Interalar Distance Research Articles

Long-Term Nose Evaluation After Treatment of Bilateral Cleft Lip Using the Spina Technique.

Bilateral cleft lip (BCL) repair is a challenge due to anatomic and functional distortions, worse than unilateral cleft. With regard to the nose, BCL can result in certain characteristics, such as a short columella, a flattened and widened tip, and horizontally oriented nostrils. Lip and nose treatment is advocated by some surgeons to achieve a better outcome. One of the techniques used to treat this condition is the one recommended by Victor Spina, in a complex protocol involving more than one surgical procedure and long-term follow-up. The aim of this study is to evaluate the growth of the nose in patients treated using the Spina technique. This was a retrospective and analytical study of the medical records of patients who were treated using the Spina technique at the Assistance Center for Cleft Lip and Palate (CAIF) at Hospital do Trabalhador in Curitiba, Brazil. Anthropometric measurements of interalar distance and nose tip projection were made from frontal and submental photographs taken at three moments: pre-first surgery, pre-definitive surgery, and late follow-up. Furthermore, other analyzed parameters were: sex, date of birth, age at time of surgery, and late follow-up. With these data, a comparison of nose growth was made between patients with BCL and a population without craniofacial anomalies observed in a study by FARKAS et al (1992). The comparison also took sex and age variables into account. Regarding the interalar distance measurements, both sexes showed a widening of the nose before starting treatment. This widening was maintained throughout follow-up. The growth curve, in turn, remained similar among males, with an average growth rate of only 3.2% higher in patients with BCL. Among females, the difference was one of 16.92%. In terms of nasal tip projection, there was an average increase of 1.12cm (86.15%) in males and 0.69cm (57.02%) in females. It was possible to notice a nasal growth rate in those with BCL similar to the normal pattern and a significant improvement in nasal tip projection in male patients. However, with regard to the data of both sexes, but especially females, the low number of patients jeopardized the significance of the results.

Three-Part Analysis for Designing Nasal Alar Reduction Surgery in Asian Patients.

The external nasal alar reduction can be associated with many complications, such as nostril malformation and significant scarring. The authors proposed a 3-part analysis method for the design of nasal alar reduction surgery with the aim of improving nasal alar morphology more precisely. The 3-part analysis was based on the patient's flared nose, wide nasal base, and drooping ala, respectively. We included 20 patients who underwent this surgery between January 2021 and January 2022. The visual analog scale (VAS) and the Stony Brook Scar Evaluation Scale (SBSES) were used to assess postoperative scar outcomes. The preoperative and postoperative ratios of the interalar distance to intercanthal distance and nostril shape were analyzed. Patient-reported satisfaction with the esthetic outcome was also assessed. All operations were successfully completed. There were no postoperative complications, such as wound infection or skin necrosis. Both VAS and SBSES assessment of postoperative scarring suggested keloid hyperplasia at 3 months postoperatively. At 12 months postoperatively, the scarring was insignificant and improved significantly over 3 months postoperatively. The mean ratio of the interalar distance to intercanthal distance decreased significantly from 1.15 preoperatively to 1.01 postoperatively (P<0.05). The shape of the patient's nostrils was also significantly improved after surgery compared with the preoperative period. Patient-reported satisfaction after surgery was high at long-term follow-up. The 3-part analysis to design an external nasal alar reduction procedure can accurately improve the morphology of nasal flaring, excessively wide nasal alar base, and nasal ptosis in Asian patients. IV.

An anthropometric assessment method for facial profile determination in forensics

Objectives: It is extremely difficult for forensic experts to identify the individuals, especially during mass disasters and natural calamities such as earthquakes. In most cases, the facial profile is completely destroyed and the dentition is the only source or tool which helps in identifying the individuals and their gender. The aim of this study was to evaluate and correlate inner intercanthal distance (IICD), outer intercanthal distance (OICD), interalar distance (IAD), and bizygomatic width (BZW) to the maxillary intercanine distance (MICD) to determine facial profile and gender. Material and Methods: The study was carried out after informed consent and involved 100 subjects who satisfied the inclusion criteria. Five parameters were measured: IICD, OICD, IAD, BZW, and MICD using digital Vernier caliper. The data were summarized in table form and were statistically analyzed using Pearson correlation. Results: OICD was more in females, whereas MICD was more in males. Significant correlation was observed between IICD and BZW (r = 0.224, P = 0.014), IICD and IAD (r = 0.411, P = 0.001), BZW and MICD (r = 0.229, P = 0.022), and IAD and MICD (r = 0.247, P = 0.013); negative correlation was observed between OICD and MICD (r = −0.023, P = 0.818). Conclusion: MICD can be used as a tool for the determination of facial profile and gender, although a larger sample size is required for further study.

Use of custom silicone putty for nasal tube stabilisation in orthognathic surgery

Orthognathic surgery typically contraindicates standard oral intubation techniques. Nasal intubation may distort the nasal profile thus complicating orthognathic surgery involving the midface. Using silicone putty to stabilise the tube in a custom position may minimise these changes. A prospective analysis was undertaken of patients undergoing nasal intubation with and without silicone putty stabilisation. Pre- and post-intubation measurements were made of nasolabial angle and interalar width. Silicone putty significantly reduced the changes of nasal intubation on nasolabial angle (p < 0.001) but did not affect interalar distance (p > 0.05). Silicone putty should be considered to stabilise the nasotracheal tube in orthognathic surgery.

A New Definition for Alar Flare Based on "Alar Flare Angle".

An accurate diagnosis and an appropriate treatment are important parts of successful rhinoplasty. We proposed a new definition for alar flares to guide our clinical work. A retrospective study was conducted on patients with alar flares from July 2017 to July 2021, and the follow-up time ranged from 12 to 27 months, mean of 16 months. We defined the alar flare angle by the formation of two lines: the line that connects the alar to the alar root point and line that connects the alar to the pronasale. The alar flare angle, interalar distance and nasal base width were measured, and alar wedge excision or alar base excision and tip elevation were performed. Scars, complications and satisfaction scales were evaluated after surgery. Through an analysis of the database, we found that the ideal alar flare angle was between 130 degrees and 140 degrees. If it was less than 130 degrees, it represented alar flares, and patients asked for alar surgery. A total of 33 patients were included. All patients underwent tip elevation, 12 patients underwent external alar wedge excision, and 5 patients underwent external alar wedge excision and alar base excision. External alar wedge excision can be used to completely correct alar flares, and in our study, the alar flare angles were more than 130 degrees after surgery. One patient complained of an acceptable scar, and there was no infection or alar deformity. All patients were satisfied. We proposed a new definition in which an alar flare angle less than 130 degrees can be diagnosed as an alar flare. This new definition is valuable for the clinical diagnosis and treatment of alar flares. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Prediction of root canal lengths and pulp volume of the maxillary permanent first molar based on stature, crown diameters, and facial morphometry.

This study purposed to develop statistical models to predict palatal (PRL), mesial (MRL), and distal (DRL) root canal length and pulp volume (PV) of the maxillary first permanent molar using stature, gender, mesiodistal (MD), and buccopalatal (BP) crown diameters and some facial morphometries. 57 individuals were included in the study. Cone beam computed tomography was used to measure root canal lengths and PV. The PV calculation was carried out using the software ITK-SNAP 3.4.0. PRL was positively correlated with BP, stature, middle facial height, interalar distance, and bicommissural distance (BCD) (p < 0.05). DRL was positively correlated with BP, MD, and stature (p < 0.05). MRL was positively correlated with BP, MD, stature, lower face height, bizygomatic distance, and BCD (p < 0.05). PV was negatively correlated with age and BCD (p < 0.05). Although all models have significant predictive power for the root lengths and PV, no model could explain variances greater than 30%. The highest and lowest predictive ability was obtained for PRL and DRL, respectively. While the most significant predictor was BP for PRL and DRL, it was the age for PV.

Quantifying the Selection of Maxillary Anterior Teeth Using Extraoral Anatomical Landmarks.

Background: Regardless of skin color, age, sex, or other factors, all beautiful faces follow the divine proportion. Proportions of face components appear to play a role in facial attractiveness.Aim: The study determines the correlation between the mesiodistal width of anterior maxillary teeth, inter-canthal distance, inter-alar distance, and inter-commissural distance as a criterion for selecting anterior maxillary teeth.Material and Methods: A cross-sectional study was carried out at the institutional level with a sample size of 200 participants with 100 male and 100 female participants. Inter-canthal distance, inter-alar distance, and inter-commissural distance were measured using the digital caliper and a customized silver scale to measure the mesiodistal width of anterior maxillary teeth. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 24.0 (IBM Corporation, Chicago, USA). Pearson's correlation test calculated the correlation coefficient, and the level of significance was kept at p<0.05.Result: The width of the maxillary anterior and the inter-canthal gap showed a strong positive correlation, the inter-alar difference and the mesiodistal width of anterior teeth showed a moderately positive correlation, and the estimated inter-commissural width and the mesiodistal width of anterior teeth showed a strong positive correlation (p<0.05).Conclusion: These parameters are correlated to the dimensions of the tooth size and can act as a guide while selecting the teeth for future rehabilitation treatment when the natural teeth are lost.

Upoređivanje morfoloških parametara lica kod populacije sa punim zubnim nizom

Introduction: The analysis of facial parameters in young people with a full dental arch is an assessment of the representation of certain anthropological features in the Serbian geographical area, but also a starting point for their reconstruction after tooth loss in order to achieve the maximum therapeutic and aesthetic effect. Aim: The aim of the work was to measure and compare facial parameters among respondents with a complete dental arch. Material and methods: 91 dental students participated in the research, 32 (35.2%) male and 59 (64.8%) female. The average age of the respondents was 22.16±1.53 years. The length and width of the face were measured, as well as the vertical and horizontal parameters, and the facial index was calculated. Results: Men had a significantly longer (Z=4.567; p&lt;0.001) and wider face (Z=5.962; p&lt;0.001) compared to women. There was no significant difference in the face index between women and men (ch 2 =2.492; p=0.666). There was also no significant difference in the vertical analysis of the face according to gender (ch 2 =0.065; p=0.798). In the majority of subjects, the shorter middle third of the face was measured. In the case of the expected division of the lower third of the face, it exists in a significantly greater extent in males (ch 2 =5.989; p=0.014). In the majority of subjects, the intercanthal width corresponded to the width of the eye, in both sexes, without statistical significance. Further, in a significantly larger number of male and female respondents, it was determined that the bipupillary corresponds to the intercommissural distance. The interalar distance corresponding to the width of the eye was more significantly present in women (ch 2 =5.002; p=0.025). Conclusion: Measurement of facial parameters can significantly improve dental therapy by enabling optimal aesthetic performance.

The Relationship of Facial Measurements with the Mesiodistal Width of the Maxillary Anterior TeethWidth of the Maxillary Anterior Teeth

The relationship between facial measurements and the size of the maxillary anterior teeth in the Malaysian population is still a point of contention. Objective: The purpose of this study was to establish a relationship between facial measurements and the mesiodistal width of the maxillary anterior teeth (MDW), which could be used to guide the selection of anterior teeth for complete denture construction. Methods: The facial and dental measurements were obtained directly from 170 Malay adults aged between 19 to 35 who had morphologically normal permanent maxillary anterior teeth from canine to canine. The facial dimensions measured were interpupillary distance (IPD), intercanthal distance (ICD) and interalar distance (IAD). The facial dimensions were measured using a digital vernier calliper while the mesiodistal width of the maxillary anterior teeth was measured with a flexible ruler. The three facial dimensions were correlated with MDW for both genders. Results: The IPD and IAD were significantly (p&gt;0.001) larger in males (IPD: 68.30±4.24mm; IAD: 39.60±2.54mm) than in females (IPD: 65.93±3.91mm; IAD: 36.96±2.29). There was no significant correlation between any of the facial dimensions and MDW in males or females. Conclusion: For the studied population, the interpupillary, intercanthal, and interalar distances may not be used as reliable guides when determining the size of maxillary anterior teeth in complete denture construction

Correcting Wide Alar Base and Flare With Combined Sill and Alar Excision in Asian Patients.

Obvious scar and deformities are commonly observed with incision anterior to the alar-facial groove in alar excision surgery. The authors explored modified sill and alar excision to correct wide alar base and flare synchronously and decreased incident of unacceptable scar and deformities in Asian patients. The authors conducted a retrospective cohort study including 52 consecutive patients undergoing this surgery. Contrary to previous studies, the incision for alar excision was located in the alar-facial groove and was closed by intracutaneous suture. Scars were assessed with visual analog scale and the Stony Brook Scar Evaluation Scale. Ratio of the interalar distance to intercanthal distance, nostril shape, and nostril symmetry was recorded. The mean follow-up time was 18 months. Visual analog scale results showed 50 patients (96.2%) reported unnoticeable scar and 2 noticeable but acceptable scar. Stony Brook Scar Evaluation Scale results indicated 49 patients (94.2%) with good scar outcomes and 3 (5.8%) with moderate scar outcomes. The mean ratio of interalar distance to intercanthal distance reduced significantly from preoperative 1.10 to postoperative 1.02. The frequency of horizon-shaped nostrils changed from preoperative 16 cases (30.8%) to postoperative 2 cases (3.8%). The frequency of the pear-shaped (preferred shape) nostrils improved from preoperative 15 cases (28.8%) to postoperative 26 cases (50.0%). The frequency of symmetrical nostril shape improved from preoperative 36 patients (69.2%) to 42 (80.8%). There were no patients with complications like alar deformities, and patients' dissatisfaction. When performing sill and alar excision in Asian patients, the authors recommended a modified approach with the incision for alar excision being placed in the alar-facial groove and closed by intracutaneous suture, which can avoid obvious scar and deformities in Asian patients.Level of evidence: Level 4.

Correlation of intercanthal and interalar distance to intercanine distance for selection of maxillary ant. teeth

Background: Maxillofacial region’s reference points like interpupillary distance, intercanthal distance, interalar distance and bizygomatic width can significantly contribute toward reconstruction of two-dimensional (2D) facial profiles. Aim: To find correlation between intercanthal to intercanine and interalar to intercanine distance for maxillary anterior teeth selection. Methodology: This study was conducted at de’ Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore from 29-08-2013 to 28-04-2014. Sampling technique was non-probability purposive. 200 subjects are estimated for correlation of intercanthal distance to intercanine distance and correlation of interalar distance to intercanine distance as r=0.302. Results: Out of 200 cases, 102(51%) were 20-40 years of age while 98(49%) were ranging between 41-60 years of age, mean±SD was calculated as 41.01±11.90 years, 135(67.5%) were male and 65(32.5%) were females, correlation among maxillary intercanine distance with other facial land marks shows the distance of intercanine was 37.26±3.91, it was 41.26±4.57 for interalar and 34.50+2.51 was recorded for intercanthal, the value of R2, the coefficient of determination, is 0.0893 for intercanine to intercanthal and 0.0018 for intercanine to interalar. Conclusion: We concluded that intercanthal distance to intercanine distance is more correlated as compared to interalar distance to intercanine distance in Pakistani population. Keywords: Maxillary anterior teeth, intercanthal distance, intercanine distance, interalar distance, correlation

Indications for Preservation Rhinoplasty: Avoiding Complications.

Nasal dorsal preservation surgery was described more than 100 years ago, but recently has gained prominence. Our objective is to show the surgical technique, the main indications and counterindications, and the complications. It is a technique that does not cause the detachment of the upper lateral cartilage (ULC) from the nasal septum, and has the main following sequence: preparation of the septum and its resection can be at different levels (high or low, i.e., SPAR [septum pyramidal adjustment and repositioning] A or B); preparation of the pyramid; transversal osteotomy; lateral osteotomy(s); and septopyramidal adjustment. The result is a nose with a lower radix than the original, a deprojection of the nasal dorsum tending to maintain its original shape; an increase in the interalar distance (IAD) and enlargement of the nasal middle ⅓; and loss of projection of the nasal tip and roundness of the nostrils. Thus, the ideal candidate is the one who benefits from such side effects, that is: tension nose, that is, high radix with projected dorsum, projected anterior nasal septal angle (ANSA), narrow middle ⅓, narrow IAD, thin nostrils and straight perpendicular plate of the ethmoid (PPE), and, depending on the characteristics, the deviated nose. The counterindications are low radix, irregularities in the nasal dorsum, ANSA lower than rhinion, and a wide middle ⅓. And the main stigmas are: a nose with a very low radix, middle ⅓ enlarged, residual hump, and saddling of the supratip area. Other issues of this technique are: the shape of the radix; the need or not to remove PPE; wide dorsum; irregular dorsum; ANSA lower than rhinion; weak cartilages; long nasal bone; deviated PPE; and obsessive patient. We conclude that this is a great technique for noses with characteristics suitable to it; care must be taken with the stigmas it can cause.

Morphogenic correlation between facial form and intercanine width - an aid in forensic dentistry

Background: Forensic odontology is a branch of forensic dentistry that utilizes dental remains for personal identification. When facial recognition is not possible, the facial form of the person can be reconstructed with the help of teeth present and dental structures available. The teeth in the maxillary intercanine region play a vital role for the same. The intercanine width varies considerably between different populations and races and its relation with other facial parameters can be used in personal identification and even facial reconstruction. Aim: The aim of the present study is to assess the correlation between the tooth form and face form by correlating the intercanine width with other facial parameters such as interpupillary distance, interalar distance, interzygomatic distance, and intercanthus distance in the Ethnic Tamil population. Materials and Methods: The study was conducted on a sample of 100 patients aged between 20 and 40 years. Five parameters, namely the intercanine width, interpupillary width, interalar distance, interzygomatic distance, and intercanthus distance was measured using a digital Vernier caliper. The data obtained were tabulated and analyzed using SPSS statistical analysis software. Unpaired t-test was used to compare the mean values of the parameters among males and females. Pearson's correlation was run to assess the relationship between the parameters and P &lt; 0.05 was considered to be statistically significant. Results: Among 100 participants, 50 were male and 50 were female. The mean intercanine width of males (35.1 mm ± 3.8) and females (33.1 mm ± 3.1), mean interzygomatic distance of males (110.8 mm ± 12.3) and females (106.7 mm ± 8.1), and mean interalar distance of males (26.2 mm ± 5.8) and females (28.3 mm ± 4.5) were found to be statistically significant. There was a significant, moderate correlation (r = −0.3; P &lt; 0.05) between the intercanine and intercanthus width in males but not in females. Conclusion: In the present study, a weak correlation existed between intercanine distance and other facial parameters. Several parameters determine the facial form and a combination of these parameters have to be considered thereby reconstruction of the face is possible for future prospectus in forensic dentistry.

Alecgrama®: Técnica segura para Alectomia – relato de caso.

Descrever uma técnica segura para redução de base alar, através ressecção da pele, diminuindo a distância inter-alar melhorando a harmonia nasal no conjunto facial. Detalhamentos de Caso: Ao longo dos anos as técnicas cirúrgicas têm evoluído muito, e não é o contrário com a Alectomia, cujo propósito é diminuição de largura da base alar. O objetivo principal foi apresentar o resultado de um caso clínico de Alectomia feito através da técnica de Alecgrama® de Algarve &amp; Oliveira (diagrama de redução das asas nasais sem comprometer a estética e função do nariz), deixando-o mais harmônico com o perfil do paciente. Foi realizada a metodologia com a descrição detalhada do caso clínico realizado, com os benefícios de contribuir indiretamente para um grupo de indivíduos que se encontra na mesma situação. Foram relacionados aspectos ainda não observados na literatura. A metodologia bibliográfica foi utilizada com revisão da literatura pertinente com base em buscas através do MEDLINE, EMBASE, LILACS e SciELO. Conclusão: A técnica cirúrgica do Alecgrama®, mostrou-se eficaz para atender os objetivos da cirurgia e dos pedidos da paciente. A reconstrução nasal através da diminuição da base alar utilizando-se procedimento adequado e minimante invasivo, atingiu as expectativas e foi condizente com o resultado funcional e estético, sem processo de inflamação e com cicatrização apropriada, mesmo com a complexidade da estrutura nasal.

Open rhinoplasty using a columellar strut: effects of the graft on nasal tip projection and rotation.

Despite the discordance in the literature concerning the effect of columellar strut grafts on nasal tip rotation, this method is often used when an increase in nasolabial angle or nasal tip projection is desired. We aimed to elucidate the change in nasolabial angles and nasal tip projections after exclusive columellar strut graft implantations and in addition to other surgical steps. Furthermore, differences in these parameters between patients with conchal and septal columellar strut grafts were investigated. A monocentric retrospective cohort study of 173 open septorhinoplasties with columellar strut graft technique, between 2006 and 2016, was conducted. The pre- and postoperative nasal tip projection, nasolabial and nasofrontal angle and interalar distance were determined and the Goode-ratio was calculated. In cases where uprotation was not specifically desired, neither nasolabial angles nor tip projections changed significantly, irrespective of whether a columellar strut graft was used alone or with additional surgical steps. If an uprotation through surgery was desired, a significant mean increase in nasolabial angle of 4.4° was achieved. Furthermore, conchal instead of septal columellar strut grafts showed significantly better results. In our study, a columellar strut graft-without any additional surgical step-does only have an improving impact on nasal tip rotations and projections, if specifically intended to by the surgeon. In other words, if the strut graft was not chosen for an uprotational intention, it did not relevantly impact on the nasolabial angleor nasal tip projection. However, in patients where an uprotation is desired, the columellar strut graft still represents a meaningful tool. Since conchal instead of septal columellar strut grafts showed better results, we suggest using them for these patients. 2b.

Implementation of Anthropometric Measurements in Anterior Teeth Selection in Two Ethnic Groups: An In Vivo Study.

ABSTRACTAim:The aim of this study was to evaluate whether there is any consistent relationship between interalar distance and six maxillary anterior teeth in two ethnic groups.Materials and Methods:Two hundred subjects (Assamese 100 and Nyishi 100) of different age and sex ranging from 18 to 33 years were identified for this study. The distance between two widest points marked on the alae of nose was measured by means of sliding digital caliper. Statistical analysis of variance was the testing method to determine whether the nasal width and intercanine distance were different in various racial groups.Results:The mean nasal width dimension in Assamese group was 36.38 mm (range 28.55–50.00 mm). The mean nasal width dimension in Nyishi group was 35.73 mm (range 31.34–41.90 mm). For the nasal width, no significant difference was observed between two races. For the canine cusp tip to cusp tip distance, the mean value of Assamese subjects was 43.63 mm (range 39.02–50.02 mm), whereas the Nyishi presented 41.77 mm (range 36.69–47.05 mm).Conclusion:For the two racial groups studied, the measurements of the interalar width showed a weak correlation with the canine to canine distance, not sufficiently high to be used as a predictive factor. It suggests to select wider artificial teeth. Practitioners can use ethnic norms as guides, not absolute values.

Evaluation of Results and Patients’ Satisfaction of Alar Base Resection Surgery after Rhinoplasty Operations in 15 Khordad Hospital

Background: Alar base surgery is one of the controversial issues in rhinoplasty. In this surgery the nasal base width and alar flaring is got smaller with some kind of procedures. One of these procedures is wedge resection of alar base. This procedure may accompany with either some dissatisfaction of scars and adverse effects or complications. In this study, we evaluate the patient satisfaction of scar and possible complications. Materials and Methods: A total of 120 rhinoplasty patients at 15 khordad hospital were candidates for alar base wedge resection due to broad nasal base and / or alar flaring who were chosen for this study. We recorded and examined these patients before and minimum 6 months after surgery, then evaluated these information and data, which finally, compared all the preoperation and postoperation findings. Results: Mean age of patients was 30.11 years old. The full satisfaction of scar was 85.5% (103), but 6.7% (8) of patients had not satisfaction of scar due to visible scar in their alar facial groove. The rate of nostril symmetry satisfaction was 79.2% (95) and 8.3% (10) was dissatisfied due to nostril asymmetry. There was no external valve incompetency nor alar and sill notching in our study. There was not any narrowing of nostrils as well. The mean interalar distance preoperatively was 35.88 mm, which reduced to 32.61mm of mean diameter after surgery, (P-value = 0.000). Alar flaring correction was 88% (106) which was an acceptable consequence. Conclusion: The results of present study showed that in spite of surgeons fear for scar and some common complications after alar base resection, the satisfaction rate of our patients in this study were high, and complications frequencies were low. Therefore, we advise that it is better and wiser to do this operation in indicated patients surely within primary rhinoplasty and do not postpone it to another surgery.

Alar Cinching with Subcutaneous Flaps: A Procedure to Achieve Narrowing of the Nasal Base while Controlling the Alar Axis and Sidewall Curvature.

Insufficient narrowing of alar width, alar distortion, and noticeable scarring are commonly encountered after alar base reduction. The authors aimed to demonstrate an alar cinching with subcutaneous flaps procedure to reduce the alar width while controlling the alar axis and sidewall curvature. A retrospective chart review of 560 patients who underwent alar base reduction between 2000 and 2015 was performed. The clinical outcomes of alar cinching with subcutaneous flaps were compared to those of vestibular floor excision with cinching suture. Mean change in alar width was compared to assess narrowing efficacy between the two groups. In addition, mean changes in interalar distance for the upper, middle, and lower parts of the alae were compared to evaluate the alteration of alar axes. Seventy-three patients who underwent alar base narrowing alone (alar cinching with subcutaneous flaps, n = 42; vestibular floor excision with cinching suture, n = 31) were identified. Alar cinching with subcutaneous flaps was significantly more effective than vestibular floor excision with cinching suture in reducing alar width. In patients with vertical alar axes, alar cinching with subcutaneous flaps achieved more uniform narrowing of the entire alae, resulting in prevention of alar distortion. The incidence of complications after alar cinching with subcutaneous flaps was 5.7 percent. Alar cinching with subcutaneous flaps achieved sufficient narrowing of the nasal base in the long-term follow-up in patients with any type of alar axis and enabled the reduction of sidewall curvature while eliminating the need for wedge resection. Therapeutic, III.

Relationship Between Width of Maxillary Anterior Teeth and Interalar Distance

There are few guides to estimate the size of denture teeth. The purpose of this observational cross sectional study of Iranian adults was to evaluate the relationship between interalar width compared to intercanine tip distance and to the summed width of the maxillary anterior teeth in adults. The samples were selected from dental students in Isfahan University. Interalar width was measured with calipers. Maxillary inter-canine distance was measured between cusp tips on dental casts. Mesiodistal widths of the six anterior teeth also were measured. Independent t-tests, Pearson’s correlation coefficients, and linear regression were used for statistical analysis. Mean interalar width was 36.38 mm (sd = 3.81), intercanine tip distance was 34.15 mm (sd = 2.05), and mean width of maxillary anterior teeth was 48.23 mm (sd = 2.07). There were significant associations between interalar width and summed widths of the maxillary anterior teeth and with intercanine distance. In addition, predictive equations for estimation of tooth sizes using interalar width were calculated by regression. These statistical relationships may also be useful forensically.

Correlation between Interalar Distance and Mesiodistal Width of Maxillary Anterior Teeth in Thrissur, Kerala, Indian Population.

Aims and Objectives:The aim of this study was to assess the validity of interalar distance as an aid in maxillary anterior teeth selection in Thrissur, Kerala, Indian population. The study also evaluated whether interalar distance and maxillary anterior teeth undergo any changes as age increases in this population and whether there is a gender difference in these parameters in this population.Materials and Methods:A study was planned on 1200 participants in Thrissur Municipal Corporation area, Kerala, India, with the aim of checking the validity of interalar distance as a successful aid in maxillary anterior teeth selection. The collected data were analyzed using SPSS version 21.0. Mean standard deviation and 95% confidence intervals were estimated. Student's t-test was used for comparison between gender and two age groups such as 18–25 and 40–50 years. One-way ANOVA analysis was done for combined effects.Results:The study showed that there is a high statistical significance between the interalar distance and the mesiodistal width of six maxillary anterior teeth in females (P < 0.01) and no significance in males.Conclusion:The study concluded that, within the population evaluated, there was a high significant correlation between interalar distance and the mesiodistal width of six maxillary anterior teeth in both males and females. Both interalar distance and mesiodistal width of maxillary anterior teeth showed a significant increase in size as age increases. There was a significant increase in size difference for males compared to females in relation to interalar distance and not for mesiodistal width of maxillary anterior teeth.