome compared to non-syndromic controls: A meta-analysis

ObjectivesThe aim of the present meta-analysis was to provide a complete synthesis of all studies involving lateral cephalometric measurements in populations with Down Syndrome (DS). MethodsA literature search was carried out using six electronic databases to identify studies comparing cephalometric characteristics between populations with DS and control (healthy) populations. Studies were selected according to the research objectives, and predefined inclusion and exclusion criteria. Only the cephalometric measurements included in three or more studies selected were analyzed. The random-effects meta-analysis model was used for data analysis, and all analyses were carried out using RevMan5 software. ResultsFrom an initial 871 articles identified through the literature search, ten cross-sectional studies were finally selected based on the inclusion and exclusion criteria. Ten cephalometric measurements underwent meta-analysis, five linear and five angular measurements. Concerning the five linear measurements, namely S-N, ANS-PNS, Go-Gn, Ar-Go, and N-ANS, all were significantly smaller in the DS group with the exception of Go-Gn. Of the five angular measurements, only three were statistically different between the DS and control groups. SNB and ANB angles were smaller in individuals with DS, whereas the basilar angle was larger. Subgroup analysis was also carried out based on age, and it was found that the gonial angle was significantly smaller before puberty, in individuals with DS. No differences between groups were found for the SNA angle. ConclusionThere are significant cephalometric differences between individuals with and without DS. Individuals with DS have a shorter anterior cranial base, maxillary length, upper anterior facial height and mandibular height. The ANB and SNB angles were also smaller in those with DS, but the SNA angle showed no differences. These findings may indicate that the Class III malocclusion commonly found in individuals with DS does not seem to be due to mandibular prognathism. Clinical relevanceLateral cephalometric measurements in individuals with DS show significant differences from individuals without DS. Practitioners need to be aware of this and monitor growth from an early age in these children.

Comparison of Steiner Cephalometric analysis of lateral skull X-ray images with CBCT in a group of students of the dental school of the University of Cuenca

The Steiner analysis from images obtained from cone beam computed tomography is one of the essential tools today for diagnosis in the area of orthodontics, within this aspect its high value for the study of points, angles and cephalometric planes allows the prediction of the possible treatment plan for each patient according to the specific characteristics resulting in each patient. Objective: To compare the results in Steiner cephalometric measurements obtained in 2D lateral skull radiographs and in 3D cephalograms generated from Cone Beam Computed Tomography (CBCT). Methodology: Type of comparative analytical study. A non-probabilistic sample was established by convenience consisting of 29 diagnostic studies divided into: 29 lateral skull X-rays and 29 standardized CBCT. Subsequent localization, tracing and measurement of skeletal and dental angles were performed according to Steiner's cephalometric analysis using Nemostudio 2022 software. The study and analysis was performed using the Intraclass Correlation Coefficient. Results: The mean difference between the skeletal angles SNA, SNB, ANB, SND and Occlusal Plane Angle showed that there is no significant discrepancy when performing a cephalometric analysis in three-dimensional images compared to two-dimensional images. Conclusion: There is a high degree of reliability and accuracy of cephalometric measurements for obtaining skeletal and dental angles in two-dimensional images obtained from a CBCT with respect to a lateral radiograph.

Comparison of angular cephalometric measurements between CBCT mid-sagittal plane projections and conventional lateral cephalometric radiographs

The purpose of this study was to verify the angular measurement values of conventional Lateral Cephalometric Radiographs (LCRs) and Cone-Beam Computed Tomography (CBCT) Mid- Sagittal Plane (MSP) projections when using the same cephalometric analysis method.

Analysis of Cephalometric Points in Male and Female Mandibles: An Application to Gender-Affirming Facial Surgery.

Gender-affirming facial surgery is a common intervention for transgender patients because of its ability to decrease the frequency of misgendering. Many anatomic targets can be addressed, but the mandible is the primary aspect of the lower third of the face that is manipulated during these procedures. This study's objective is to quantify the differences in cephalometric measurements between male and female mandibles on maxillofacial imaging, with the goal of identifying surgical targets for gender affirmation. A nonrandomized, retrospective, single-institution, case-control study of 387 patients who underwent maxillofacial computed tomography during 2017-2020 was performed. After excluding patients with imaging that did not capture the entire head or had deforming pathology of the face, a total of 113 patients were included. Cephalometric measurements that corresponded to areas reported by patients as sources of dysphoria were selected for analysis. These included mandibular width, ramus height, lateral flare, masseter volume, total face height, and the values of the mandibular angles in degrees. The relationship of masseter volume to the other measurements was also characterized. Significantly greater masseter volume was seen in males compared with females, and a greater masseter thickness was also seen in males. The mandibular angle was more acute in males than females. Aggregate analysis of muscle volume and thickness was positively correlated with ramus height, lateral flare, and mandibular width. Ramus, mental, and total facial height correlated directly with patient height in males but not in females. These data provide a normative baseline for planning lower facial gender-affirming surgery.

Evaluation of the accuracy of fully automatic cephalometric analysis software with artificial intelligence algorithm.

The aim of this study is to evaluate whether fully automatic cephalometric analysis software with artificial intelligence algorithms is as accurate as non-automated cephalometric analysis software for clinical diagnosis and research. This is a retrospective archive study using lateral cephalometric radiographs taken from individuals aged 12-20 years. Cephalometric measurement data were obtained from these lateral cephalometric radiographs by manual landmark marking with non-automated computer software (Dolphin 11.8). Again, the same radiographs were made using fully automatic digital cephalometric analysis software OrthoDx™ (AI-Powered Orthodontic Imaging System, Phimentum) and WebCeph (Assemblecircle, Seoul, Korea) with artificial intelligence algorithm, without manual intervention of the researcher and fully automatic markings and measurements were made by the software. According to the consistency test, a statistically significant good level of consistency was found between Dolphin and OrthoDx™ measurements and Dolphin and WebCeph measurements in angular measurements (ICC > 0.75, P < .01, ICC > 0.75, P < 0, respectively. 01). A weak level of consistency was found in linear measurement and soft tissue parameters in both software (ICC < 0.50, P < .05, ICC < 0.50, P < .05), and the difference between measurements was statistically found to be different from "0." The results obtained from fully automatic cephalometric analysis software with artificial intelligence algorithms are similar to the results of non-automated cephalometric analysis software, although there are differences in some parameters. To minimize the margin of error in artificial intelligence-based fully automatic cephalometric software, the manual intervention of the observer is needed.

Effect of rapid maxillary expander with posterior bite blocks in hyperdivergent patients with adenoid hypertrophy- A cephalometric study

To analyze the effect of Rapid Maxillary Expansion (RME) with posterior bite blocks on craniofacial structures in hyperdivergent patients with adenoid hypertrophy and to compare them with control group. 32 patients of adenoid hypertrophy (mean age 11.6 yrs, range 8-12 years) with a transverse discrepancy were selected and divided into two groups in a random way - Group A: (n=16) hyrax RME with posterior bite block group, Group B: (n=16) control group. Group A- Lateral and Posteroanterior cephalograms were recorded pretreatment (T0), postexpansion (T1), and after 9 months retention (T2). Group B- Lateral and Posteroanterior cephalograms were recorded pretreatment (T0), and after 9 months (T2) concurrent with Group A. Cephalometric measurements in sagittal, vertical and transverse dimensions were taken and comparison was made using Paired and Unpaired t-test with p &amp;#60; 0.05 as statistically significant. Group A underwent insignificant increase in SN-MP angle whereas it increased significantly in Group B. The lower facial height and jarabak’s ratio decreased significantly. All transverse parameters increased significantly with maximum increase in intermolar width when compared with Group B. Significant increase in the transverse dimensions of mid face occurs with RME thus increasing the upper airway patency and effective control of the vertical growth pattern, typical of adenoid hypertrophy, was seen in the treatment group when compared with the control group.

Craniofacial Morphology of Temporomandibular Disorder Patients with Different Disc Positions: Stratifying Features Based on Sex and Sagittal Skeletal Pattern.

Disc displacement (DD) appears in the majority of temporomandibular disorder (TMD) patients. The correlation between craniofacial morphology and different disc positions has been underlined, while the craniofacial morphological differences based on sex and sagittal skeletal pattern stratification have been insufficiently studied. In this study, 304 patients with TMD complaints were included and classified into normal position, disc displacement with reduction (DDwR) and disc displacement without reduction (DDwoR) groups according to magnetic resonance imaging. A total of 24 cephalometric measurements, covering the cranial base, vertical relationship, sagittal relationship, mandible position and morphology, and dental relationship, were assessed using lateral cephalograms. A stratified analysis was performed based on the sex and sagittal skeletal pattern. Overall, DD patients had distinctive craniofacial morphological features. The posterior cranial base length and mandibular arc angle were statistically different only in females, while the Y-axis angle, occlusal plane angle and sella nasion point A angle (SNA) might be unique features in males. Skeletal class II had the most statistically different measurements compared to the others. Differences in the Frankfort mandibular incisor angle (FMIA) and saddle angle were especially displayed in skeletal class III patients. The sex and skeletal sagittal pattern could affect the morphological differences in TMD patients with different disc positions.

Effect of head rotation on two-dimensional cephalometric measurements using cone beam-computed tomography.

The purpose of this study was to identify the variation of bi-dimensional cephalometric measurements following real head rotation. Thirty cone beam-computed tomography (CBCT) head films were oriented according to three axes: horizontal Frankfort plane, transverse bi-orbital plane, and Opisthion-Nasion median plane. Axial rotation of 2°, 4°, 6°, and 8° from the Odontoïdale point were performed. Horizontal and vertical linear and angular measurements were studied on lateral cephalograms derived from each rotation T0, T2, T4, T6, and T8. A paired t-test was applied to compare the measurements between T0 and each rotational angle. Of the 18 measurements, 55% showed statistically significant differences (P < 0.05) and 22% showed clinically significant differences, mostly at T6 and T8. Horizontal linear measurements Ba-A and N-Ba decreased, and vertical linear measurement G-Sn increased gradually, as the angle of head rotation increased. Angular measurements studied did not vary. Head malpositions during X-ray acquisition should be avoided and rotated lateral CBCT cephalograms should be corrected and recentered to prevent any variation in linear measurements.

Reliability of Artificial Intelligence-Assisted Cephalometric Analysis. A Pilot Study

Recently, Artificial Intelligence (AI) has spread in orthodontics, in particular within cephalometric analysis, where computerized digital software is able to provide linear-angular measurements upon manual landmark identification. A step forward is constituted by fully automated AI-assisted cephalometric analysis, where the landmarks are automatically detected by software. The aim of the study was to compare the reliability of a fully automated AI-assisted cephalometric analysis with the one obtained by a computerized digital software upon manual landmark identification. Fully automated AI-assisted cephalometric analysis of 13 lateral cephalograms were retrospectively compared to the cephalometric analysis performed twice by a blinded operator with a computerized software. Intra- and inter-operator (fully automated AI-assisted vs. computerized software with manual landmark identification) reliability in cephalometric parameters (maxillary convexity, facial conicity, facial axis angle, posterior and lower facial height) was tested with the Dahlberg equation and Bland–Altman plot. The results revealed no significant difference in intra- and inter-operator measurements. Although not significant, higher errors were observed within intra-operator measurements of posterior facial height and inter-operator measurements of facial axis angle. In conclusion, despite the small sample, the cephalometric measurements of a fully automated AI-assisted cephalometric software were reliable and accurate. Nevertheless, digital technological advances cannot substitute the critical role of the orthodontist toward a correct diagnosis.

Artificial Intelligence Splint in Orthognathic Surgery for Skeletal Class III Malocclusion: Design and Application.

Digital splints are indispensable in orthognathic surgery. However, the present design process of splints is time-consuming and has low reproducibility. To solve these problems, an algorithm for artificial intelligent splints has been developed in this study, making the automatic design of splints accessible. Firstly, the algorithm and program of the artificial intelligence splint were created. Then a total of 54 patients with skeletal class III malocclusion were included in this study from 2018 to 2020. Pre and postoperative radiographic examinations were performed. The cephalometric measurements were recorded and the difference between virtual simulation and postoperative images was measured. The time cost and differences between artificial intelligent splints and digital splints were analyzed through both model surgery and radiographic images. The results showed that the efficiency of designing splints is significantly improved. And the mean difference between artificial intelligent splints and digital splints was <0.15mm in model surgery. Meanwhile, there was no significant difference between the artificial intelligent splints and digital splints in radiological image analysis. In conclusion, compared with digital splints, artificial intelligent splints could save time for preoperative design while ensuring accuracy. The authors believed that it is conducive to the presurgical design of orthognathic surgery.

Prospective Evaluation of Children with Robin Sequence following Tübingen Palatal Plate Therapy.

To assess the long-term functional orthodontic outcome of the Tübingen palatal plate (TPP) in children with Robin sequence (RS) in comparison to age- and sex-matched healthy controls. Between 09/2019 and 10/2020, we performed orthodontic assessments in 41 children at our Department of Orthodontics. Included were patients with RS (17 non-syndromic; four syndromic) and healthy controls (n = 22, average age in both groups 9.9 y). Facial analyses of 2D images, digital study casts and cephalometric measurements were made. The orthodontic examinations showed no statistically significant group differences regarding functional extraoral, intraoral and pharyngeal parameters, or in skeletal patterns. The relationship between the upper and lower incisors was significantly increased (overjet 4 (2-10) vs. 3 (0-9) mm; p = 0.01) with a significant deficit in the lower face proportions (Jaw Index 4.15 (1.9-9.6) vs. 2.98 (0-9); p = 0.02; Facial convexity angle 157 (149-173) vs. 159 (149-170); p = 0.01). Children with RS treated with the TPP showed normal long-term functional orthodontic outcomes, thanks to the functional adaption of the stomatognathic system. However, soft tissue growth did not completely match skeletal growth, resulting in a more convex facial profile.

Determination of the Sex in the Population of Salem District Using Various Cephalometric Measurements - A Cross Sectional Study

Determination of the Sex in the Population of Salem District Using Various Cephalometric Measurements - A Cross Sectional Study

Reconstruction of the mandible from partial inputs for virtual surgery planning.

Statistical Shape Models (SSMs) and Sparse Prediction Models (SPMs) based on regressions between cephalometric measurements were compared against standard practice in virtual surgery planning for reconstruction of mandibular defects. Emphasis was placed on the ability of the models to reproduce clinically relevant metrics. CT scans of 50 men and 50 women were collected and split into training and testing datasets according to an 80:20 ratio. The scans were segmented, and anatomical landmarks were identified. SPMs were constructed based on direct regressions between measurements derived from the anatomical landmarks. SSMs were developed by establishing correspondence between the segmented meshes, performing alignment, and principal component analysis. Anterior and bilateral defects were simulated by removing sections of the mandibles in the testing set. Measurement errors after reconstruction ranged from 1.07˚ to 2.2˚ and 0.66mm to 2.02mm for mirroring, from 0.45˚ to 3.67˚ and 0.66mm to 2.54mm for the SSMs, and from 1.74˚ to 5.01˚ and 0.64mm to 2.89mm for the SPMs. Surface-to-surface errors ranged from 1.01mm to 1.29mm and 1.06mm to 1.33mm for mirroring and SSMs, respectively. Based on the results, SSMs are recommended for VSP in the absence of normal patient anatomy.

Comparison between clear aligners and twin-block in treating class II malocclusion in children: a retrospective study.

The study herein evaluated and compared the efficacy of Clear Aligners (CA) and Twin-Block (TB) appliances as the early orthodontic treatments of developing class II division 1 malocclusion. Twenty-four patients each for CA (11.73 ± 0.33 y) and TB (11.87 ± 0.34 y) groups were selected according to the inclusion and exclusion criteria. The cephalometric X-rays and intraoral photos were taken for the patients after nearly 12 months of treatment. Treatment impacts were evaluated by the molar correction and overjet reduction. The vertical and sagittal changes were analyzed through cephalometric measurements. Sella-nasion-point B angle (SNB), point A-nasion-point B angle (ANB), Wits Appraisal (AO-BO) and overjet were statistically significant regarding the sagittal changes analyzed before and after the treatments in both groups, respectively. So, no significant difference was noted in the sagittal changes between CA and TB groups. However, for the vertical changes, OP (occlusal plane) angle of CA group and OP angle, AFH (anterior facial height) and PFH (posterior facial height) of TB group were statistically significant. Moreover, the Z angle and cranial facial difficulty (C.F. difficulty) were also statistically significant in both groups. Class II children with retrognathic mandible are effectively treated by employing the CA, which has almost the same impact as of TB in sagittal and vertical changes. Resultantly, the patient profile is improved. The CA and TB treatments thus minimize the subsequent treatment difficulty by reducing the C.F. difficulty.

Reproducibility of linear and angular cephalometric measurements obtained by an artificial-intelligence assisted software (WebCeph) in comparison with digital software (AutoCEPH) and manual tracing method.

It has been suggested that human errors during manual tracing of linear/angular cephalometric parameters can be eliminated by using computer-aided analysis. The landmarks, however, are located manually and the computer system completes the analysis. With the advent of Artificial Intelligence in the field of Dentistry, automatic location of the landmarks has become a promising tool in digital Orthodontics. Fifty pretreatment lateral cephalograms obtained from the Orthodontic department of SRM dental college (India) were used. Analysis were done by the same investigator using the following methods: WebCeph™, AutoCEPH© for Windows or manual tracing. Landmark identification was carried out automatically by Artificial Intelligence in WebCeph™ and with a mouse driven cursor in AutoCEPH©, and manually using acetate sheet and 0.3-mm pencil, ruler and a protractor. The mean differences of the cephalometric parameters obtained between the three methods were calculated using ANOVA with statistical significance set at p<0.05. Intraclass correlation coefficient (ICC) was used to determine both reproducibility and agreement between linear and angular measurements obtained from the three methods and intrarater reliability of repeated measurements. ICC value of >0.75 indicated good agreement. Intraclass correlation coefficient between the three groups was >0.830, showing good level of agreement, and the value within each group was >0.950, indicating high intrarater reliability. Artificial Intelligence assisted software showed good agreement with AutoCEPH© and manual tracing for all the cephalometric measurements.

Craniofacial morphology in Obstructive Sleep Apnea patients.

To evaluate the correlation between cephalometric skeletal parameters and Obstructive Sleep Apnea syndrome (OSAs) severity, in adult patients with OSAs. One hundred patients (94 males,6 females mean age 59,3) with diagnosis of OSAs were retrospectively enrolled. Each patient received Home Sleep Apnea Testing (HSAT) and latero-lateral radiograph. Eight cephalometric parameters (cranial deflection angle, saddle angle, articular angle, divergence angle, cranial base angle, skull base length, mandibular length, maxilla length) were analyzed and then related to Apnea/Hypopnea Index (AHI) and to the Oxygen Desaturation Index (ODI), recorded by HSAT. A Spearman's rho correlation test between cephalometric measurements and HSAT indices was performed. Statistical significance was set at p< 0.05. A negative statistically significant correlation was found between mandibular length (Condilion-Gnathion distance) and AHI (rho= -0,2022; p<0,05) and between maxilla length (Ans-Pns) and AHI (rho= -0,2984; p<0,01) and ODI (rho= -0,2443; p<0,05). A statistically significant correlation was also observed between the divergence angle (S-N^Go-Me) and AHI (rho=0,2263; p<0,05) and between cranial deflection angle (Fh^NBa) and AHI (rho=0,2212; p<0,05) and ODI (rho=0,1970; p<0,05). The OSAs severity may be related to certain predisposing features in craniofacial morphology, such as maxillary and mandibular length, divergence and cranial deflection. Key words:OSAs, Home Sleep Apnea Testing, AHI, ODI, Cephalometry, Airway.

Craniofacial characteristics in Crouzon's syndrome: A systematic review and meta-analysis.

The purpose of this meta-analysis was to strengthen the credibility of primary research results by combining open-source scientific material, namely a comparison of craniofacial features (Cfc) between Crouzon's syndrome (CS) patients and non-CS populations. All articles published up to October 7, 2021, were included in the search of PubMed, Google Scholar, Scopus, Medline, and Web of Science. The PRISMA guidelines were followed to conduct this study. PECO framework was applied in the following ways: Those who have CS are denoted by the letter P, those who have been diagnosed with CS via clinical or genetic means by the letter E, those who do not have CS by the letter C, and those who have a Cfc of CS by the letter O. Independent reviewers collected the data and ranked the publications based on their adherence to the Newcastle-Ottawa Quality Assessment Scale. A total of six case-control studies were reviewed for this meta-analysis. Due to the large variation in cephalometric measures, only those published in at least two previous studies were included. This analysis found that CS patients had a smaller skull and mandible volumes than those without CS.in terms of SNA° (MD = -2.33, p = <0.001, I2 = 83.6%) and ANB°(MD = -1.89, p = <0.005, I2 = 93.1%)), as well as ANS (MD = -1.87, p = 0.001, I2 = 96.5%)) and SN/PP (MD = -1.99, p = 0.036, I2 = 77.3%)). In comparison to the general population, people with CS tend to have shorter and flatter cranial bases, smaller orbital volumes, and cleft palates. They differ from the general population in having a shorter skull base and more V-shaped maxillary arches.

Cephalometric comparison of mandibular growth in Brazilian children with Class II malocclusion and normal occlusion during the growth stages determined by the cervical vertebrae maturation.

This study compared mandibular growth in children, aged 7 to 12 years, with Class II malocclusion and normal occlusion, between the following stages of cervical vertebrae maturation: initiation (I), acceleration (A), transition (T). A total of 148 lateral cephalograms (78 males, 70 females) of Class II malocclusion patients, and 60 lateral cephalograms (30 males, 30 females) of normal occlusion patients were included. The following linear cephalometric measurements were performed: Co-Gn (effective mandibular length), Co-Go (ramus height), and Go-Gn (length of mandibular body). Mean values of increments between stages (I-A, A-T, I-T) were obtained for each group and gender. Results were compared using the Student t-test, and a significance level of 0.05% was adopted. Females group: A-T interval presented a greater increment in Co-Go in the Class II group, which was not significant for the I-T interval, with numerically smaller increments in Co-Gn and Go-Gn, without statistical significance. Males group: intervals I-A, A-T and I-T showed numerically smaller growth increments in the Class II group, with statistical significance for Co-Gn in I-A (p=0.001) and I-T (p=0.003). Comparing genders of the Class II group, Co-Go was higher in males (p=0.002) and I-T interval (p=0.031). In the Normal Occlusion group, the male gender had the greatest Co-Gn (p=0.038) for the I-A interval. In A-T and I-T, Co-Go in males was higher, with statistical significance (p=0.000 and p=0.002, respectively). Growth phenomenon affects the mandibular dimensions regardless of the character of the malocclusion, with a tendency to be smaller in the presence of Class II malocclusion.

A comparison of transversal changes occurring in the treatment of rapid maxillary expansion with acoustic rhinometry

Aim: The aim of this study was to determine the relationship between cephalometric transversal measurements and nasal patency before and after rapid maxillary expansion (RME) treatment applied to patients with maxillary transversal deficiency. Methodology: The records of 30 patients with maxillary transversal insufficiency and 20 patients without normal dentofacial and nasal symptoms were used. Acoustic rhinometry (MCA1, MCA2, VOL1, VOL2) and cephalometry measurements (JR–JL, MMTI, nasal width) were analyzed before (TO) and six months after (T1) RME. Results: There were no significant differences in age and gender between the groups. After the RME treatment of the patients in the study group, there was a significant increase in the cephalometric measurement (JL–JR, MMTI, nasal width) and acoustic rhinometry measurement parameters (MCA1, MCA2, VOL1, VOL2). Cephalometric measurements showed consistent changes in the patients in the study group, suggesting that RME treatment increased the maxilla’s growth capacity. The postero-anterior cephalometry results improved after RME treatment and approached those of the control group. Conclusion: Significant improvement was observed in the cephalometric transversal measurements after RME treatment. This improvement indicated that RME increases maxillary growth capacity. There was no correlation between cephalometric and acoustic rhinometry. This result may be due to the inability of postero-anterior cephalometry to effectively evaluate the maxilla-related part of the nasal structures. How to cite this article: Metli ŞN, Yıldırım M, Erdur EA, Erdur Ö. A comparison of transversal changes occurring in the treatment of rapid maxillary expansion with acoustic rhinometry. Int Dent Res 2022;12(Suppl.1):97-102. https://doi.org/10.5577/intdentres.434 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Effects of Age and Gender on Hard and Soft Tissue Cephalometric Features of an Iranian Population Over 12 Years Old

Background: This study aimed to investigate age- and gender-specific soft and hard tissue cephalometric features in an Iranian population with normal class I occlusion. Methods: A total of 111 Iranians (56 females and 55 males) in two age groups including individuals aged between 12-16 years and individuals aged over 16 years, with well-balanced faces and class I occlusion, were selected. Overall, 81 (40 soft tissue and 41 hard tissue) cephalometric measurements of the selected samples were traced on all cephalograms. The obtained values were compared in terms of gender and age differences and also ethnic differences between Iranian and European races. Results: This study indicated significant differences between Iranian men and women of different ages and Caucasians in terms of hard and soft tissue cephalometric measurements, which should be considered in orthodontic and surgical treatments. Some of the most important differences are greater values of facial convexity angle, nasolabial angle, and soft tissue chin thickness in Iranians than in Caucasians. Conclusion: In general, slightly more convex profiles, more protruded lips, less prominent noses, higher nose tips, and proclined and protruded central incisors are acceptable in the Iranian population. Also, Iranian women have more convex soft and hard tissue profiles, shorter anterior and posterior facial heights, larger interlabial gaps, less deep superior sulci, thinner and shorter upper lips, and thinner soft tissue chins than men. Also, non-growing adults have more advanced mandibles, larger noses, more sloping nasal tips, and larger skeletal dimensions compared with growing ones.