Convexity Angle Research Articles

Evaluating the relationship between dimensions of the upper airway and facial profile according to initial lateral cephalometric radiography in orthodontic patients in the north of Iran

PurposeDecreased upper airway dimensions due to adenoid enlargement may have unfavorable aesthetic and/or functional effects on the soft or hard tissue profile development. The aim of this study was to investigate the associations between adenoid sizes to upper airway size ratio (airway ratio) in the midsagittal plane and various types of soft and hard tissue facial profile convexity. Materials and methods251 lateral cephalometric images of pre-orthodontic healthy subjects with age group of 6•12, 13•18, 19•25 and 26•29 years, were collected. They were classified into four subgroups based on the airway ratio (grade 1: <1/4 í 100), (grade 2: 1/4•1/2 í 100), (grade 3:1/2•3/4 í 100) and (grade 4: >3/4 í 100). The radiographs were characterized as convex, normal and concave soft tissue facial profile according to the facial convexity angle. Cephalometric analyses were done using Dolphin imaging computer software 11.95. Kruskal Wallis test was used to evaluate differences between airway ratio and facial morphologies; the mandibular plane angle was compared between airway ratio subgroups by Chi square. ResultsAirway ratio was not significantly different (P = 0.241) between soft tissue facial convexity subgroups and within age subgroups. Mandibular plane angle was in a significant relation within airway ratio (p = 0.028). ConclusionThere was not any significant relation between decreased upper airway ratios and types of the soft or hard tissue facial profile convexity, however there was a significant relation between upper airway ratios and age subgroups. A significant revers correlation was seen between the mandibular plane angle and nasopharyngeal dimensions.

Incompetent lip seal affects the form of facial soft tissue in preschool children

ABSTRACT Objective: To examine whether incompetent lip seal (ILS) influences the form of facial soft tissue. Methods: Four hundred forty-four preschool children 3–5 years of age were selected. The images of the subjects’ facial surface were obtained with a three-dimensional laser scanner. Coordinates of 16 facial landmarks were established and identified on the three-dimensional facial images, and the differences between children with (wILS) and without ILS (woILS) were measured. Results: The angle of sagittal facial convexity, excluding the nose, in 4- and 5-year-old children was significantly smaller in wILS children than in woILS children. The nasal prominence angle and the protrusion angle of lips in wILS children were significantly smaller than those in woILS children, at all ages. Conclusion: Children with ILS have anteriorly prominent subnasales and lips and flatter noses. The influence of ILS on facial form begins to appear even before 3 years of age.

Oft Tissue Proile Analysis by Means of Linear and Angular Parameters in Pakistani Population

Objective: The objectives of the study were to determine the soft tissue norms of non-growing adults of Pakistani origin and to assess any gender dimorphism in the soft tissue proile. Methods: A cross-sectional study was conducted on the lateral cephalograms of esthetically pleasing proiles of 70 undergraduate students aged 19-24 years of Dr. Ishrat ul Ebad Khan Institute of Oral Health Sciences. Several soft tissue linear and angular measurements of upper and lower lips, nose, and chin were carried out on lateral cephalogram. An independent sample t- test was used to compare cephalometric variables between genders. Results were taken signiicant at p-value ≤ 0.05. Results: Among the linear parameters, we found signiicant differences in upper lip length (p <0.001), thickness (p <0.001), prominence (p= 0.03), strain (p<0.001), sulcus depth (p = 0.01) and S plane to upper lip (p = 0.02). The lower lip linear parameters showed signiicant differences in E (p = 0.02) and S planes (p = 0.01), and H line (p <0.001). Among the angular parameters, we found statistically signiicant differences in the Z (p <0.001), H line (p = 0.01), angle of facial convexity (p<0.001), nasofacial (p= 0.04), nasomental (p= 0.05) and nasolabial angles (p<0.001). Conclusions: Males showed more prominent upper and lower lips, decreased prominence of nasal tip and increased soft tissue chin thickness as compared to females. Signiicant differences were found in various angular parameters among males and females.

A cephalometric study in patients with Wilson’s disease

It was previously noticed that patients with Wilson’s disease (WD) might have distinct dento-maxillo-facial structures. We performed a case-control study to investigate the characteristics of facial structure between patients with WD and healthy controls. We recruited 44 adult patients with WD and 67 healthy controls and took their lateral cephalometric films. Thirteen angular parameters were used to describe the craniofacial features and evaluated blindly. Our date showed that higher SNA angle, ANB angle, angle of convexity and lower AB angle were detected in both male and female WD group. The average SNA angle in male patient group was 84.23 ± 3.55, larger than the control group (81.52 ± 3.53, p = 0.006) and lower facial proportion was 60.87 ± 12.92%, higher than the control group (56.58 ± 2.51%, p = 0.048). The average SNA angle in female patient group was 83.20 ± 3.75, larger than that in control group (81.06 ± 3.37, p = 0.039). Female neurologically early-onset WD patients (<20 years) had larger SNtoGoGn angle (37.53 ± 5.29 vs 28.46 ± 7.10, p = 0.004), higher lower facial proportion (57.42 ± 1.65% vs 55.53 ± 1.83%, p = 0.03), larger Y-axis (65.12 ± 4.84 vs 58.47 ± 2.72, p = 0.004), larger mandibular plane angle (32.24 ± 5.32 vs 20.90 ± 5.75, p < 0.001) and lower facial angle (85.76 ± 4.36 vs 91.04 ± 2.46, p = 0.009) than the late-onset female patients. In conclusion, we found both male and female WD patients tend to bear some craniofacial features of maxillary protrusion and vertical mandibular growths pattern. Female patients with early onset age of neurological symptoms were more inclined to have vertical mandible growth and mandibular retrusion.

Cephalometric features of Angle class III malocclusion with different dentoalveolar compensation (retrospective study)

Introduction: This study was to investigate dentoalveolar compensation in untreated skeletal Class III patients. Methods:This retrospective study was conducted on 102 untreated Class III malocclusion patients. They were divided into group 1 (overjet<0mm, n=51) and group 2 (overjet ≥ 0mm, n=51). Twenty-six cephlometric readings were compared between the two groups. Correlation analysis was performed between the overjet with skeletal and dental measurements and Regression analysis was performed to determine the overjet. Results: The results showed a significantly higher SNB, S-N-Pg, gonial angle and L1-NB mm in the negative overjet group. While, the ANB angle, angle of convexity, Wits appraisal, bony chin and U1- A-Pg mm were significantly higher in the positive overjet group. However, no statistically significant difference was found in the rest of the readings. Correlational analyses showed that the overjet has significant negative correlation with SNB, S-N-Pg, L1-Frankfort, gonialangles. On the other hand, it had significant positivecorrelation with ANB angle, angle of convexity, Wits appraisal, bony chin, L1-MP angle and U1-A-Pg mm. Nine regression equations for the overjet were calculated with the highest coeffcient of determination of 0.33. Conclusion: Dentoalveolar compensation was seen in Class III cases with less skeletal discrepancy, lower mandibular prominence, larger bony chin, greater angle of convexity and smaller gonial angle. Moreover, the position of the maxillary and mandibular incisors on the basal bone, rather than their inclination, contributed in dentoalveolar compensation

INVESTIGATE THE LATERAL MORPHOLOGY FEATURES OF THE SOFT TISSUES FACIAL PROFILE OF STUDENTS AT HUE UNIVERSITY OF MEDICINE AND PHARMACY

Background: To survey the lateral morphology features of the soft tissues facial profile and identify some indicators, size of facial soft tissue of students at Hue University of Medicine and Pharmacy. Materials and methods: Cross-sectional description research on 183 students of Hue University of Medicine and Pharmacy, including 81 males and 102 females. The subjects were taken a photogrammetric to determine the lateral morphology features of the soft tissues facial profile. Results: Most of the lateral soft tissue angles in male were smaller than in females, with the exception of the cervicomental and two lips angles. The difference between men and women was statistically significant (p &lt; 0.05) in the total facial convexity, cervicomental, nasofrontal and mentolabial angles. The convex form was 94.0%. Conclusion: Most of the lateral soft tissue angles in male were smaller than in females, with the exception of the cervicomental and two lips angles.The convex form was majority. Key words: anthropometry, lateral morphology of the soft tissues facial profile, digital photo

Differences in Angular Photogrammetric Soft-Tissue Facial Characteristics among Parents and Their Offspring.

Background and objectives: The objective of this study was to determine if the angular photogrammetric analysis of soft-tissue characteristics can determine similarities between parents and their offspring in the Serbian population. Materials and Methods: A total of 15 families (52 participants) met the participation criteria of this study and their facial profile images were analyzed using the ImageJ software. Subjects were divided into groups of mothers and fathers and four groups of children (divided according to their age and gender). In total, twelve angular measurements were made on the standardized digital images of the profiles of the participants and the obtained data were compared using one-way ANOVA. Results: The obtained results showed that there were statistically significant differences in the values of the nasal and cervicomental angles, as well as the angle of the total facial convexity, between the group of fathers, on one side, and groups of male/female children, on the other. Conclusions: This work represents the first photogrammetric analysis of facial soft-tissue characteristics of children and adults in the Serbian population. The data suggest that there are much more similarities between the facial soft-tissue angles of fathers and their male offspring. Furthermore, mothers tend to have statistically insignificant differences in angle sizes, compared to both male and female offspring.

Facial photogrammetric profile measurements and sagittal dental occlusion in the young Congolese Bantu Adult (DRC)

The aim of the present study was to determine, according to the kind of dental occlusion, the profile photogrammetric characteristics of the young Congolese Bantu adult (DRC Congo). It was a cross-sectional study, including 302 young Congolese Bantu adults (161 males and 141 females), aged between 18-30 years old. All were in full permanent dentition, out of which 157 in dental normocclusion, 74 in distocclusion, and 71 in mesiocclusion. The included subjects were subjected to anthropometric measurements performed using a photographic tool. The recorded data was analysed using the SPSS 20.0 statistic software for Windows. A general linear univariate model was established to compare the photogrammetric variables according to the gender and the type of dental occlusion. A post-hoc test was performed to specify the level of differentiation between the groups. The level of significance was fixed at P<0.05. The gender dimorphism was observed for eight out of the seventeen variables, namely the facial angle, the FMA, the naso-labial angle, the Z angle, the convexity angle, E/Ls, E/Li, and H/Li. The majority of the observed differences were found in the dental normocclusion situations. In Class III situation, there was almost no difference between males and females, except for variable E/Ls. The photogrammetric measurements of the face captured the morphological specificities related to the type of dental occlusion and to the gender dimorphism. The expressiveness of the gender dimorphism was more pronounced in the subgroup of subjects in dental normoclusion, a little less in distocclusion, and almost none in dental mesiocclusion. Therefore, profile photographs may be a viable alternative to determine normative values for the facial skin profile of the Congolese subject, and may be used as a reference for the diagnostic and treatment approach.

Soft-tissue changes after Class II malocclusion treatment using the Sander bite-jumping appliance: a retrospective study.

The soft tissue profile outcome after functional treatment of Class II malocclusion is important for a patient's aesthetic and psychosocial results. The soft tissue effects of the Sander bite-jumping appliance (BJA), which is the device that produces the greatest mandibular advancement according to a systematic review, have never been investigated. The aim of the present study was to assess the soft tissue effects of the BJA in comparison to matched untreated controls. A total of 19 patients treated with BJA during puberty were retrospectively recruited, and 15 untreated controls were retrieved from a previous growth study to match the treated group. Lateral cephalograms were used to evaluate the pre- and post-treatment differences in the ANB angle, the inclination of the upper and lower incisors, facial convexity, the nasolabial angle and the sagittal position of the skeletal and soft tissue at points A and B. Independent t-tests or Mann-Whitney U tests were used to detect differences between the two groups. Statistically significant differences were found for the ANB angle, the inclination of the upper incisors and facial convexity. Functional treatment of Class II patients with the Sander BJA during puberty was effective at improving the profile and reducing the facial convexity angle in the short term.

Asymptomatic Basilar Artery Plaque Distribution and Vascular Geometry.

Aim: Development of atherosclerotic plaques is affected by vascular geometry and hemodynamics. Hemodynamics in the basilar artery (BA) is unique as the flow converges from vertebral arteries (VAs). Here, we investigated the characteristics of BA plaque based on VA and BA geometry.Methods: Consecutive patients evaluated using high-resolution magnetic resonance imaging (MRI) at a general health center were screened. Geometric characteristics of VA (VA dominancy and VA-BA angles) and BA (BA convexity and BA angles) were assessed. The burden of BA plaques was investigated in each wall (anterior, posterior, left, and right lateral). The characteristics of BA plaques were compared according to VA dominancy (right vs. left), BA angle of lateral view (lateral mid-BA angle; dichotomized), and total plaque burden (divided by tertiles).Results: Of the 1029 subjects, BA plaques were observed in 98 (9.5%) patients, and were more frequently located at the anterior wall (32.4%) and posterior wall (35.0%) than the right wall (15.3%) and left lateral wall (17.6%). Right and left lateral plaques were more frequent in the left and right convex BA, respectively (p = 0.009 and p = 0.024, respectively). Anterior plaques were more frequently observed in low lateral mid-BA angle (p = 0.043). BA plaques were predominant in anterior and posterior walls in patients with lower plaque burden, whereas they were predominant in right and left lateral walls in patients with higher plaque burden (p = 0.001 and p = 0.025, respectively).Conclusions: Asymptomatic BA plaque location was associated with BA convexity and lateral mid-BA angle. The anteriorly and posteriorly located BA plaques may extend to the lateral walls as the plaque burden increases.

A two-step optimization scheme based on equivalent stiffness parameters for forcing convexity of fiber winding angle in composite frames

For stiffness design optimization of composite frame structures, one of the major problems when using fiber winding angles as design variables directly is the lack of convexity of the objective function, which may lead to different local optima depending on initial designs when a traditional gradient-based optimization algorithm is applied. Therefore, the present paper adopts a gradient-based two-step optimization scheme to cope with the difficulty and search for a better optimal design of composite frames in which the fiber winding angles are taken as design variables. To realize the two-step optimization scheme, the equivalent stiffness parameters of a composite beam with circular cross-section are derived in explicit expressions and used to force the convexity of the design optimization of the composite frame. The stiffness matrices are linearly expressed in terms of the stiffness parameters, which guarantee the convexity of the design variable feasible region in the stiffness parameter space. The equivalent stiffness parameters are adopted to keep invariance of physical quantities between fiber winding angle and equivalent stiffness parameter spaces. In the two-step optimization scheme, the minimum identification problem with the constraint that the objective function at the new starting point is less than or equal to the previous objective function at the optimum point in fiber winding angle space is established. Then, the two-step optimization scheme can be implemented in the fiber winding angle and structural equivalent stiffness parameter spaces, respectively, until the minimum identification problem is not possible to identify a new starting point. The proposed two-step optimization scheme for composite frames fully takes advantage of the stiffness parameters in convexity and fiber winding angles as practically physical quantities, respectively. The sensitivity information of the objective function with respect to fiber winding angles and equivalent stiffness parameters is derived by the analytical sensitivity analysis method. Numerical examples show that the two-step optimization scheme can effectively force convexity of the optimization model and help to eliminate the initial design dependency. The effectiveness of the proposed two-step scheme is further verified through the particle swarm optimization (PSO) algorithm which is an evolutionary algorithm with global optimization capability.

Soft tissue growth changes from 8 to 16 years of age: A cross-sectional study.

Objective:The present cross-sectional study was conducted to evaluate and compare the soft tissue growth changes between males and females of two groups from 8 to 16 years.Materials and Methods:One hundred sixty skeletal class I lateral head cephalograms were screened aged between 8 to 16 years-Subjects were divided into two groups. Group I (8 to 12 years) and Group II (12 to 16 years) and further these groups were subdivided into male and female subgroups. Total eight linear and four angular parameters were studied.Results:All the parameters increased in their dimension while angle of total facial convexity including nose and Nasolabialangle decreases. Among the linear variables, Noseheight, Lip thickness at laberale inferious, Lip thickness at B point, Soft tissue chin thickness and Measurements of lips to E-plane were found significant for both subgroups. While rest of the linear variables like Upper lip height, Lower lip height, Nose depth and Sagittal depth also increased but this increase wasfound non-significant. Among the angular parameters angle of total facial convexity including nose and Nasolabialangle decreases and angle of facial convexity excluding nose, and Nose inclination increases with the age, and these changes were found non-significant.Conclusion:In this study, we observed that males showed a greater value of all parameters in comparison to females, and with the advancement of age, all the parameters increased, except for angle of total facial convexity and nasolabial angle.

Study on the correlation parameters of Class II malocclusion in child tooth dentition early stage by using 3D technique

Objective:To record the dentition, jaw and facial growth and development of children with class II malocclusion at the age of 7-8 years old in the early dental transitional stage with 3D technology and to provide the study basis for the growth and development parameters of normal children and children with class II malocclusion.Methods:Twenty-four children who were suffering class-II malocclusion in the early dental transitional stage and received treatment between July 2016 and July 2017 in our hospital were selected as the study group, and 20 healthy children were selected as the control group in the same period. SIRONA CEREC dentition scanning, 3D reconstruction of the lower mandible and 3d MD face scanning were performed on the children. Relevant data were recorded and compared.Results:The dentition scanning results suggested that the study group had significantly larger anterior overbite and anterior overjet and smaller width of the upper arch than the control group; there was a significant difference between the two groups (P<0.05). The 3D reconstruction of the lower mandible suggested that the study group had smaller Go angle and SNB angle and shorter ANS-Me distance, Go-Me distance and N-Me distance compared to the control group; the differences had statistical significance (P<0.05). The face scanning results demonstrated that the nasolabial angle and facial convexity angle of the study group were significantly larger than those in the control group, and the difference was statistically significant (P<0.05).Conclusion:The dentition scanning results suggested that the study group had significantly larger anterior overbite and anterior overjet and smaller width of the upper arch than the control group; there was a significant difference between the two groups (P<0.05). The 3D reconstruction of the lower mandible suggested that the study group had smaller Go angle and SNB angle and shorter ANS-Me distance, Go-Me distance and N-Me distance compared to the control group; the differences had statistical significance (P<0.05). The face scanning results demonstrated that the nasolabial angle and facial convexity angle of the study group were significantly larger than those in the control group, and the difference was statistically significant (P<0.05).

Post-orthodontic cephalometric variations in bimaxillary protrusion cases managed by premolar extraction - A retrospective study.

Bimaxillary protrusion is a common dentofacial condition associated with proclination of maxillary and mandibular incisors in relation to the dental and cranial bases resulting in soft tissue procumbency. The present retrospective study aimed to investigate dental and soft tissue profile changes using cephalometric analysis to evaluate bimaxillary protrusion patients after extraction of the first four premolars and subsequent retraction of the anterior teeth. Pre-treatment and post-treatment cephalometric radiographs of 46 Saudi patients (16 males and 30 females), 18-30 years of age with bimaxillary protrusion, were selected based on inclusion criteria. Dental and soft tissue landmarks were traced using the Dolphin® imaging software and statistically analyzed with SPSS® 21 software. The upper and lower incisors retroclined by a mean value of 9.6° and 9.65°, respectively, and an average distance of 4.1 mm. The level of maxillary incisor exposure was reduced by approximately 1.1 mm after treatment. A mean increase of 6.6° in the nasolabial angle was also observed. Multiple regression analysis showed that retraction of both upper and lower incisors by 1 mm would result in a 0.44 mm retraction of the upper and lower lips. A statistically significant increase in the nasolabial angle and upper lip length was found in relation to upper and lower incisor retraction and retroclination. A significant reduction was also evident in the post treatment upper incisor exposure, facial convexity angle and mentolabial sulcus depth.

Determination of downs hard tissue cephalometric norms for Himachali Mongoloid tribes

ObjectiveThe purpose of this study was (a) to establish hard tissue cephalometric norms for the population of Himachali Mongoloid tribes, (b) to study the sexual dimorphism in hard tissue cephalometric norms of this population and (c) to compare the Himachali Mongoloid norms with the norms established by Downs. Material and methodSixty Himachali Mongoloid subjects were selected on the basis of Angle’s Class I molar relationship, well aligned arches, full complement of teeth, having clinically acceptable facial esthetics, no previous history of Orthodontic treatment, subjects native of the tribal belt of Himachal Pradesh. Lateral head films were traced and Downs cephalometric parameters were recorded. Statistical analysis was done to compare the difference between the established norm and the norm established by Downs for the Caucasian population. ResultSignificant difference was seen in the Angle of convexity, with Himachali Mongoloid tribe population having a more forwardly positioned middle part of the face. This population had less steeper cant of occlusal plane, more acute interincisal angle, more inclined lower incisors in relation to the mandibular and the occlusal plane and more forwardly positioned maxillary incisor in relation to the A-pog line. ConclusionThese findings suggested that ethnic differences in the facial traits exist and awareness of dentofacial pattern of each ethnic group will ensure better success of the treatment in establishing optimal facial harmony.

Three-Dimensional Soft-Tissue Evaluation in Patients with Cleft Lip and Palate.

BackgroundIn cleft lip and palate (CLP) patients, the shape of the facial soft tissues shows variety in 3 dimensions (3D). Two-dimensional (2D) photographs and radiographs are insufficient in the examination of these anomalies. The aim of this retrospective study was to examine the soft tissue and craniofacial characteristics of individuals with nonsyndromic unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), skeletal Class III malocclusions, or skeletal Class I malocclusions using 3D facial imaging.Material/MethodsThe entire study group consisted of a total of 158 patients, aged 8–32 years: 29 of the patients had UCLP, 22 BCLP, 54 had skeletal Class III malocclusions, and 53 had skeletal Class I malocclusions. 3D stereophotogrammetric soft-tissue recordings of all patients were analyzed. ANOVA and the Kruskal-Wallis test were performed to compare the groups.ResultsStatistically significant differences were observed among the groups in terms of linear, angular, proportional. and volumetric measurements. While nasal differences were not observed in the Class III group, nose and upper-lip deformities were common in the CLP groups. Upper-lip projection was reduced in all 3 groups. In the Class III patients, the lower lip and chin were more prominent than in the other groups. The facial convexity angle was increased in the CLP and Class III groups. The upper-lip volume was decreased in the BCLP, the UCLP, and the Class III groups.ConclusionsPatients with skeletal Class III or CLP anomalies showed significantly different soft-tissue characteristics than the Class I control group. 3D stereophotogrammetric facial imaging is an easy and noninvasive method that can be used in examination and recording of these facial deformities. It is possible to make volumetric measurements using this method.

Photogrammetric Facial Analysis of Attractive Celebrities Using the Glabella for Planning Rhinoplasty and Analyzing Surgical Outcomes

Background Identifying problems and making a surgical plan through a preoperative analysis is important in facial aesthetic surgery. Thus, popular conceptions of an attractive face must be analyzed beforehand. The landmarks used as reference points may change after rhinoplasty, resulting in errors in the prediction and assessment of outcomes. To reduce such errors, it is advantageous to use reference points and landmarks that are subject to minimal variation. This study measured and analyzed landmarks with little preoperative and postoperative variation in rhinoplasty, and established appropriate standards for landmarks indicative of ideal profiles. Methods A photogrammetric analysis was performed of 80 famous and attractive celebrities from Korea, Southeast Asia, Japan, China, and America. The nasofrontal angle, nasal angle, nasolabial angle, angle of facial convexity, and angle of total facial convexity were measured. Results The angle of total facial convexity differed significantly among countries (P=0.013). No significant difference in nasal angle, facial convexity, or total facial convexity was observed between Western and Eastern countries. A significant difference in the nasofrontal angle (Asian: 138.66°, Western: 134.35°; P=0.006) was observed. The nasolabial angle (Asian: 97.09°, Western: 104.59° degrees; P=0.007) was significantly more acute in Asian than in Western subjects. Conclusions In this study, we performed a more accurate analysis using the glabella instead of the nasion to measure the facial profiles of patients planning to undergo rhinoplasty and proposed standard values through an analysis of ideal and attractive facial profiles. Keywords: Anthropometry, Photogrammetry, Rhinoplasty

Abstract: Autologous Rib Cartilage Rhinoplasty for Harmonious Asian Face: Combining an Extended Columellar Strut Graft with a Pair of Maxillary or a Premaxillary Graft

PURPOSE: It is critical that the aim of the rhinoplasty should not only be an improvement of the nose itself but should also pursue a harmonious relationship with other facial structures. Recently, rib cartilage rhinoplasty for Asian nose is widely used, because of increased revision cases due to complications of implants and higher expectation of the patients.1 Additionally, it is a common the characteristic that the midfacial skeleton of the Asian, which is the basement of the nose, is flat or sunken. Therefore, when performing rhinoplasty, Asian rhinoplasty should include evaluation and augmentation of the retruded midface for the harmonious facial relationship.2 The purpose of this presentation is an evaluation of the effect of the combining the extended columellar strut graft with a pair of maxillary or a premaxillary graft in Asians who have sunken midface for the harmonious face in the autologous rib cartilage rhinoplasty. METHODS and MATERIALS: We conducted a retrospective review of the medical charts and postoperative photographs of the selected 403 patients over three months follow-up among 890 cases who underwent autologous rib cartilage rhinoplasties between March 2010 and December 2016, without deformity or procedures on the glabella and chin, in VIP international plastic surgery center, Seoul, South Korea. Selected 403 cases were divided into three groups; Type 0 – extended columellar strut graft (ECSG) alone; Type I – ECSG + a pair of maxillary grafts; and Type II – ECSG + a premaxillary graft. For the objective evaluation of the effect of combining grafts, the angle of facial convexity angle on the profile view of the standardized photographs was measured. Since the facial convexity angle which was connected between soft tissue glabella, subnasale and soft tissue pogonion is a useful tool for the evaluation of the general harmony of the forehead, midface and lower face.3 RESULTS: Total number of cases is 403. Complication rate is 11.7% (45/403, 29 minor, 16 major). Mean follow-up period is 19.4 (maximum=72, minimum=3). The pre and postoperative FCA changes were as follows; Type 0 (N=45) -1.62 ± 1.42 from 170.38 ± 3.36 to 168.76 ± 2.91; in type I (N=305) -4.97 ± 1.68 from 174.17 ± 2.11 to 169.38 ± 2.10; and in type II (N=53) -8.26 ± 2.08 from 180.43 ± 3.20 to 172.17 ± 2.57 (p<0.05). CONCLUSION: We recommend combining ECSG with a pair of maxillary grafts for moderate retruded midface patients and with a premaxillary graft for severe retruded patients in Asian rib cartilage rhinoplasty.

Soft tissue facial profile changes after orthodontic treatment with or without tooth extractions in Class I malocclusion patients: A comparative study

ObjectiveTo analyze the soft tissue facial profile changes in Class I malocclusion patients after orthodontic treatment with or without tooth extraction. MethodsForty lateral cephalograms of 20 individuals with Angle Class I malocclusion submitted to orthodontic treatment were included in this study. The individuals were divided in two groups: no tooth extraction (Group A) and extraction of four first premolars (Group B). Cephalometric measurements related to the soft tissue facial profile (Nasolabial Angle, Mentolabial Angle, Interlabial Angle, Facial Convexity Angle, Total Facial Convexity Angle, Lower Face Angle, MAFH/LAFH Proportion, Lower Face Vertical Proportion, H.NB Angle, Ricketts E Line) were collected in two stages (pre-treatment and post-treatment). The Student T, Wilcoxon and Mann-Whitney tests analyzed the results. The significance level was 5%. ResultsAmong the cephalometric variables evaluated, only the measurements Interlabial Angle and H.NB Angle showed statistically significant changes during treatment. Increase was observed in the Interlabial Angle and decrease in H.NB Angle in both groups, resulting in a less convex facial profile with lip retraction. ConclusionThe findings suggest that changes in the soft tissue facial profile are similar in Class I patients treated with or without tooth extraction.

Facial profile based evaluation of gingival zenith position in maxillary central incisors among Saudi, Indian & Bangladeshi population

BackgroundRecently quantitative evaluation of gingival zenith position was evaluated in different facial forms suggesting clinicians may need to evaluate patients facial form and then decide to distalise the Gingival Zenith position in relation to Vertical Bisected Midline (VBM). The aim of the study was to quantitatively evaluate the gingival zenith width in convex, concave and straight facial profiles for Saudi, Indian and Bangladeshi nationals. Materials/methods114 subjects of each Saudi, Indian & Bangladeshi nationality were grouped into convex, concave and straight profile based on angle of convexity. Gingival zenith position (GZP) on #11 and #21 was evaluated on the scanned dental plaster model using CBCT. Inter and Intra group comparison was done using one-way ANOVA test. ResultsMean GZP values ranged from 0.84 mm to 1.10 mm, 0.75 mm to 1.02 mm and 0.87 mm to 1.14 mm for Saudi, Indian and Bangladeshi subjects respectively. Statistically significant (p < 0.05) difference was observed in convex, concave and straight profile subjects of these nationalities. ConclusionGZP variation does exist in different facial profiles of Saudi, Indian & Bangladeshi nationalities with respect to central incisors. Clinical significanceThese findings help clinician to consider facial profile as important entity in designing the smile following restorative and prosthetic procedures such as crown lengthening, teeth selection, implant esthetics and laminates.