Facial Soft Tissue Thickness Measurements Research Articles

Facial soft tissue thickness measurement method and relationship with BMI, age and sex

IntroductionFacial aesthetics results from the harmony of various components of the craniofacial region, a structure whose physiognomy and topography are determined by a set of hard and soft tissues. Few works in the literature have investigated the relationship between the variables of sex, age, BMI and soft tissue thickness and have considered how these variables may influence operative outcomes. The purpose of this study is to increase the pre-operative knowledge of the thickness of the soft tissues of the face through an analysis of their measurement conducted on cone beam computed tomography (CBCT) and to investigate the impact that the variables of gender, age and BMI have on their determination. Materials and methodsFor this study 82 patients were recruited between January 2020 and January 2021 in the Department of Maxillofacial Surgery of the University of Naples “Federico II”. A descriptive analysis of the sample was carried out on the selected sample, calculating averages and standard deviations for the individual variables analyzed. ResultsBMI has a predominant role on some craniometric points while age and sex have a more marginal role. Our analysis shows that some points are affected by only one variable, BMI (G’ N’ PR’ ID’ SM’ GN’ PG’ MIO’ ACP’ GO’ ZY’ SC’ IC’ ECMS’ and MMB’); some points are affected by both BMI and gender (MP’ and MR’); while only two (RHI’ and MSO’) are influenced by all the three variables. ConclusionA priori knowledge through CBCT of the thickness of the soft tissues of the face and a comparison with the data we propose could provide the surgeon with advance notice of the characteristics of the tissues which she/he will encounter.

Alterations in Facial Soft Tissue Thickness Post-Facemask Treatment in Noncleft Skeletal Class III and Bilateral Cleft Lip Palate Class III Patients.

The purpose of this retrospective study was to assess the alteration in the facial soft tissue thickness after rapid maxillary expansion with facemask treatment in bilateral cleft lip and palate (BCLP) Class III patients and noncleft Class III patients. Case records including lateral cephalograms of 30 patients (19 females, 11 males) treated using a rapid maxillary expansion with facemask treatment were analyzed. Group I (age: 11.4 ± 1.02 years) (10 females, 5 males) consisted of noncleft skeletal Class III patients, and group II (age: 10.8 ± 0.84 years) (9 females, 6 males) comprised skeletal Class III patients with bilateral cleft lip and palate. Fifteen hard tissue and 10 soft tissue measurements were made at the beginning and at the end of the treatment to evaluate the change with rapid maxillary expansion combined facemask treatment. The bilateral cleft lip and palate group displayed a statistically significant increase in the thickness of the subnasale, labrale superius, labrale inferius, labiomentale, and pogonion, whereas the thickness of the stomion was found to be significantly decreased. The noncleft group demonstrated a statistically significant decrease in the thickness of the stomion and gnathion. There was a statistically significant difference between the bilateral cleft lip and palate and noncleft groups in the facial soft tissue thickness measurements at labrale superius, gnathion, and subnasale points and in Y axis, U1-SN, U1-NA in the hard tissue measurements. The results of the study indicated that the rapid maxillary expansion with facemask treatment produced diverse alterations in the facial soft tissue thickness of bilateral cleft lip and palate patients and noncleft Class III patients.

Facial soft tissue thickness in forensic facial reconstruction: Impact of regional differences in Brazil.

Forensic facial reconstruction aims to assemble and provide the appearance of a face over a skull, in order to lead to recognition of that individual, making possible the application of primary identification methods. The scientific literature presents facial soft tissue thickness (FSTT) tables for reference from a range of different geographic regions. However, the consensus on its importance or on how to use specific population data related to FSTT is not unanimous. Brazil is formed by geographic regions with diverse populations, which are reflected in facial features. This paper aimed to measure and compare FSTT of distinct Brazilian samples to ascertain the need for specific data sets for different regions. A specific protocol for cone beam computed tomography was used to standardize measurement, and it was applied in a sample of 101 subjects. The FSTT measurements of a Brazilian population from the Midwest Region was compared to a previous sample from Southeast, which was collected using the same protocol. High compatibility was observed when comparing the averages of FSTT among samples of these two different geographic regions. Regarding age groups, notable differences on the medium and inferior face were observed in females. Minor variances found are unlikely to affect the practice of forensic facial reconstruction. Facial features, such as eyes, lips, nose, and skin may also be relevant in the differentiation of people from these two areas in Brazil. Therefore, concerning the Southeast and Midwest Brazilian regions, the need to apply different data sets is unnecessary.

Lip morphology estimation models based on three-dimensional images in a modern adult population from China

Lips are the main part of the lower facial soft tissue and are vital to forensic facial approximation (FFA). Facial soft tissue thickness (FSTT) and linear measurements in three dimensions are used in the quantitative analysis of lip morphology. With most FSTT analysis methods, the surface of soft tissue is unexplicit. Our study aimed to determine FSTT and explore the relationship between the hard and soft tissues of lips in different skeletal occlusions based on cone-beam CT (CBCT) and 3dMD images in a Chinese population. The FSTT of 11 landmarks in CBCT and 29 lip measurements in CBCT and 3dMD of 180 healthy Chinese individuals (90 males, 90 females) between 18 and 30years were analyzed. The subjects were randomly divided into two groups with different skeletal occlusions distributed equally: 156 subjects in the experimental group to establish the prediction regression formulae of lip morphology and 24 subjects in the test group to assess the accuracy of the formulae. The results indicated that FSTT in the lower lip region varied among different skeletal occlusions. Furthermore, sex discrepancy was noted in the FSTT in midline landmarks and linear measurements. Measurements showing the highest correlation between soft and hard tissues were between total upper lip height and Ns-Pr (0.563 in males, 0.651 in females). The stepwise multiple regression equations were verified to be reliable with an average error of 1.246mm. The method of combining CBCT with 3dMD provides a new perspective in predicting lip morphology and expands the database for FFA.

Facial soft tissue thickness differences among different vertical facial patterns

In forensic facial approximation, facial soft tissue thickness (FSTT) measurements play a major role. These values are affected by many factors such as ethnicity, age and sex, in addition to measurement errors. We hypothesize that an additional source of error is the lack of consideration of facial type in the assessment of FSTT norms.The purpose of this study was to: 1- evaluate the presence of significant effects of vertical facial type within the FSTT measurements in adults and 2- assess the correlations between FSTT and hard and soft tissue cephalometric measurements.The sample consisted of the lateral cephalometric radiographs of 222 adult individuals (87 males; 135 females, 23.49±6.24 years of age) with normal occlusion and balanced profiles. Hard and soft tissue cephalometric measurements were taken, in addition to FSST at 10 facial landmarks. The sample was categorized into 3 vertical pattern groups based on the MP/SN angle: hypodivergent, normodivergent and hyperdivergent. Statistical analyses included MANOVA test and Pearson moment product for associations among variables. Statistically significant effect of vertical divergence on FSTT values was limited to the levels of Stomion, Labiomentale and Pogonion and FSTT measurements were associated with measurements related to the lower face (Lm and Pog) Moderate to high correlations between mandibular length and ramus length and FSTT values related to the lower face (LL, Lm and Pog mainly) emphasize further the important role of the underlying skeleton.

Influence of sex and body mass index on facial soft tissue thickness measurements in an adult population of southwest of Iran.

Facial soft tissues have different thicknesses among different genders and ethnicities. This study was aimed to investigate the association of sex, ethnicity and body mass index (BMI) with facial soft tissue thickness measurements using magnetic resonance imaging to make a database for the Iranian southwest population (for Lur and Arab populations). In this analytical cross-sectional study, measurements of superficial soft tissues were taken at nine points of midline including glabella (GB), nasion (NA), end of nasals (END), mid-philtrum (MID), upper lip margin (UL), lower lip margin (LL), chin-lip fold (CLF), mental eminence (ME) and beneath chin (BC), eight points of axial sections including frontal tubers (FT), supraorbital margin (SO), external orbital margin (EX) and zygomatic arch (ZY) on both sides, and also two points of coronal section including both sides of the masseteric region (MST). For association of sex with the measurements, NA, MID, UL, LL and BC were significantly higher in men (Pc < 0.05). The most accurate measurement was MID with area under curve (AUC) = 85.03%, followed by UL (81.21%), NA (72.18%), LL (71.19%) and BC (68.10%). For association of ethnicity with BMI and measurements, higher amounts of GB and MID were associated in Arab patients. This study showed significant association of soft tissue thickness measurements with sex, BMI and ethnicities of southwest of Iran. MID had the most diagnostic value for male sex. The results of this study can be used in forensic medicine to diagnose the legal and biological identity of the corpse.

Application of cone beam computed tomography in facial soft tissue thickness measurements for craniofacial reconstruction.

Context:The paradigm shift from two- to three-dimensional imaging has marked the beginning of a new era in diagnosis. Newly developed cone-beam computed tomography (CBCT) designed specifically to visualize maxillofacial pathologies is being used in forensic investigations also. Facial reconstruction is a specialized forensic technique to identify the deceased from the unknown skull. It is dependent on population-specific facial soft tissue thicknesses.Aims:This study aims to propose the mean dataset of facial soft tissue thickness for South Indian population by utilizing CBCT. It also aims to evaluate the sex and racial differences in the values if any.Settings and Design:This descriptive study was conducted on CBCT scans of South Indians.Materials and Methods:Eighty CBCT scans of South Indian adults aged 18–80 years were selected. Facial soft tissue thickness measurements at 34 craniometric landmarks were carried out.Statistical Analysis:Descriptive statistics was done. Student's t-test estimated the differences of soft tissue thickness between the sexes; bilateral measurements and also racial differences. Tukey's honest significant difference test was used for multiple comparisons among Indian studies.Results:Males had thicker soft tissue than females in most of the landmarks. Differences in the bilateral soft tissue thicknesses were negligible. Indians had thicker facial tissues than the Koreans and CBCT was found efficient in measuring soft tissue thickness.Conclusion:The present study provides facial soft tissue thickness dataset using CBCT which will be useful in forensic facial reconstructions of South Indian population as well as in maxillofacial and plastic reconstructive surgeries.

Variation of Facial Soft Tissue Thickness in Nepalese Adult Orthodontic Subjects

Introduction: Variations in facial soft tissue thickness have been established previously by studies conducted in different population. Hence, it is essential to obtain facial soft tissue thickness measurement data specific to a population and develop individual standards. The objective of this research is to obtain facial soft tissue thickness data of Nepalese adult male and female subjects seeking orthodontic treatment with different sagittal skeletal malocclusion and evaluate variations in facial soft tissue thickness.&#x0D; Materials &amp; Method: Facial soft tissue thicknesses was measured manually on ninety pretreatment lateral cephalogram at eleven points (Glabella, Nasion, Rhinion, Subnasale, Labrale superius, Stomion, Labrale inferius, Labiomentale, Pogonion,Gnathion and Menton). One-way Analysis of variances [one-way ANOVA] followed by Least significant difference (LSD) post hoc test was used to determine difference in facial soft tissue thickness measurements among three sagittal skeletal group for both sexes. In addition, Student’s t-test was used to find difference in facial soft tissue thickness between the male and female subjects in each skeletal Class.&#x0D; Result: Statistically significant differences were found at points Rhinion, Subnasale, Labrale superius, Stomion and Gnathion in males and at Subnasale, Labrale superius, Stomion and Labrale inferius in females while comparing facial soft tissue thickness among three sagittal skeletal classes. Also, it was observed that mean facial soft tissue thickness was greater for males as compared to female subjects with significant differences at Subnasale, Labrale superius, and Labrale inferius in each skeletal Class.&#x0D; Conclusion: Facial soft tissue thickness varies considerably among different population group, sex and sagittal relationship of jaws.

Midsagittal facial soft tissue thickness norms in an adult Mediterranean population

The use of facial soft tissue thickness (FSTT) values is essential in forensic facial approximation. Few studies have assessed the FSTT norms in Mediterranean populations and none in the Lebanese population. The purpose of this study was to (1) present midsagittal facial FSTT norms for Lebanese adults with well-balanced faces and normal occlusion; (2) evaluate the presence of sexual dimorphism within these measurements; (3) establish a potential correlation between these measurements and (4) build on the existing database of FSTT data from previously published studies. FSTT measurements at 10 midsagittal locations were obtained from the lateral cephalometric radiographs of 87 males and 135 females (mean age of 23.49±6.24years). In additional to means, Shorth and 75-Shormax values are presented. Differences between sexes were assessed using the MANOVA test and correlations between different measurements were computed. The thinnest (3.07±0.72mm) and thickest (15.61±2.38mm) craniofacial soft tissue measurements existed at Rhinion and Subnasale, respectively. There was a statistically significant and large effect of sex on the combined FSTT variables (p<0.001; eta-squared=0.393). Males displayed larger FSTT values at all landmarks except at Glabella (p=0.162). Significant correlations were observed between almost all measurements with the highest being between the upper and lower lips (r=0.763) and between Pogonion and Gnathion (r=0.784). The descriptive values of FSTT values reported in this study add to the body of research necessary for the enhancement of facial approximation methods The uniquely strong effects of sex on FSTT measurements combined and on selected single FSTT measurements are an area for further research.

In vivo facial soft tissue depths of a modern adult population from Germany.

Forensic facial reconstruction may be the final option available to draw public attention in cases where the identity of an individual cannot be established by standard identification methods. Two fundamental components of all forensic facial reconstruction techniques are cranial morphology and soft tissue depth databases. The purpose of this study was to extend such databases by providing a complete set of accurate facial soft tissue thickness measurements, acquired from a contemporary adult population from Germany. The material for the study consisted of 320 (160 male, 160 female) anonymised multi-slice computerised tomography (MSCT) scans of individuals drawn from a German population. In Amira®, 3D models of the surfaces of the skull and the facial skin were semi-automatically segmented using calculated thresholds and surface extraction algorithms. Facial soft tissue depth was measured at 10 midline and 28 bilateral anatomical landmarks. The analysis of facial soft tissue thickness versus BMI, sex and age indicated that, at a number of the landmarks, facial soft tissue depth is significantly (p<0.05) influenced by all three biometric variables. Facial soft tissue thickness increased with increasing BMI. The differences between males and females were statistically significant (p<0.05) for almost all anatomical landmarks with the exception of a few in the region of the nasal root and orbitals. Asymmetry was noted at over half of the bilateral landmarks. The differences between the results from this sample and those obtained from comparable databases contradict the hypothesis that population specificity significantly influences facial soft tissue thickness.

Progress in Application of Measuring Skeleton by CT in Forensic Anthropology Research

Individual identification by measuring the human skeleton is an important research in the field of forensic anthropology. Computed tomography （CT） technology can provide high-resolution image of skeleton. Skeleton image can be reformed by software in the post-processing workstation. Different skeleton measurement indexes of anthropology, such as diameter, angle, area and volume, can be measured on section and reformative images. Measurement process is barely affected by human factors. This paper reviews the literatures at home and abroad about the application of measuring skeleton by CT in forensic anthropology research for individual identification in four aspects, including sex determination, height infer, facial soft tissue thickness measurement and age estimation. The major technology and the application of CT in forensic anthropology research are compared and discussed, respectively.

Repeatability of facial soft tissue thickness measurements for forensic facial reconstruction using X-ray images

The repeatability of facial soft tissue thickness measurements at 10 standard anatomical landmarks was evaluated using lateral X-ray images obtained from 50 adult subjects. The intra-and inter-observer error rates were calculated after four practitioners took measurements using Denta Pacs 8.1 software. The results indicated high inter- and intra-observer repeatability, suggesting X-ray images can be used to measure facial soft tissue thicknesses for the purpose of craniofacial reconstruction and superimposition.

Radiographic assessment of facial soft tissue thickness in South Indian population – An anthropologic study

Facial reconstruction is a technique used in forensic anthropology to identify an unknown person. Various methods used for facial reconstruction are drawings, sculpture and computer aided image building which is mainly based on facial soft tissue thickness measurement. Several methods have been established for measuring facial soft tissue thickness (FSTT) with each one having certain limitations. There is limited data available on FSTT among South Indian population. Hence the present study was ventured to determine the FSTT among South Indian adults and also to find FSTT difference between male and female.308 subjects of South Indian origin (18–27years) having full set of permanent dentition who require orthodontic treatment were included in the study. Subjects were assessed for Body Mass Index (BMI) and diagnostic digital x-ray of lateral cephalogram (LC), Lateral oblique (LO) view and posterior-anterior (PA) view was obtained. The digital image was transferred to Adobe Photoshop CS4 software and 23 different soft tissue points were measured.Mean FSTT was more in males compared to females except for three landmarks. Statistically significant difference was observed in 20 landmarks when height and weight was compared in males, whereas in females only 12 landmarks showed significant difference. BMI showed good correlation with FSTT in both males and females, which was confirmed by linear regression. The best regressor in terms of estimating FSTT in association with age/sex/BMI were nasion, sub nasale, labial superioris, labrale inferius, gnathion, inferior border of zygomatic, right and left gonion. Stepwise discriminant analysis using all variables showed 94.8% of overall accuracy in sex determination.The observation of present study suggests that LO and PA view along with LC gives information regarding mean FSTT among South Indian population. Even though BMI plays a dominant role in determining FSTT, but age, sex, height and weight should also be considered with care while facial reconstruction. Additionally the present regression equation contributes towards increase in the specificity of the tissue depths and can be used in real cases by allowing the practitioners to calculate individual tissue depth.

Variations of midline facial soft tissue thicknesses among three skeletal classes in Central Anatolian adults.

Facial reconstruction is a technique employed in a forensic investigation as a last resort to recreate an individual's facial appearance from his/her skull. Forensic anthropologists or artists use facial soft tissue thickness (FSTT) measurements as a guide in facial reconstructions. The aim of this study was to develop FSTT values for Central Anatolian adults, taking into consideration sex and skeletal classes; first, to achieve better results obtaining the likenesses of deceased individuals in two or three-dimensional forensic facial reconstructions and, second, to compare these values to existing databases. Lateral cephalograms were used to determine FSTT values at 10 midline facial landmarks of 167 adults. Descriptive statistics were calculated for these facial soft tissue thickness values, and these values were compared to those reported in two other comparable databases. The majority of the landmarks showed sex-based differences. Males were found to have significantly larger landmark values than female subjects. These results point not only to the necessity to present data in accordance with sexual dimorphism, but also the need to consider that individuals from different geographical areas have unique facial features and that, as a result, geographical population-specific FSTT values are required.

Reproducibility of Facial Soft Tissue Thickness Measurements Using Cone-Beam CT Images According to the Measurement Methods.

The purpose of this study was to establish the reproducibility of facial soft tissue (ST) thickness measurements by comparing three different measurement methods applied at 32 landmarks on three-dimensional cone-beam computed tomography (CBCT) images. Two observers carried out the measurements of facial ST thickness of 20 adult subjects using CBCT scan data, and inter- and intra-observer reproducibilities were evaluated. The measurement method of "perpendicular to bone" resulted in high inter- and intra-observer reproducibility at all 32 landmarks. In contrast, the "perpendicular to skin" method and "direct" method, which measures a distance between one point on bone and the other point on skin, presented low reproducibility. The results indicate that reproducibility could be increased by identifying the landmarks on hard tissue images, rather than on ST images, and the landmark description used in this study can be used in the establishment of reliable tissue depth data using CBCT images.

In vivo facial soft tissue thickness measurements for Turkish Subadults

Facial soft tissue thicknesses are mainly used in facial reconstruction for the purpose of forensic identification. Several studies of facial soft tissue thickness (FSTT) in subadults have been published from different ancestral backgrounds such as Caucasoid, African-American, Hispanics and Japanese subjects. However, there is no existing available FSTT data for Turkish subadults. This study reports FSTT data in Turkish subadults of both sexes, aged between 3 and 18. FSTTs were measured at 31 anatomical points on the faces of 450 individuals. A table of mean FSTTs was developed for boys and girls divided into three age groups (3–8; 9–13; 14–18). Differences between boy and girl measurements in three age groups were compared using Student’s t-test. Significant differences were observed at some landmarks in each age group. In order to observe differences among age groups, an ANOVA (one-way analyses of variance) followed by a LSD (least significant difference) Post Hoc test was applied to the variances. The boys showed a general increase in tissue thickness with an increase at all the midline and cheek points. The girls showed increased tissue thickness with age at all points except supraglabella, upper lip, frontal eminence, lateral nasal, sub-orbital and supraglenoid.

Facial soft-tissue thickness in patients affected by bilateral cleft lip and palate: A retrospective cone-beam computed tomography study

The purposes of this study were to evaluate the facial soft-tissue thicknesses and craniofacial morphologies of patients affected by bilateral cleft lip and palate (BCLP) and to compare the findings with a well-matched control group without any clefts using cone-beam computed tomography. The study sample consisted of 40 retrospectively and randomly selected patients divided into 2 groups: a BCLP group (20 patients; mean age, 13.78±3.20years) and an age- and sex-matched control group without clefts (20 patients; mean age, 13.94±2.52years). Craniofacial and facial soft-tissue thickness measurements were made with cone-beam computed tomography. The Student t test and multiple linear regression analyses were performed for the statistical evaluations. The BCLP group had an increased SN-MP angle (P=0.003), a decreased Co-A (P=0.000), and retruded maxillary (P=0.000) and mandibular (P=0.026) incisors. In addition, patients affected by BCLP had statistically significantly decreased thickness measurements for the variables subnasale (P=0.005) and labrale superior (P=0.026) compared with the controls. The most predictive variables were found at U1-SN (r=0.417, P=0.004), IMPA (r=0.368, P=0.010), and ANB (r=-0.297, P=0.031) for subnasale and U1-SN (r=0.284, P=0.038) for labrale superior. The BCLP group showed greater vertical growth, greater retrusion of the maxilla and the maxillary and mandibular incisors, and decreased subnasale and labrale superior thicknesses compared with the well-matched controls without clefts. These differences should be taken into account when planning orthodontic and orthognathic surgery treatment for those patients.

Facial soft tissue thickness in the Brazilian population: New reference data and anatomical landmarks

Facial soft tissue thickness measurement can be useful among several medico-legal techniques that aim to establish the identity of skeletal remains. This study examined the soft tissue thickness that covered the faces of autopsied cadavers sent to the Medico-Legal Institute of Guarulhos from September 2010 to September 2011. Forty-nine anatomical facial landmarks were measured in cadavers less than 24h after death; these data were analysed using two-tailed t-tests. This project was approved by an ethics committee. One hundred cadavers were studied (74 males and 26 females). A majority of these individuals had died between 41 and 60 years old. Of the 49 anatomical landmarks, only five differed between the sexes (i.e., p-value less than 0.05): upper lip margin (p=0.006), superior labial sulcus (p=0.006), stomion (p=0.001), right lateral orbit (p=0.008), and left cheilion (p=0.009). The inclusion of additional anatomical landmarks allowed us to establish more precise facial thickness parameters that have the potential to be applied to cadaver facial approximations in Brazil; furthermore, some anatomic landmarks presented a higher discriminant power with regard to sex.

Influence of sex and body mass index on facial soft tissue thickness measurements of the northern Chinese adult population

Forensic facial reconstruction is a mixture of science and art, as it attempts to reestablish the contours of the soft tissues over the skull. From a forensic point of view, identification of an unknown body relies heavily on this visual aspect of recognition. To obtain acceptable results in forensic facial reconstruction, accurate facial soft tissue thickness data are essential. Until now, despite numerous works related to soft tissue thickness, there is little information in this area for the Chinese population. To this end, this study developed soft tissue thickness data for the Chinese adult population. Spiral computed tomography (CT) data and the body mass index (BMI) of 200 northern Chinese aged 18–32 years were collected. Soft tissue thickness measurements at 20 anthropological landmarks on the skull were taken, based on the three-dimensional models of the skull and face reconstructed from the spiral CT data of each subject. Considering the sex and BMI of the individuals, general descriptive analyses of soft tissue thickness were determined. Statistical analyses were performed between males and females in each BMI group, as well as between each of the BMI categories for males and females, respectively. The results revealed that males have thicker soft tissues than females at most of the anthropological landmarks in the Chinese population, similar to other populations. However, only one-third of these differences were statistically significant between males and females. Taking into consideration the nutritional status, the soft tissue thickness measurements increased with increased BMI levels for both sexes at each landmark, and the statistically significant differences were depicted between the different BMI categories at most of the landmarks. In conclusion, this study has provided useful reference points of the adult northern Chinese population for forensic facial reconstruction, and recommends that the nutritional status of the subject be considered during skull reconstruction procedures.

The variation of facial soft tissue thickness in Iraqi adult subjects with different skeletal classes (A comparative cephalometric study)

Background: The variation of facial soft tissue thickness is an important factor in facial reconstruction and superimposition methods in forensic dentistry as well as for orthodontist and plastic surgeons because they provide the basis for quantification and repeatability. The purpose of this study was to compare facial soft tissue thickness of Iraqi patients with different types of skeletal relations. Materials and method: Lateral cephalometric study was conducted on 60 adult Iraqi patients with normal vertical dimensions (diagnosed clinically and radiographically as SN-Mandibular Plane angle 28○-36○), aged 18-30 years, classified according to skeletal sagittal relationship using ANB angle into three groups (each group consist of 10 male and 10 female subjects): Class I group (ANB2-4○), Class II group (ANB>4○) and Class III group (ANB<2○). Cephalometric analysis of soft tissue thickness was achieved by 10linearmeasurements using AutoCAD program 2007. Results and Conclusions: This study showed that the facial soft tissue thickness measurements were significantly higher in male than in female in almost all measured midline landmarks, in comparing the three skeletal relation groups, Class III group show the highest readings when compared to Class I and Class II, Class II show the lowest results among the three groups (except for the labiomental fold area and pogonion area), while Class I group lies between the other two groups for all the measured values.