Soft Tissue Cephalometric Analysis Research Articles

Adaptive Planning and Overcoming Pitfalls in Asian Rhinoplasty

Background This anthropometric planning is devised for surgeons who assess the esthetic perspectives in Asian rhinoplasty and to provide an easy clinical method us- ing two dimensional photograph. And specific planning in Asian secondary rhinoplas- ty are also depicted accordingly. Method & Discussion In order to use a 2-dimensional digital photograph as a tool for the soft tissue cephalometric analysis (STCA) the surgeon can subjectively rotate the photograph to decide the ideal landmarks. Once this is done, consultation and plan- ning begins. Complicated concepts can be simplified and adaptive ideal points need- ed in rhinoplasty can be determined according to the Asian concepts of beauty so that it will be used under a clinical setting. Initiation of planning starts by identifying the ideal Sellion and Subnasale, thus, determining the length of the nose. Determi- nation of these two points is the foremost important step in planning. Thereafter, an ideal Tip forms naturally from the nasofrontal angle and the columellar-labial angle. Even with the well performed preoperative planning, the shortcomings in secondary Asian rhinoplasty, such as unexpected scar, may be totally different pitfalls to over- come. Conclusions With two-dimensional digital photograph and simplified planning in STCA, planning ideal points will bring clarity to a relatively different planning process from western rhinoplasty for surgeons undertaking primary or secondary Asian rhi- noplasty.

Facial Soft Tissue Cephalometric Norms in a Central Indian Ethnic Population

Aim: Based on Arnett's soft tissue cephalometric analysis (STCA), the present study aims to establish cephalometric norms for central Indian population and any significant sexual dimorphism. Materials and methods: The digital lateral cephalograms of 100 adults (50 males and 50 females) between the age group of 17 to 25 years with normal occlusion and well-balanced faces were obtained. These radiographs were manually traced according to Arnett's STCA. The obtained values were statistically analyzed to establish STC norms for central Indian population. Results: Significant differences were observed in the lateral cephalometric norms between the central Indian and the white samples. Also significant sexual dimorphism was noted between males and females of the central Indian sample. Conclusion: Ethnic differences exist between central Indian and white sample which should be considered when formulating an orthodontic treatment plan for Indian population.

The Impact of Extraction vs Nonextraction Treatment on Soft Tissue Profile in Borderline Class I Malocclusion: A Cephalometric Study

Introduction: The continuous controversy concerning extraction of premolar teeth and its supposed effects on the facial profile led to the origin of this study, which compares the pretreatment and post-treatment facial profiles of patients who underwent premolar extraction with those of patients who did not undergo extraction. Objective: To analyze the soft tissue changes between the two different treatment groups, equally susceptible to both treatment options (extraction and nonextraction) and to compare the changes taking place in the soft tissue variables from one group to another using the cephalometric analysis. Materials and methods: The diagnostic extraction and treatment decisions were based on a total space analysis with differential extraction protocols. The pretreatment and posttreatment cephalograms of the borderline sample (100 female patients, 50 of the patients were treated with premolar extraction and 50 were treated without premolar extraction) were then subjected to a thorough soft tissue cephalometric analysis. Results: The results indicated that the three variables that played the most important role in the clinician’s treatment decision were indicators of lower crowding, soft tissue convexity and lower incisor protrusion. Significant differences (p < 0.05) regarding upper and lower lip protrusion, upper lip thickness (p < 0.05) and the nasolabial angle (p < 0.05) occurred after treatment. Conclusion: Extraction treatment of Class I borderline malocclusions led to significant soft tissue changes in relation to the upper and lower lip position and thickness as well as the nasio labial angle, whereas the nonextraction treatment resulted in significant upper lip retraction and lower lip protraction.

Soft Tissue Esthetic Norms for Mahabubnagar Population of Southern India

The Aim of the study was to establish Soft Tissue Cephalometric Norms for skeletal and dental relationships amongst the Mahabubnagar adult population. Sixty subjects (30 Males & 30 Females) subjects from different part of Mahabubnagar in the age group 18-25 Years (Mean age 21.3 Years) were selected at random for the study and lateral cephalograms were taken. All the cephalograms were traced by two operators using conventional hand tracing. The parameters used in the study were taken from Arnett and Bergman soft tissue cephalometric analysis (STCA). Overall 46 measurements including 40 linear, 6 angular parameters were used. Mean and standard deviation values were calculated. The difference between males and females were evaluated using student t-test. The values obtained from the study showed significant difference in most of the parameters from that of Arnett et al., norms and between males and females within Mahabubnagar population. Males had thicker soft tissue structures, acute nasolabial angle, increased facial lengths and heights, increased midface deficiency, recessive lower face, more convex profile and less upright mandibular incisors than females within Mahabubnagar population.

Arnett's Soft-tissue Cephalometric Analysis Norms for the North Indian Population: A Cephalometric Study

Objective: To determine the soft-tissue cephalometric norms as per Arnett’s analysis for male and female subjects of North Indian population and to compare these cephalometric norms with Arnett’s norms for Caucasian population. Materials and methods: Frontal and profile photographs of 150 subjects with normal occlusion and pleasing profile were rated by a panel of judges, from which 50-male and 50-female subjects were selected and their lateral cephalograms were taken for the present study. Arnett’s soft-tissue cephalometric analysis (STCA) was done on these cephalograms using Nemotech cephalometric software. Mean values of various parameters were obtained and these values were compared to Arnett’s norms for Caucasian population using Student t-test. These values were also compared among males and females of North Indian population. Results: High overjet, thicker soft-tissue, less facial length, retruded lower face and midface and convex profile were observed in the North Indian population as compared to Caucasian population. Males of North Indian population have thicker soft-tissue structures, more acute nasolabial angle, longer faces and more deep-set facial structures than females whereas females have greater interlabial gap and maxillary incisor exposure. Conclusion: Statistically significant differences in certain parameters were found between North Indian population and Caucasian population and also between males and females of North Indian population.

Residents' journal review

Residents' journal review

Soft tissue cephalometric analysis applied to regional Indian population

Introduction:Importance of soft tissue consideration in establishing treatment goals for orthodontics and orthognathic surgery has been recognized and various cephalometric analysis incorporating soft tissue parameters have evolved. The great variance in soft tissue drape of the human face and perception of esthetics exists and normative data based on one population group cannot be applied to all. The study was conducted to compare the standard soft tissue cephalometric analysis (STCA) norms with norms derived for population of western Uttar Pradesh region of India.Materials and Methods:The sample consisted of lateral cephalograms taken in natural head position of 33 normal subjects (16 males, 17 females). The cephalograms were analyzed with soft tissue cephalometric analysis for orthodontic diagnosis and treatment planning, and the Student's t test was used to compare the difference in means between study population and standard STCA norms.Results:Compared with established STCA norms, females in our study had steeper maxillary occlusal plane, more proclined mandibular incisors, and less protrusive lips. Both males and females showed an overall decrease in facial lengths, less prominent midface and mandibular structures and more convex profile compared with established norms for the White population.Conclusions:Statistically significant differences were found in certain key parameters of STCA for western Uttar Pradesh population when compared with established norms.

Reliability of Soft Tissue Analysis in Conventional and Digital Cephalographs

Aims: This study compared the reliability of measurements of soft tissue cephalometric analysis be- tween the direct digital and conventional cephalometric images using computerized cephalometric pro- gram and hand tracing. Materials and Methods: The adult sample consisted of (30) Iraqi subjects (females and males) with age ranged 18 - 25 years old, the samples satisfied the criteria of this study. Nine soft tissue measurements were recorded from lateral cephalometric radiographs using either hand tracing or digitally directly on the monitor. The data were analyzed using descriptive statistic and stu- dent's t-test. Results: No significant differences were found between the conventional or hand tracing and digital cephalometric analysis. Conclusions: The analysis of soft tissue profile using digital cepha- lometric analysis is reliable as using the conventional method. Yet, the digital method had more benefit than the conventional method, such as reduction of the radiation dose and the image enhancement.

Soft Tissue Cephalometric Norms for Orthognathic and Cosmetic Surgery

Proportionality of the lower and middle thirds of the face is a key determinant of successful orthognathic treatment. A flatter profile and marked variance of the soft tissue envelope in the Japanese population complicates the accurate assessment of these proportions. This study aimed to identify gender differences and establish norms for Japanese young adults using the method of soft tissue cephalometric analysis (STCA) by Arnett et al (Am J Orthod Dentofacial Orthop 116:239, 1999). Lateral cephalograms of 49 young normal Japanese subjects (19 men, 30 women) were selected from the archival records and analyzed with STCA. The Student t test was used to compare mean values of the male and female groups. Significant differences were found between women and men. Men had a flatter occlusal plane and a more acute nasolabial angle than women. Men showed larger values for upper and lower lip thickness, menton soft tissue thickness, and vertical face length, especially in the lower third of the face. Women had a more projected midface than men. Compared with established STCA norms, the Japanese have more midfacial projection. Significant gender differences were found in the thickness, lower third length, and midface projection in Japanese young adults, which should be taken into account when interpreting measurements for orthognathic surgical planning. These differences can serve as norms for STCA in young Japanese adults. Differences were noted between the reference values of Arnett et al and Japanese subjects.

Three-dimensional Determination of Dental Occlusion and Facial Structures using Soft Tissue Cephalometric Analysis

A high accuracy 3D structured-light scanning system and method for integration of 3D digital dental cast models and human face model is proposed. The original two cameras and DLP projector system for surface 3D reconstruction is designed. The techniques for alignment of 3D human face model with the 3D dental cast models according their location and orientation in a mouth is presented. This technique allows evaluation of morphological parameters used for treatment planning and gives to a dentist new effective and convenient means for teeth occlusion study and documenting. This system is useful objective tool for medical tasks solution and further investigations are required in order to confirm effectiveness in orthodontic patients care. Ill. 5, bibl. 8 (in English; abstracts in English and Lithuanian).DOI: http://dx.doi.org/10.5755/j01.eee.121.5.1658

Soft-tissue cephalometric norms for north Indian Mongoloids

IntroductionHarmonious facial esthetics and functional occlusion have long been recognized as the two most important goals of orthodontic treatment. The purpose of this study was: (1) To establish soft tissue cephalometric norms for Mongoloid tribes of north India using Holdaway analysis. (2) To study the sexual dimorphism in soft tissue cephalometric norms of this population. (3) To compare the norms obtained in this study with Holdaway norms. MethodsLateral cephalometric radiographs of 60 north Indian Mongoloid subjects (30 male, 30 female) in the age group of 18–25years with normal occlusion and well balanced faces were used. The cephalograms were analyzed with Holdaway soft tissue cephalometric analysis. Unpaired t-test was used to compare results obtained for Mongoloid subjects with Holdaway norms and to determine sexual dimorphism. ResultsStatistically significant differences were found for nose prominence, superior sulcus depth, soft tissue subnasale to H-line, basic upper lip thickness, max incisor to upper lip, H-angle, lower lip to H-line and soft tissue chin thickness. In comparison of sexes, statistically significant differences were found for basic upper lip thickness, max incisor to upper lip and H-angle. ConclusionThese results show that the soft tissue facial profile of north Indian Mongoloid subjects and North-Europeans are different. These racial differences must be considered during diagnosis and treatment planning.

Appraisal of the cephalometric norms for the upper and lower lips of the South Indian ethnic population

Aim:The guidelines for planning an improvement in the facial appearance till recently existed in the form of evaluation of linear and angular parameters and ratios related to the hard tissues in the various cephalometric analyses. The present study aimed at establishing Arnett et al.'s norms of the upper and lower lip for the local population and assessing the extent by which these differ from the original norms proposed by Arnett et al.Materials and Methods:Forty pretreatment lateral cephalograms (20 males and 20 females) with normal occlusion and well-balanced face were chosen for this study. Upper and lower lip lengths, thicknesses, and chin thickness were all measured according to soft tissue cephalometric analysis by Arnett et al.Results:The obtained data were statistically analyzed and compared with other studies.Conclusion:Males had thicker and longer upper and lower lips when compared to females, but they were comparatively thinner than the results of Arnett et al. Females had more interlabial gap than males. The difference in soft tissue parameters in different ethnic groups shows the importance of defining what is optimal for a particular group.

Poster 31: Lower Facial Soft Tissue Cephalometric Analysis of the Elliptical Window Genioglossus Advancement Osteotomy in Treatment of Obstructive Sleep Apnea

Statement of the Problem: Some procedures for the surgical treatment of obstructive sleep apnea significantly change the lower facial profile of the patient. The elliptical window genioglossus advancement osteotomy is designed to maintain the pre-surgical facial profile while advancing the base of tongue to alleviate nocturnal obstruction during sleep. This study sought to determine the significance of facial profile soft tissue changes involved with this procedure.

Standards of soft tissue Arnett analysis for surgical planning in Turkish adults

The aims of this study were (1) to establish standards for Arnett soft tissue cephalometric analysis of Anatolian Turkish young adults and (2) to identify possible gender differences between males and females. After analysing the cephalometric radiographs of 350 individuals, 133 subjects (67 males, mean age 22.6 +/- 2.2 years, and 66 females, mean age 22.1 +/- 2.6 years) with normal antero-posterior and vertical skeletal relationships were selected. The true vertical line was established. The landmarks were marked and soft tissue facial analysis was performed. For statistical evaluation, an independent-samples t-test was used. The lower lip thickness of the Turkish population was lower and menton thickness was greater than Arnett's norms. Turkish subjects have depressed orbital rims, cheek bones, subpupils, upright and thin upper and lower lips, retruded incisors, and pogonion and point B. Most of the Turkish mean harmony values were within the range of Arnett's harmony standards. Soft tissue thicknesses were greater and facial lengths, except upper incisor exposure, were longer in Turkish males than females. These differences between ethnic groups should be taken into consideration when formulating orthodontic/orthognathic treatment plans for patients with dentofacial deformity.

Estudo comparativo entre a Análise Facial Subjetiva e a Análise Cefalométrica de Tecidos Moles no diagnóstico ortodôntico

OBJETIVO: avaliar a concordância entre a Análise Facial Subjetiva, proposta por Capelozza Filho, e a Análise Cefalométrica de Tecidos Moles, de Arnett e McLaughlin. MÉTODOS: fotografias de frente e de perfil e telerradiografias em norma lateral padronizadas de 50 indivíduos, com média de idade de 24 anos e 1 mês, foram utilizadas para essa avaliação. Verificou-se, também, nos indivíduos classificados como Padrão I, a correspondência dos valores médios e desvios-padrão das medidas obtidas com os valores normativos da Análise Cefalométrica de Tecidos Moles para os indivíduos com harmonia facial. RESULTADOS: constatou-se, em indivíduos do Padrão I, que os lábios sempre se encontram à frente da Linha Vertical Verdadeira e que, apesar de grandes variações do ponto pogônio, o equilíbrio facial ainda se mantinha. CONCLUSÃO: os resultados demonstraram que a Análise Facial Subjetiva é um método eficiente na classificação do padrão facial.

Soft-tissue cephalometric norms in a South Indian ethnic population

An esthetically pleasing smile is a key determinant of successful orthodontic treatment and patient satisfaction. The great variance in soft-tissue drape of the human face complicates accurate assessment of the soft-tissue profile. Variability is also characteristic of different faces and facial types, and normative data based on 1 population group do not represent all. This study was undertaken to establish norms for a South Indian ethnic population. The sample comprised lateral cephalograms taken in natural head position of 60 normal subjects (30 men, 30 women). The cephalograms were analyzed with a soft-tissue cephalometric analysis for orthodontic diagnosis and treatment planning, and the Student t test was used to compare the means of the 2 groups. Statistically significant differences were found between South Indian men and women in certain key parameters. Men have thicker soft-tissue structures and a more acute nasolabial angle than women. Men have longer faces, and women have greater interlabial gap and maxillary incisor exposure. Men have more deep-set facial structures than women. Compared with established norms for white people, South Indian subjects have more deep-set midfacial structures and more protrusive dentitions. Statistically significant differences were found between South Indian men and women in certain key parameters. Differences were also noted between white and South Indian faces.

Orthognathic surgery: an art or a science!! Evaluation of soft tissue changes using Burstone analysis

The major goal of orthognathic surgery is establishment of balanced and stable dentofacial complex. An important aspect of this end is achievement of an aesthetically pleasing facial soft tissue profile which is functionally acceptable. Treatment planning for patients who require orthognathic surgery should include both hard and soft tissue cephalometric analysis. Although a hard tissue analysis will show the nature of existing skeletal discrepancy, it is incomplete in providing information concerning the facial form and proportion of the patient and in many instances may actually be misleading.

Presentation and validation of a voxel-based three-dimensional (3-D) hard and soft tissue cephalometric analysis

Presentation and validation of a voxel-based three-dimensional (3-D) hard and soft tissue cephalometric analysis

ORIGINAL ARTICLE: Soft tissue cephalometric analysis: Diagnosis and treatment planning of dentofacial deformity

This article will present a new soft tissue cephalometric analysis tool. This analysis may be used by the orthodontist and surgeon as an aid in diagnosis and treatment planning. The analysis is a radiographic instrument that was developed directly from the philosophy expressed in Arnett and Bergman “Facial keys to orthodontic diagnosis and treatment planning, Parts I and II” (Am J Orthop Dentofacial Orthod 1993; 103:299-312 and 395-411). The novelty of this approach, as with the “Facial Keys” articles, is an emphasis on soft tissue facial measurement. (Am J Orthod Dentofacial Orthop 1999;116:239-53)

Aesthetic Guidelines in Genioplasty

It has been demonstrated previously that many individuals requesting chin enlargement have small or retruded mandibles. A weak chin may be only one aspect of this particular class II skeletal deformity, the other components being a procumbent, retrusive lower lip, excessive labiomental fold depth, and decreased to normal lower face height. To avoid unaesthetic results, the chin should not be advanced beyond the retrusive lower lip, the only component over which osseous genioplasty has no control. This may result in residual sagittal "weakness" of the lower face, for which visual compensation can be achieved by vertical overelongation of the chin. Thirty-two patients requesting chin enlargement presented with the aforementioned class II deformity. Twenty patients had decreased lower face height and 12 patients had normal lower face height. Preoperative soft-tissue cephalometric analysis documented physical findings. The extent of sagittal chin movement was planned to advance the soft-tissue pogonion no further than the lower lip. Vertical chin movement was intentionally designed to overelongate the lower face relative to the midface in all patients. Radiographs were repeated at a mean 8.2 months following surgery to document skeletal displacements. Mean chin advancement was a modest 4.2 mm (2- to 7-mm range), and chin vertical displacement was a mean 7.9 mm (5.5- to 9-mm range). All patients had residual sagittal disproportion of the pogonion relative to the subnasale (-7.6 mm mean) and newly created vertical disproportion with mean lower face heights of 69.8 mm compared with mean midface heights of 64 mm.(ABSTRACT TRUNCATED AT 250 WORDS)