Soft Tissue Facial Angle Research Articles

Appraising mandibular prognathism in class III malocclusion following orthognathic surgery: Patient-reported and cephalometry-based outcomes

Patients with class III malocclusion often exhibit mandibular prognathism and complain of “prognathic appearance”. The overall positive effects of orthognathic surgery on facial appearance have been demonstrated using patient-reported outcome measures (PROMs), but studies investigating the correlation between subjective PROMs results and objective measurements of imaging studies are sparse in the literature.This study recruited consecutive patients with skeletal class III malocclusion who underwent two-jaw orthognathic surgery between January 2016 and January 2021. The PROMs survey was conducted focusing on subjective perception of mandibular appearance. Lateral cephalometric images were measured to examine the correlation with the PROMs results.A total of 96 patients were eligible for this study. Of these, 74 patients (77.1%) reported complete correction of prognathic appearance postoperatively, whereas 22 patients (22.9%) perceived residual prognathic appearance. In a comparison of postoperative measurements between completely and incompletely satisfied patients, there were significant differences in SNB, ANB, convexity, facial angle, Nv-B, Nv-Pog, SN'B', soft tissue facial angle, lip–chin–throat angle, N'v-B′, and N'v-Pog’. The PROM results were significantly associated with the objective measurements of imaging studies.Investigating the correlation between PROMs and objective measurements enables integration of patients’ perception of the outcomes into future therapeutic strategy and surgical planning, contributing to the enhancement of patient satisfaction.

Holdaway Soft Tissue Cephalometric Standard for Malay Adults

Objectives: The aim of this study were: 1. To report facial soft tissue measurements in Class I Malay adult, 2. To compare between gender, 3. And to check applicability of Holdaway values for Class I Malay adults. Materials and Methods: Lateral cephalometric of 20 men and 20 women age 20-30 years with Class I skeletal was selected from Orthodontic Clinic, Faculty of Dentistry UiTM. The subject has no orthodontic or orthognathic surgery done before the radiograph was taken. The radiograph was traced and evaluated by the authors. Cephalometric landmarks were located according to Holdaway analysis. Ten linear and two angular measurements were produced on each radiograph and measured. For each variable, the mean and standard deviation (SD) was calculated using simple t-test (p<0.05). Results: Soft tissue measurements for Malay have significant difference as compared to Holdaway value except for three parameters which are soft tissue facial angle, superior sulcus depth, and soft tissue chin thickness. When compared between genders, male has larger value in skeletal profile convexity, upper lip strain and soft tissue thickness while females demonstrated higher value in nose prominence and superior sulcus depth. Conclusions: It has been concluded that Malay values for Holdaway soft tissue analysis were found to be statistically different. Hence Holdaway soft tissue values are not applicable for use in orthodontic practice for Malay population. Further research to confirm values obtained for Malay population would aid in better diagnosis and treatment planning.

Three-dimensional evaluation of soft tissues in hyperdivergent skeletal class II females in Guangdong

ObjectivesTo establish the three-dimensional facial soft tissue morphology of adolescent and adult females in the Guangdong population and to study the morphological characteristics of hyperdivergent skeletal class II females in Guangdong compared with that of normodivergent class I groups.Materials and methodsThe 3dMDface system was used to capture face scans of 160 patients, including 45 normal and 35 hyperdivergent skeletal class II adolescents (aged 11–14 years old) and 45 normal and 35 hyperdivergent skeletal class II adults (aged 18–30 years old). Thirty-two soft tissue landmarks were mapped, and 21 linear, 10 angular and 17 ratio measurements were obtained by 3dMDvultus analysis software. Data were assessed with a t-test of two independent samples between the normal adolescent and adult groups and between the normal and hyperdivergent skeletal class II groups.ResultsThe linear measurements of the Guangdong adult females were larger than those of the adolescents in both Class I and Class II groups. However, the angular and ratio measurements had no significant difference. The vertical linear measurements were higher and the sagittal and transverse linear measurements were smaller in the hyperdivergent class II group (p < 0.05). The soft tissue ANB angle, chin-lip angle, and mandibular angle were significantly larger and the soft tissue facial convexity angle and nasal convexity angle were significantly smaller in the hyperdivergent class II group (p < 0.05). Additionally, there were significant differences in the ratio measurements between the hyperdivergent class II groups and the control groups (p < 0.05).ConclusionsThe three-dimensional facial morphology of Guangdong adolescent and adult females was acquired. The facial soft tissue measurements of the adults were higher in the three dimensions except for the facial convexity and proportional relationships which were similar, suggesting that the growth pattern remained the same. The three-dimensional facial soft tissue features of hyperdivergent skeletal class II were characterized by the terms “long, convex, and narrow”. Three-dimensional facial measurements can reflect intrinsic hard tissue characteristics.

Gambaran Profil Jaringan Lunak Wajah Menurut Holdaway Kajian terhadap pasien ortodonti Rumah Sakit Gigi dan Mulut Fakultas Kedokteran Gigi Universitas Trisakti (Penelitian)

Background: The purpose of orthodontics treatment is to create the best balance among occlusal relationship, dental, and facial aesthetic, also the stability of the result. Facial profile analysis is one of proper method to precisely diagnose and decide an accurate treatment planning. Holdaway analysis considered as one of the most detailed because, Holdaway evaluate the entire facial profile. In general, malocclusion is associated with unaesthetic facial and dental appearances. So that, it becomes a main reason for patients to visit orthodontics clinic, especially to RSGM-FKG Usakti. Objective: To describe the average facial profile on orthodontics patient of RSGM-FKG Usakti using Holdaway’s method. Method: Observational research using cross sectional method to orthodontics patient of RSGM-FKG Usakti that came from January to December 2014. Eleven of Holdaway’s parameter was used as a measurement on sefalogram. The result of analytical line measurement collected in a tabulation of distribution-frequency. Result: Furthermore, The 11 measurements ; soft tissue facial angle, skeletal profile convexity, and H angle was convex. Sulcus labialis superior, lower lip to H line, and soft tissue chin thickness was ideal. Basic upper lip, upper lip strain, subnasal to H line and sulcus labialis inferior to H line was less ideal and prominence of small nose. Conclusion: The average facial profile on orthodontics patient of RSGM-FKG Usakti using Holdaway’s parameter is convex based on skeletal profile convexity and H angle.

Soft-tissue Cephalometric Norms of Kashmiri Population with Normal Occlusion and Well-balanced Faces

Objective: To establish soft-tissue cephalometric norms of Kashmiri population and to compare them with European-American norms.Material and Methods: A total of 102 subjects falling in the age group of 19 to 25 years were selected from random and representative sample of 5317. Reference lines were traced according to the definitions given by Holdaway, Rickett, Steiners, Merrifield, and nasiolabial angle. Thirteen linear and 4 angular measurements were analyzed on the lateral cephalogram of the sample.Results: Significant differences were found between male and female subjects in measurements of the soft-tissue facial angle, upper lip thickness, upper lip strain, lower sulcus depth and soft-tissue chin thickness, and upper lip to S line and nasiolabial angle. Soft-tissue cephalometric norms of Kashmiri population that were measured in the present study when compared with the norms set by Holdaway’s parameters, Rickett’s E line, Merrifield Z angle, Steiner’s S line, and nasiolabial angle did not fall within the normal range. The facial angle was found to be greater by 1.36°, upper lip sulcus depth was greater by 0.53 mm, convexity at point A was greater by 2.43 mm, the H angle was greater by 5.64°, upper lip thickness and strain were greater by 2.30 and 2.36 mm, respectively, soft-tissue chin thickness was greater by 0.92 mm, upper lip to S line was greater by 0.60 mm, and lower lip was greater by 0.91 mm when compared with the standard European-American norms.Conclusion: According to the present study, the measured soft-tissue cephalometric norms for Kashmiri population differed from the standard norms. When planning orthodontics treatment, it should be kept in mind that the profile may not necessarily be orthognathic.

Clinical application of autologous costal cartilage transplantation in repair of upper lip depression in secondary repair of cleft lip

To discuss the clinical application and effectiveness of autologous costal cartilage transplantation in the repair of upper lip depression in the secondary repair of cleft lip. The clinical data of 10 patients of secondary repair of upper lip depression with cleft lip by autologous costal cartilage transplantation between January 2017 and January 2019 were retrospectively analysed. There were 7 males and 3 females with an average age of 24 years (range, 18-33 years). There were 8 cases of bilateral lip fissure and 2 cases of unilateral lip fissure. All of them underwent early lip repair at the age of 2-3 years old. The change of the profile of the soft tissue profile of the upper lip of the patient was quantitatively analyzed before operation and at immediate after operation, including the soft tissue facial angle (G-Sn-Pg'), the nasolabial angle (Cm-Sn-UL), the mentolabial angle (UL-LL-Pg'), the distance between the most salient point of the upper lip to the aesthetic plane (UL-E), the highest point of the frontal part, the projection distance of the most salient point of the upper lip on the plane of the orbital ear (G-UL), and the upper lip protrusion (ULP). One case had incision infection and healed after dressing change, and in the other 9 patients, the incisions healed by first intention, and no acute infection and other complications occurred. The appearance of the lateral morphology of the upper lip at immediate after operation was significantly improved when compared with that before operation. The value of UL-LL-Pg', UL-E, G-UL, and ULP were significantly increased and G-Sn-Pg' was significantly decreased when compared with preoperative ones ( P<0.05). There was no significant difference in Cm-Sn-UL between pre- and post-operation ( t=0.821, P=0.433). All the 10 patients were followed up 6-24 months, with an average of 15 months. During the follow-up, the soft tissue morphology of the upper lip was good. No long-term complications such as cartilage absorption and cartilage displacement were found. Autologous costal cartilage transplantation is a safe and effective treatment for upper lip depression in the secondary repair of cleft lip.

The Soft Tissue Angular Analysis of Facial Profile in Unoperated Adult Patients with Unilateral Cleft Palate

The purpose of this study was to investigate the differences in facial profile development between unoperated adult cleft palate (UACP) patients and normal controls and to analyse the reasons for the differences. A total of 50 individuals with a unilateral cleft palate and 20 normal controls were selected to undergo angular measurement of their facial profiles. Data with significant differences between the two groups were analysed. Seven angle measurements of the facial profile showed that the mid-facial protrusion of the UACP patients had no significant differences from the control group (p > 0.05). But their angle of the medium face (N'-Trg-Sn) was significantly lower than the non-cleft controls (p < 0.05), suggesting a worse vertical development of the middle face. A significantly larger nasal tip angle (Cm-Sn/N'-Prn) for UACP patients suggested they had a rounder and blunter nasal tip (p < 0.05). The soft tissue facial angle and chin-lip angle of UACP patients had significant differences from non-cleft controls (p < 0.05), but the head position angle (Sn-Sm-THP) had no significant difference between two groups (p > 0.05), which suggested a steep mandibular plane for UACP patients but without severe retraction of the chin. The development of facial protrusions in UACP patients is similar to that in normal adults, but the vertical development in the middle face is insufficient. Such hypoplasia may be related to the intrinsic deficiency of the maxilla. There is a tendency for flat nasal growth and insufficient development of the chin in UACP patients. 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 .

Esthetic Outcome and Airway Evaluation following Bi-Jaw Surgery V/S Mandibular Setback Surgery in Skeletal Class III Malocclusion Using Surgery First Approach.

Background:Class III skeletal deformity is the result of mandibular prognathism, maxillary deficiency, or a combination. Treatment frequently requires a combination of orthodontics and orthognathic surgical procedures to improve facial esthetics and harmonize facial profile.Objectives:The objective of the study is to assess and quantify, by means of cephalometric analysis, the pre- and postoperative soft-tissue and airway changes following bi-jaw surgery and mandibular setback surgery after the correction of skeletal Class III deformities using surgery-first approach.Materials and Methods:Patients with skeletal Class III malocclusion were classified based on the A point–nasion–B point, beta angle, and Witt's appraisal. The cases were divided based on the type of surgery-first orthognathic approach they received. Group A (20 patients) comprised patients who underwent bi-jaw surgery (Le Fort I + bilateral sagittal split osteotomy [BSSO]) and Group B (20 patients) who underwent BSSO alone. After the lateral cephalograms were digitized, the cephalograms were evaluated for soft-tissue changes and airway changes.Results:The soft-tissue response to simultaneous two-jaw surgery was superior to those seen in mandibular setback procedures with the exception of the changes seen in the facial contour angle and soft-tissue facial angle. There was a significant decrease in lower airway in cases treated with mandibular setback alone.Conclusion:Cases treated with bi-jaw surgeries had a significant soft-tissue improvement in the long term compared to mandibular setback surgeries. Since there was a significant reduction in the lower airway in cases treated with isolated mandibular surgeries, bi-jaw surgeries maybe preferred over mandibular setback surgeries.

Soft tissue cephalometric norms of Iranian Class I adults with good occlusions and balanced faces.

The aim of this study was to assess the soft tissue measurements of Iranians with good occlusion and to compare the Iranian norms with other ethnicities. A total of 25 anthropometric variables were measured by a dentist in 50 Iranian Class I subjects (25 males, 25 females) with good occlusion and well-balanced faces. The differences between the two genders, as well as the differences between Iranian norms and the Holdaway and Burstone analyses, were statistically analyzed using a t-test (α=0.05). The subjects' mean age was 21.6±4.1 years. There were significant differences between males and females regarding the mentocervical angle, the nasolabial angle, Merrifield's Z-angle, the angle of facial convexity, soft tissue chin thickness, and upper lip thickness (P<0.05). The Holdaway norms can be used for the Iranian population, except for the following measurements which might be significantly different: facial convexity angle, nasolabial angle, interlabial gap, soft tissue facial angle, skeletal profile convexity, H-angle, lower lip to H-line, lower sulcus depth, and soft tissue chin thickness (P<0.05). There was a considerable sex dimorphism in the Iranian population. The Holdaway norms are not useful for the Iranian population regarding most measurements.

Cephalometric analysis of the soft tissue profile in Hunan Han adults with normal occlusion

To analyze the characteristics soft tissue profile in Hunan Han adults with normal occlusion and to explore the differences of the soft tissue profile in gender, region and race. Lateral cephalometric radiographs were performed for 323 volunteers (164 females and 159 males) from Hunan Province. The digital cephalometric radiographs were imported into the WinCeph8.0 measurement and analysis system in a same computer. According to the Holdaway analysis method, the mean and standard deviation were calculated. Then the results were compared to the data from Liaoning, Nepalese, Japanese, North American Caucasians. The normal value of cephalometric facial soft tissue profile in Han population adults with normal occlusion in Hunan Province were obtained. There were significant differences in subnasale to H line (Sn-H), upper lip tension, lower lip sulcus depth (Si-PgsLs), and soft tissue chin thickness (Pg-Pgs) between males and females (all P<0.05). Compared with Liaoning Province, significant regional differences in soft tissue facial angle (FH-NsPgs), upper lip sulcus depth (Ss-Ls), Sn-H, lower lip thickness, upper lip thickness, H angle, lower lip to H line (Li-PgsLs), Si-PgsLs, and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the Japan, significant regional differences in FH-NsPgs, nose prominence (Sn-Pn), lower lip thickness, upper lip tensity, H angle, Li-PgsLs, Si-PgsLs, and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the Nepalese, significant regional differences in Sn-Pn, Ss-Ls, Sn-H, skeletal profile convexity (A-NPs), basic upper lip thickness, upper lip tensity, H angle, Li-PgsLs and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the North America, significant regional differences in Sn-Pn, Ss-Ls, Sn-H, A-NPs, basic upper lip thickness, upper lip tensity, H angle, Li-PgsLs, Si-PgsLs and Pg-Pgs were found in Hunan Province (all P<0.05). There are both similarities and differences in facial soft tissue profile between males and females with normal occlusion in Hunan Province. The characteristics of facial soft tissue profile in Hunan Province are different from that in Liaoning area, Nepal, Japan and North America.

A cephalometric investigation of horizontal lip position in adult Nigerians

The aims of this study were to (1) identify soft tissue cephalometric norms for horizontal lip position in an adult Nigerian population; (2) compare values for Nigerian males and females; and (3) compare Nigerian norms with established norms for Caucasians and other populations. A cross-sectional descriptive study. Lagos University Teaching Hospital Dental Clinic, Idi-araba, Lagos, Nigeria. One hundred students (44 males and 56 females) of the College of Medicine, University of Lagos, aged 18-25 years, of Nigerian ancestry, with a normal class I occlusion and no facial asymmetry. Lateral cephalometric radiographs of the subjects were taken in natural head position. Radiographs were manually traced and 11 soft tissue cephalometric parameters measured. These were derived from the Steiner, Ricketts, Burstone, Merrifield and Holdaway soft tissue analyses. Male and female values were compared using Student's t-test with a level of significance at P<0·05. Statistically significant differences were observed between Nigerian males and females in eight of the variables studied, with males having more protrusive upper and lower lips than the females. Variables, which did not vary by sex, were soft tissue facial angle, nose prominence and soft tissue chin thickness. In addition, Nigerian norms were higher than norms reported by Steiner, Ricketts, Burstone and Holdaway for Caucasian populations, while the Z-angle was lower than the norm established by Merrifield. Gender-specific soft tissue norms for horizontal lip position should be used for orthodontic treatment planning in Nigerian subjects. Nigerians have more protrusive upper and lower lips compared to Caucasians.

Soft-tissue cephalometric norms in a north Indian ethnic population.

Background:Soft tissues play the primary role of physical appearance and facial esthetics. This study aimed to establish soft-tissue cephalometric standards in North Indian adults, which can be used in diagnosis, treatment planning, and stability of orthodontic outcome and orthognathic patients.Materials and Methods:A group of 60 individuals (30 males and 30 females) with normal occlusion and proportional facial profile were chosen. For the entire chosen sample, lateral cephalograms were obtained. Standard values of 11 soft-tissue measurements were determined.Results:Soft-tissue measurements showed that men had greater soft-tissue facial angle (92.10°) than women (89.92°). Also, they had more nose prominence (18.10 mm) than women (16.44 mm). Skeletal profile convexity (A to N-pog) of men (0.40 mm) was less than women (1.76 mm). Basic upper lip thickness was higher in men (16.60 mm) compared to women (14.24 mm), while H-angle was higher in women (16.68°) as compared to men (14.30°). In the lower face area, inferior sulcus to the H line distance was more in men (7.30 mm) than women (4.80 mm). Men had greater soft-tissue chin thickness (14.10 mm) than women (12.84 mm).Conclusion:The differences in soft-tissue cephalometric norms between men and women of North Indian faces were established, so the orthodontist or surgeon must individualize treatment planning, using local norms as the reference.

Soft Tissue Morphology of Jordanian Adolescents

To determine soft tissue cephalometric norms of a sample of Jordanian adolescents and to compare them with those of North Americans. Forty-one subjects aged 14 to 17 years were selected from a larger random and representative sample of 320 adolescents attending 12 schools in the capital of Jordan, Amman. Seven reference lines were identified and traced according to definitions by Holdaway and Ricketts, and 2 angular and 12 linear measurements were analyzed. Significant differences were found between males and females in measurements of soft tissue facial angle, H angle, subnasale to H line, basic upper lip thickness, upper lip thickness and labrale inferius and superius to E line (P < .05). Males had a more prominent upper lip in relation to the overall soft tissue profile, while the lips of females were considerably more retrusive in relation to the nose and chin. Jordanian norms were similar to those of North Americans, with only two exceptions: the H angle and skeletal convexity which were 5.4 degrees and 3.2 mm greater in Jordanians, respectively. Jordanian soft tissue norms were similar to American norms with the exception of the former having a more prominent upper lip position in relation to the overall soft tissue profile.

Non-invasive 3D facial analysis and surface electromyography during functional pre-orthodontic therapy: a preliminary report

Objectives:Functional orthodontic devices can modify oral function thus permitting more adequate growth processes. The assessment of their effects should include both facial morphology and muscle function. This preliminary study investigated whether a preformed functional orthodontic device could induce variations in facial morphology and function along with correction of oral dysfunction in a group of orthodontic patients in the mixed and early permanent dentitions.Material and Methods:The three-dimensional coordinates of 50 facial landmarks (forehead, eyes, nose, cheeks, mouth, jaw and ears) were collected in 10 orthodontic male patients aged 8-13 years, and in 89 healthy reference boys of the same age. Soft tissue facial angles, distances, and ratios were computed. Surface electromyography of the masseter and temporalis muscles was performed, and standardized symmetry, muscular torque and activity were calculated. Soft-tissue facial modifications were analyzed non-invasively before and after a 6-month treatment with a functional device. Comparisons were made with z-scores and paired Student's t-tests.Results:The 6-month treatment stimulated mandibular growth in the anterior and inferior directions, with significant variations in three-dimensional facial divergence and facial convexity. The modifications were larger in the patients than in reference children. In several occasions, the discrepancies relative to the norm became not significant after treatment. No significant variations in standardized muscular activity were found.Conclusions:Preliminary results showed that the continuous and correct use of the functional device induced measurable intraoral (dental arches) and extraoral (face) morphological modifications. The device did not modify the functional equilibrium of the masticatory muscles.

Soft-Tissue Facial Characteristics of Attractive Italian Women as Compared to Normal Women

To compare the facial characteristics of two different groups of attractive women with those of reference women. The three-dimensional coordinates of 50 facial landmarks were collected in 71 healthy reference women (18-30 years old) and in 24 coetaneous "attractive" women selected during two different beauty competitions; soft tissue facial angles, distances, areas, and volumes were computed and compared using analysis of variance. When compared with reference women, both groups of attractive women shared several similar facial characteristics: relatively large forehead (P < .001), reduced mandible (P = .008), and rounded face (reduced surface-to-volume ratio, P = .002). They had a more acute soft tissue profile, an increased upper facial width (P < .001) and middle facial depth, larger mouth, and more voluminous lips (P = .005) than reference women. Both groups of attractive women had several facial characteristics suggesting babyness. Nonetheless, each group of women was characterized by a different development of these features. Esthetic reference values can be a useful tool for clinicians, but should always consider the characteristics of individual faces.

Soft-Tissue Facial Characteristics of Attractive and Normal Adolescent Boys and Girls

To identify possible esthetic canons in facial size and shape of Italian adolescent boys and girls. The three-dimensional coordinates of 50 facial landmarks (forehead, eyes, nose, cheeks, mouth, jaw, ears) were collected in 231 healthy, reference adolescents (10- 17 years old) and in 93 similar age group "attractive" adolescents selected by a commercial casting organization. Soft-tissue facial angles, distances, areas, and volumes were computed. Comparisons were made with analysis of variance. Attractive adolescents had wider, shorter, and less deep faces than reference adolescents, with a relatively larger forehead and maxilla, and a reduced mandible relative to the maxilla. Lips were larger and more prominent, and the nasolabial angle was reduced, but in older boys the effect was reversed. The prominence of the soft-tissue profile, and of the maxilla relative to the mandible, were larger in attractive boys, but smaller in attractive girls than in their reference peers. In the horizontal plane, attractive "young" adolescents had a flatter face, while the opposite pattern was observed in the "old" adolescents, with a relatively more prominent chin. Attractive adolescents had smaller noses than reference subjects of the same age and sex. Overall, all the measurements appeared sufficiently homogenous, and the quantitative characteristics of an "attractive" face well defined. Esthetic reference values can be used to determine optimal timing and goals in orthodontic treatment.

Three-dimensional Facial Morphometry of Attractive Children and Normal Children in the Deciduous and Early Mixed Dentition

To identify possible esthetic canons in facial size and shape of Italian children. The three-dimensional coordinates of 50 facial landmarks (forehead, eyes, nose, cheeks, mouth, jaw, ears) were collected in 220 healthy reference children (4-9 years old) and in 89 "attractive" children of a similar age group selected by a commercial casting organization. Soft-tissue facial angles, distances, and volumes were computed. Comparisons were made with the Student's t-test. Attractive children had a larger face than the reference children, with a larger maxilla and forehead; overall, their faces were wider and deeper, but less vertically developed. Lips were more voluminous in attractive children, with a higher mouth. The nose was larger in attractive children than in reference children. The soft-tissue facial profile was more convex in attractive children, with a more prominent maxilla relative to the mandible. Overall, considering that in the analyzed ages body growth and dental changes are very fast and individually determined, all the measurements appeared sufficiently homogenous, and the quantitative characteristics of an "attractive" face well defined. Esthetic reference values can be used to determine optimal timing and goals in orthodontic treatment.

Heritability of facial proportions and soft-tissue profile characteristics in Turkish Anatolian siblings

The purpose of this study was to determine the possible effects of genetic factors on facial proportions and soft-tissue profile characteristics in Turkish Anatolian siblings. The material consisted of lateral and posteroanterior cephalometric head radiographs of 138 siblings (70 women, 68 men) living 15 years or more in the province of Erzurum in eastern Turkey. The subjects were required to have completed their pubertal growth spurts and to have received no previous orthodontic or prosthodontic treatment. The heritability assessments of craniofacial and soft-tissue measurements were undertaken according to narrow-sense heritability. For the calculation and evaluation of heritability estimate values, the mixed-model least-squared and maximum likelihood computer program model type II was used for statistical analysis. According to the narrow-sense heritability estimate values, the measurements of total depth index, soft-tissue chin thickness, soft-tissue facial angle, Merrifield angle, and Holdaway angle showed the highest heritability coefficients (P <.001). Total height index, anterior height index, facial width index, upper to lower facial height index, and lower lip-E line measurements demonstrated moderate heritability values (P<.01). The upper depth index had a low but statistically significant heritability value (P <.05). However, no statistically significant heritability coefficient in upper lip-E line measurement was found. Turkish Anatolian siblings have similar facial features regarding facial proportions and soft-tissue measurements.

Soft Tissue Facial Angles in Individuals with Ectodermal Dysplasia: A Three-Dimensional Noninvasive Study

To supply quantitative information about the facial soft tissues of patients with hypohidrotic ectodermal dysplasia. Prospective assessment. National meetings of hypohidrotic ectodermal dysplasia patients and families. Facial and mandibular corpus convexities in the horizontal plane; facial convexity in the sagittal plane; interlabial, naso-labial, nasal convexity, and left and right soft tissue gonial angles were calculated from the three-dimensional coordinates of 11 soft tissue facial landmarks obtained in 18 male and 17 female hypohidrotic ectodermal dysplasia patients aged 3 to 41 years and in 504 reference healthy individuals. In addition, z-scores were computed and the patients were grouped by cluster analysis. Male and female z-scores did not differ. In the pooled group, facial convexities in the horizontal and sagittal planes were significantly (Student's t, p < .01) increased (flatter) in hypohidrotic ectodermal dysplasia patients, compared with normal controls. The naso-labial angle was significantly reduced (more acute). Upper and lower facial convexity and mandibular corpus convexity in the horizontal plane deviated less from the norm with increasing age. Facial convexity in the horizontal and sagittal planes, soft tissue gonial angles, and naso-labial and interlabial angles deviated less from the norm with increasing number of teeth present in the mouth. Cluster analysis identified three homogeneous groups, all characterized by a peculiar facial phenotype. Modifications in facial convexity and gonial and interlabial angles differentiated each cluster. Patients with hypohidrotic ectodermal dysplasia had flatter faces in the horizontal and sagittal planes than normal controls had. Cluster analysis revealed patterned differences in facial phenotype.

The use of parental data to evaluate soft tissues in an Anatolian Turkish population according to Holdaway soft tissue norms

The relative influence of genetic and environmental factors in the etiology of malocclusion has long been a matter for discussion. The aim of this study was to compare the soft tissue structures of parents and their prepubertal, pubertal, and postpubertal offspring according to the Holdaway soft tissue norms to determine the similarity among them. Differences related to age and sex between the parents and offspring were also evaluated. Lateral cephalometric radiographs were used to determine the similarities in soft tissue structures in 120 families, which were divided into prepubertal (n = 40), pubertal (n = 40), and postpubertal (n = 40) groups according to the children's skeletal ages. A total of 12 variables (2 angular and 10 linear) were measured according to Holdaway's soft tissue analysis. Pairs were formed between family members (mother to son, mother to daughter, father to son, father to daughter, midparent (mean of the father's and mother's values) to son, and midparent to daughter) in each group. Descriptive statistics and multiple linear regression analysis were performed. Statistically significant correlations between parents and their offspring were found. The parental data showed that a mother's genetic influence on her child's soft tissues was greater than the father's. Moreover, it was found that daughters had greater genetic influences from their parents than did sons. As age increased, the similarity was greater. Soft tissue facial angle (beta: 0.671), soft tissue chin thickness (beta: 0.549), and basic upper lip thickness (beta: 0.537) were the most similar variables between parents and their offspring. A few selected cephalometric measurements of the parents might furnish important data to the clinician in predicting a child's facial growth characteristics and aging process.