Vertical Facial Height Research Articles

A Cephalometric Study Of Vertical Skeletal Changes After Extraction And Non-Extraction Fixed Orthodontic Treatment Of Class I Malocclusion In North Indian Population

Background: Orthodontic treatments frequently involve tooth extractions to address crowding and protrusion, but the effects of these extractions on vertical skeletal changes are still debated. Research has extensively covered aspects like soft tissue response and smile aesthetics, yet there is no consensus on their impact on vertical dimensions. This issue is particularly pertinent for hyperdivergent individuals, who make up about 22% of orthodontic patients. A proposed technique for such cases includes counterclockwise rotation of the lower jaw and advancement of posterior teeth to manage open bites or excessive vertical facial height. This study aims to compare vertical skeletal changes in Class I malocclusion patients undergoing extraction versus non-extraction fixed orthodontic treatments. Material and Methods: We analysed pre- and post-treatment lateral cephalometric radiographs from 60 Class I crowding patients, evenly split into extraction and non-extraction groups. Eight vertical skeletal parameters were assessed and compared statistically between the two groups. Superimposition analysis of radiograph tracings was used to explore vertical changes related to molar mesialization, particularly in the extraction group. Results: The extraction group demonstrated significant reductions in vertical skeletal dimensions compared to the non-extraction group. Measurements including FMA, SN-GoGn, Y-axis, SN-PP, and PP-MP showed significant differences, with reductions in the extraction group (P = 0.001). Procrustes superimposition indicated effective molar mesialization in the extraction group, which was not observed in the non-extraction group. Conclusion: Extraction of first premolars in fixed orthodontic treatment leads to a notable decrease in vertical skeletal dimensions, in contrast to the slight increase seen with non-extraction treatments. This reduction is largely due to molar mesialization, which enhances vertical skeletal dimensions and treatment stability in Class I crowding cases.

ANALYSIS OF ANTERIOR FACIAL HEIGHT DIMENSION BASED ON SKELETAL CLASSIFICATION OF CIMAHI WEST JAVA POPULATION

Dento-facial aesthetics is an essential aspect of contemporary orthodontics, reflected by increasing demands for many aspects of patient's aesthetic improvement. Facial vertical height determines an individual's aesthetics and is vital to establishing facial harmonies. One of the facial vertical problems is related to anterior facial height. Vertical facial height is strongly influenced by the vertical position of the maxilla and mandible, so that it can be affected by the relation between the skeletal jaw. This study aims to determine the difference between the anterior facial height and the skeletal jaw relation. Based on different skeletal classifications by Steiner skeletal analysis, measurements on lateral cephalometric radiographs by comparing and connecting the anterior facial height. This research used an analytic-cross-sectional study with total sampling from 2019-2021. Fifty lateral cephalometrics between 18 and 41 years of age patients, with inclusion criteria, were included in this study. Each sample was analyzed using Steiner's skeletal classification, and the AFH and PFH were measured. The study result showed that 30% of the sample had skeletal class I malocclusion, 42% had skeletal class II, and 28% had skeletal class III. The mean score by skeletal classification for LAFH was 66.92 mm, the mean of UAFH was 50.22 mm, and the mean TAFH was 114.02. Based on the analysis results, there was no significant difference between anterior facial height (UAFH, LAFH, and TAFH) based on skeletal classification.

Cephalometric Evaluation of Age-dependent Craniofacial Skeletal Changes in Iranian Population with Class II Malocclusion: A Cross-sectional Study

Background: Class II malocclusion is one of the most prevalent occlusion discrepancies. Knowledge of growth changes in craniofacial components can help clinicians plan orthodontic treatment, determine the proper timing to initiate the treatment, and predict the treatment outcome, especially in growth modification protocols. This study evaluates craniofacial skeleton changes in class II malocclusion subjects compared to class I malocclusion. Methods: In this cross-sectional study, cephalograms of 858 individuals aged between 7 and 23 were investigated. The samples were divided into the class I group (ANB angle 0–4) and class II group (ANB angle≥4 degrees), including 426 and 432 cephalograms, respectively, and each group was divided into seven subgroups considering age. Cephalometric analysis was performed using OnyxCeph software, and statistical analyses of variance, mean, paired t test, and independent samples t test were performed using SPSS software. Results: The results showed no significant differences between class I and class II groups in variables related to the cranial base and vertical facial height. In class II groups, the SNA angle was significantly greater. The total mandibular height (Co-Gn), facial angle (Npog-FH), and SNB angle were significantly greater in class I compared to the class II group. Conclusion: Protrusion of the maxilla affects the formation of class II malocclusion, but an underdeveloped mandible is the main component of Class II malocclusion formation. With increasing age, especially after puberty, the mandible may become more retruded in class II patients.

Effects of vertical control on anatomic and aerodynamic characteristics of the oropharyngeal airway during premolar extraction treatment of Class II hyperdivergent nonsevere crowding malocclusion

This study aimed to analyze the effects of premolar extraction treatment with vertical control on changes in the anatomy and aerodynamics of the oropharynx in Class II hyperdivergent malocclusion with nonsevere crowding. Thirty-nine patients with Class II hyperdivergent malocclusion were enrolled consecutively. All the participants underwent 4 premolar extractions. The high-pull J-hook and mini-implants were used to provide vertical control. Cone-beam computed tomography was performed before and after treatment. The participants were divided into a decreased lower vertical facial height group (n= 23) and an increased lower vertical facial height group (n= 16) on the basis of superimposition. The aerodynamic characteristics, including airway resistance (inspiration, Rin; expiration, Rex) and maximum velocity (inspiration, Vmaxin; expiration, Vmaxex) at inspiration and expiration, were calculated using computational fluid dynamics. Anatomic characteristics, including volume and cross-sectional area (CSAmin), were measured using the Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). After treatment, the median volume and CSAmin increased by 2357 mm3 and 43 mm2, respectively, and median Rin and Vmaxex decreased by 0.15 Pa/L/min and 0.24 m×s-1, respectively, in decreased lower vertical facial height group. In contrast, the median CSAmin decreased by 9.5 mm2 in the increased lower vertical facial height group. All the changes were statistically significant (all P<0.05). Significant differences in volume, CSAmin, Rin, and Vmaxex were observed between the 2 groups. Vertical control might improve the anatomic and aerodynamic characteristics of the oropharyngeal airway during premolar extraction treatment of Class II hyperdivergent malocclusion with nonsevere crowding.

Cephalometric evaluation of deep overbite correction using anterior bite turbos.

To evaluate the outcome of treating deep overbite (OB) using anterior bite elevators concurrently with a pre-adjusted edgewise appliance. The Case Western Reserve University (CWRU) cephalometric analysis was used to isolate tipping movement of upper (TUI) and lower incisors (TLI), bodily tooth movement of upper (BUI), and lower incisors (BLI), as well as vertical skeletal changes in the anterior region of the maxilla (MXSK) and mandible (MNSK). Thirty treated subjects were examined at pretreatment (T1) and posttreatment (T2) and compared to an untreated control group matched on age, sex, and Angle malocclusion from the Bolton Brush Growth Study Collection (CWRU, Cleveland, Ohio). Overbite (OB) in the treated group was decreased significantly (P < .001) (-5.6 mm) compared to controls. Statistically significant (P < .001) changes were found for BUI (-0.7 mm), TUI (0.9 mm), TLI (-1.4 mm), BLI (-1.1 mm), and MNSK (-1.6 mm). Most of the overbite correction was in the lower arch and included tipping and intrusion of the lower incisors along with an increase in lower vertical facial height. Deep OB correction was achieved efficiently using anterior bite elevators with pre-adjusted edgewise appliance. Correction using bite turbos would be a treatment option for individuals presenting with decreased lower facial height and deep bite.

Can smile influence the lower anterior vertical facial height on frontal view in an adult Asian female subject? A cross-sectional study

Objectives: Smile is a universal phenomenon, the effect of which is not discovered on the lower anterior facial height (LAFH). The objective of this study was to determine the influence of smile on different LAFH in frontal view as assessed by different panels of raters using visual analog scale (VAS) in a female subject. Material and Methods: The frontal photographs (at rest and on smile) were taken at natural head position of a female subject aged 28 years old after taking informed consent. LAFH of the photographs was modified using a Photoshop software (Adobe Systems, San Jose, Calif.). Sixty raters equally divided into orthodontic residents, general dentists, and laypersons were given a VAS to make subjective assessments of facial attractiveness of the modified photographs. Comparison of raters’ scores was done using Kruskal–Wallis and Mann–Whitney U-tests. Wilcoxon Signed-Rank test was used to compare the esthetic scores of the subject at rest and with smile. Results: The mean age of the all raters was comparable (early adulthood). All raters preferred normal or slightly shorter LAFH in both postures, that is, at smile and rest. Similarly, all raters disliked long face modifications. On comparing smile and rest photographs at various LAFH, we found less VAS scores for smile. Gender of raters played no role in difference of VAS scores. Conclusion: All the panels of rater found normal LAFH to be the most attractive; however, the panels disliked long face modifications on both smile and at rest. Smile had no positive influence on the VAS scores as assumed so the effect of “Smiloflage” must be investigated further to understand it properly.

Kondiler Hipoplazi ile Birlikte Mandibular Koronoid Aplazi: Literatür Taraması ile Çok Nadir Bir Olgu

Mandibular coronoid aplasia is defined as the absence of the coronoid process and hypoplasia is defined as defective or underdeveloped coronoid process. Hypoplasia of the mandibular condyle means that the condyle is smaller than normal. Both of these situations are very rare in the literature. In the literature, condylar hypoplasia is usually associated with coronoid hyperplasia and is seen together. The case report we prepared is a case of unilateral coronoid aplasia with condylar hypoplasia, which is not associated with the syndrome, and is the second case in the literature in this way. In the clinical examination of a 38-year-old female patient, a decrease in the right vertical face height and a deviation to the right at the chin tip were observed. As a result of radiological evaluation, right coronoid process aplasia and right condyle hypoplasia were observed.

Iatrogenic retroposition of the lips sequel after bicuspid extraction-a retrospective study

AimThis study aims to explore the prevalence of Iatrogenic retroposition of the lips sequel (IRLS) after bicuspid extraction, associated dentofacial characteristics and the effectiveness of surgical treatment. Materialand methods: Patients with bicuspid extraction as part of an orthodontic treatment plan were retrospectively included. IRLS was identified by clinical evaluation and cephalometric Legan and Burstone analysis. Association of demographic and cephalometric variables were assessed. The effectiveness of combined orthodontic-orthognathic correction of the retroposition of the lips was evaluated. ResultsOut of 144 patients with extracted bicuspids, eight Class I patients, nine Class II patients and five Class III patients were seeking treatment because their lips had retruded as a consequence of compensating orthodontic treatment. Lower jaw bicuspid extraction and a decreased vertical facial height in Class II patients correlated significantly more with IRLS development. Postoperative cephalometric analysis of orthodontic-orthognathic treated patients reported improvement in lip projection and naso-labial angle. Only two Class I patients reported postoperative normalization of the lip position according to Legan and Burstone. ConclusionThe consequence of bicuspid extractions on soft tissue profile differs according to skeletal jaw relation. The impact of orthognathic surgery on IRLS is beneficial, although insufficient to completely correct the facial profile when judged on cephalometric standards.

Differences in the heritability of craniofacial skeletal and dental characteristics between twin pairs with skeletal Class I and II malocclusions.

ObjectiveTo investigate differences in the heritability of skeletodental characteristics between twin pairs with skeletal Class I and Class II malocclusions.MethodsForty Korean adult twin pairs were divided into Class I (C-I) group (0° ≤ angle between point A, nasion, and point B [ANB]) ≤ 4°; mean age, 40.7 years) and Class II (C-II) group (ANB > 4°; mean age, 43.0 years). Each group comprised 14 monozygotic and 6 dizygotic twin pairs. Thirty-three cephalometric variables were measured using lateral cephalograms and were categorized as the anteroposterior, vertical, dental, mandible, and cranial base characteristics. The ACE model was used to calculate heritability (A > 0.7, high heritability). Thereafter, principal component analysis (PCA) was performed.ResultsTwin pairs in C-I group exhibited high heritability values in the facial anteroposterior characteristics, inclination of the maxillary and mandibular incisors, mandibular body length, and cranial base angles. Twin pairs in C-II group showed high heritability values in vertical facial height, ramus height, effective mandibular length, and cranial base length. PCA extracted eight components with 88.3% in the C-I group and seven components with 91.0% cumulative explanation in the C-II group.ConclusionsDifferences in the heritability of skeletodental characteristics between twin pairs with skeletal Class I and II malocclusions might provide valuable information for growth prediction and treatment planning.

The Relationship between Dentofacial Vertical Pattern and Bite Force Distribution among Children in Late Mixed Dentition

Background: Digital bite measurement systems such as the T-Scan III allow for the computerized measurement of occlusal force distribution. This study aimed to establish the relationship between dentofacial vertical pattern and bite force distribution among children in late mixed dentition. Materials and Methods: In total, 86 children (45 male, 41 female) aged between 9 and 11 years with short (n = 28), medium (n = 28), and long (n = 30) facial heights were included in this study. The height, weight, age, and gender were recorded. Occlusal bite force distribution and time of occlusal cycle were recorded using a T-Scan III device (Tekscan Corp. Boston, MA, USA). The bite force distribution was compared among facial types using a One-Way ANOVA and post hoc test, a linear regression model with time of occlusion as dependent variable was developed. Results: No significant differences were observed in occlusion time between genders. Children with long facial height had a significantly lower anterior bite force distribution (p &lt; 0.05) and significantly higher posterior bite force distribution (p &lt; 0.05) than those with average or short facial height. Age, gender, height, and weight had no significant association with time of the occlusal cycle. Conclusion: Children with an increased vertical facial height have a more posterior distribution of force than children with average or short facial heights in the late mixed dentition.

Scientific estimation of the subject-to-camera distance from facial photographs for craniofacial superimposition

Subject-to-camera distance (SCD) is widely acknowledged to be a critical variable in craniofacial superimposition, but in practice it has been notoriously difficult to estimate from facial photographs. The recently proposed PerspectiveX algorithm offers the first potential capability to objectively undertake this estimation using quantified data. In this study, we test PerspectiveX’s legitimacy first by determining if the palpebral fissure length that it uses, falls in the relative-parallel-zone of the face (RPZ) where perspective distortion effects are minimal, thereby justifying its use for craniofacial superimposition (Study 1). Secondly, we validation test the PerspectiveX algorithm by using facial photographs acquired at known, whole meter ground truth distances between 1 and 10 m (Study 2). For study 1, we used 3D face scans to quantitatively map the relative parallel zone (RPZ) in 30 upright living subjects. For study 2, we used 2D facial photographs of up to 50 subjects at known 1 m interval distances. Results show the RPZ to cover a very thin vertical area of the face, but one that includes the palpebral fissure and the eyelids. This justifies the use of the palpebral fissure length in PerspectiveX. When tested using photographs taken at known distances, PerspectiveX performed with a signed mean and mean absolute error of 3.8% and 6.8% respectively for two prime lenses (85 and 100 mm). For a zoom lens operated at its extremes of 24 and 105 mm focal-lengths, PerspectiveX performed with a signed mean and mean absolute error of 4.4% and 11.0%, respectively. These errors are small in the superimposition context, translating into less than 1% difference in vertical face height. This supports the use of PerspectiveX in superimposition to objectively set the skull-to-camera distance, such that it replicates the face-to-camera distance to provide optically valid 1:1 comparisons of skulls and faces.

Influence of incisor inclination and anterior vertical facial height on facial attractiveness in an adult Asian male

Balanced facial proportions and hard tissue relationships are important factors in facial attractiveness. The objective of this study was to determine the most pleasing maxillary incisal inclination (MII) on the lateral profile and the impact of various lower anterior facial height (LAFH) ratios (at rest and with a smile) on facial attractiveness. This cross-sectional study was performed with 66 raters equally divided into 3 panels: general dentists (GD), orthodontic residents (OR), and laypersons (LP). Lateral profile view photographs of an Asian man were modified using Photoshop software (Adobe Systems, San Jose, Calif) to show altered MII and LAFH ratios at rest and when smiling. Subjective evaluations of facial attractiveness were performed by raters using a visual analog scale. Kruskal-Wallis test was used to compare esthetic scores among raters, and the Mann-Whitney U test was applied to compare ES between groups. Kruskal-Wallis test showed significant differences in esthetic scores among raters for -10° (P=0.028) and -15° MII (P=0.030). Similarly, significant differences were found in ES for 8% LAFH ratio (P=0.022), and 4% LAFH ratio (P=0.035) at rest. Mann-Whitney U test showed significant differences between raters for -10° and -15° MII and between 8% and 4% LAFH ratio at rest. All groups rated -5° inclinations to be most attractive. General dentists and orthodontic residents found normal LAFH to be the most attractive, whereas long facial height was less attractive with smile. In addition, smile had a camouflaging effect on LAFH.

Prosthetic rehabilitation of a hypohidrotic ectodermal dysplasia patient: A case report

Aim: Ectodermal dysplasia is a rare hereditary disease that arises from a developmental disorder of 2 or more ectoderm-derived tissues. Ectodermal dysplasia is seen in 3 different types: anhidrotic, hypohidrotic, and hidrotic. Its anhidrotic and hypohidrotic types are the most common. This study presents the intraoral findings and dental treatment approach of a case diagnosed with hidrotic ectodermal dysplasia that demonstrates the typical characteristics of the disease, such as anodontia, hypohydrosis (reduced sweating), hypotrichosis (sparse hair), and loss of vertical dimension.&#x0D; Methodology: A 5-year-old male patient presented to the clinic of the Prosthetic Dental Treatment Department of the School of Dentistry at Dicle University on 25.10.2020 with complaint of missing teeth. A genetic analysis conducted in 2016 showed that he was a homozygous carrier of the p.Cys148Arg (c.442 T&gt;C) mutation on the 5th exon of the ectodysplasin-A receptor (EDAR) gene. The mutation detected in the patient was associated with ectodermal dysplasia. An extraoral clinical examination revealed sparse hair, eyebrows, and eyelashes; soft, smooth, and dry skin; thin, linear wrinkles around the eyes and the lips; drooping, thickened lips; a sunken nose; fractured nails; hyperthermia due to lack of sweat glands; hyperkeratosis in the skin and soles of the feet; 2 nipples on one side of the chest; and reduced vertical facial height. An intraoral examination revealed anodontia; there were no teeth on the maxilla or the mandible and no radiographically identified tooth germ. Dry mouth due to a lack of sufficient saliva was another finding.&#x0D; Conclusion: In this case report, in the presence of anodontia, a removable total prosthesis, which is a non-invasive treatment option, was applied. Production of endosseous implants was postponed for a later time following the patient’s growth and development.&#x0D; &#x0D; How to cite this article: Gökçe D, Ayna E, Seyfioğlu Polat Z. Prosthetic rehabilitation of a hypohidrotic ectodermal dysplasia patient: A case report. Int Dent Res 2021;11(Suppl.1):292-8. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.43&#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

The influence of incisor inclination and anterior vertical facial height on facial attractiveness in an Asian woman

Orthodontic treatment can help improve facial attractiveness through the modification of factors affecting the soft tissue profile. The objectives of this study were to determine the impact of different maxillary incisal inclinations and lower anterior facial heights (at rest and with a smile) on the facial attractiveness of an Asian woman, as perceived by different panels of raters using visual analog scale (VAS) scores. A cross-sectional study was performed with 66 raters equally divided into 3 panels that consisted of general dentists, orthodontic residents, and laypersons. Raters assessed modified photographs of a subject with various incisor inclinations and lower anterior facial height/total anterior facial height (LAFH/TAFH) on lateral profile view. Modifications were made using Photoshop software (Adobe, San Jose, Calif). Subjective evaluations of facial attractiveness were performed by raters using VAS. Kruskal-Wallis test was used to compare VAS scores among raters. Mann-Whitney U test was applied to compare VAS scores between groups. Significant differences in VAS scores were found among raters for -10° (P=0.004) and -15° (P=0.021) incisal inclinations. Significant differences were found in VAS scores for -8% LAFH/TAFH (P=0.044) and 4% LAFH/TAFH with smile (P=0.002). Professionals preferred normal incisal inclinations to be the most attractive. General dentists found reduced facial height to be unattractive. Orthodontic residents and laypersons considered increased LAFH/TAFH to be most unattractive. Smile had a negative impact on VAS scores at extreme anterior facial height modifications.

Mandibular buccal shelf and infrazygomatic crest thicknesses in patients with different vertical facial heights

The purpose of this study was to use cone-beam computed tomography (CBCT) to determine bone thickness in the mandibular buccal shelf (MBS) and the infrazygomatic crest (IC) in individuals with different vertical facial heights for ultimate placement of miniscrews. The sample consisted of 100 individuals aged at least 16years, of whom 58 were women, and 42 were men. The mean age was 19.18years (± 5.5 standard deviation). The patients' facial height was determined by the gonial angle. Cross-sectional slices of the MBS and IC were obtained with CBCT to evaluate bone thickness for the insertion of miniscrews in these extra-alveolar sites. Spearman's nonparametric test was used to correlate the gonial angle with MBS and IC thickness. The level of significance was 5%. The gonial angle ranged from 102.4° to 143.2°. Bone thickness in the MBS increased posteriorly, whereas bone thickness in the IC decreased posteriorly. There was an inversely proportional correlation between the gonial angle and the MBS. There was no correlation between the IC and the gonial angle. Short-faced individuals had higher bone thickness values in the MBS than long-faced ones. There was no correlation between the patients' vertical face height and the bone width in the IC. The best site to install miniscrews in the MBS is buccal to the secondmolar distal root, whereas in the IC, it is buccal to the first molar mesiobuccal root. CBCT may be necessary to install extra-alveolar miniscrews correctly, especially in the IC.

Three-dimensional evaluation of smile characteristics in subjects with increased vertical facial dimensions

Patients seeking orthodontic treatment often have esthetic concerns (ie, they want a better smile). Patients with increased vertical facial dimensions have different smile traits than other patients. This study aimed to compare the smile characteristics of subjects with different vertical facial dimensions and to use stereophotogrammetry to evaluate the changes in facial animation upon smiling. One hundred twenty adolescents and young adults (aged 15-25years) who were referred for orthodontic treatment were divided into 2 groups according to their vertical facial height: increased (n=30) and normal (n=30). Three-dimensional stereophotogrammetric images were obtained from the patients during rest and smile. The images were superimposed, and the displacements of specific landmarks were recorded. Linear, angular, and proportional measurements were recorded on the smile and rest images. When smiling, horizontal movement of commissures was less (right, P=0.038; left, P=0.009), upper lip elevation was higher (P=0.014), and the upper lip was shorter (P=0.014) in the vertical group than in the normal group. In the vertical group, the interlabial gap was increased both at rest and when smiling (P<0.001). Statistically significant differences were found in smile index (P=0.001), nasolabial fold displacement (P=0.018), and lip angles (both P=0.001) between groups. Group and sex differences were observed when smiling. Careful consideration of these differences will help clinicians in proper diagnosis and treatment planning.

Soft Tissue Esthetic Changes Following a Modified Twin Block Appliance Therapy: A Prospective Study.

ABSTRACTAimAchieving a satisfactory facial esthetics is of utmost importance in the practice of orthodontics. Cl II div 1 patients often suffer from numerous adverse facial characteristics which may impair their social well-being. The objective of the current study was to evaluate the esthetic changes in such patients by using a modified twin block appliance.Materials and methodsSeventy adolescent patients with mandibular deficiency consecutively underwent treatment with a modified twin block appliance for a mean period of 13 months. Soft tissue analyzes of Burstone and Mcnamara were applied to evaluate the changes before and after the treatment. The esthetic changes before and after the therapy were compared using parametric paired t tests analysis. p values less than 0.05 were considered significant.ResultsFacial convexity, lip incompetence, upper lip protrusion, and columellar inclination significantly decreased (p < 0.05) while Merrifield's Z-angle nasolabial angle, lower lip length, and mentolabial angle significantly increased (p < 0.05). Vertical facial height ratio, lower lip protrusion, upper lip length as well as nasal projection and inclination, did not change significantly (p > 0.05)ConclusionOur findings indicated that a modified form of the twin block appliance can be substantially effective in the improvement of several aspects of patients’ facial balance with minimum untoward effects.Clinical significanceAdolescents suffering from mandibular deficiency can gain substantial facial balance with the twin block appliance. The whole face attractiveness, however, is another subject and should not be conflicted with the facial balance.How to cite this articleShahamfar M, Atashi MHA, Azima N. Soft Tissue Esthetic Changes Following a Modified Twin Block Appliance Therapy: A Prospective Study. Int J Clin Pediatr Dent 2020;13(3):255–260.

Cephalometric Approach to Vertical Facial Height

Introduction: The vertical heights and the proportions are very important for balance of the face and attractiveness along with the good smile. Harmonious vertical proportions and the Antero-posterior relations contribute to aesthetics. Therefore it is necessary to determine the vertical facial height and the ratios in treatment planning of the patients. The aims and objectives of this study are to compare the vertical facial heights of patients considering the Lower Anterior Facial Height (LAFH), the Upper Anterior Facial Height (UAFH), Total Anterior Facial Height (TAFH) and Posterior Facial Height (PFH) among the sexes in Class I skeletal group obtained from cephalometric analysis.&#x0D; Materials &amp; Method: The study material comprised of 52 patients (24 males and 28 females) and lateral cephalometric radiographs were traced with Skeletal Class I relationship. Cephalometric analysis was performed by using hand tracing. Independent t tests were used for comparisons.&#x0D; Result: The total anterior facial height (TAFH), lower anterior facial height (LAFH), upper anterior facial height (UAFH), total posterior facial height (TPFH) measurements showed no significant differences between both sexes in Skeletal Class I group but statistically significant difference in ratios of posterior facial height and total anterior facial height and also there was statistically significant differences in the ratio between upper facial height and the total anterior facial height (p value &lt;0.05).&#x0D; Conclusion: This cephalometric analysis can be applied to determine the vertical height of occlusion which can be helpful in prosthetic rehabilitation of edentulous patients.

Evaluation of vertical facial height reduction and severity of temporomandibular joint disorders using Shimbashi number and cephalometric analysis

ABSTRACT Objective: This study was designed to evaluate the correlation between vertical dimension at occlusion (VDO) and various grades of temporomandibular disorders (TMDs) versus controls. Methods: Clinically measured Shimbashi number and radiographic cemento-enamel junction (CEJ-CEJ) measurements on 120 TMD patients and 40 controls were evaluated. Radiographic lateral cephalometric skull images of the patients were subjected to cephalometric analysis. The relationship between Shimbashi number, the cephalometric values, and its correlation with the degree of TMD were evaluated and statistically analyzed. Results: Shimbashi number and radiographic CEJ-CEJ values in the TMD patients were significantly lower than those in the controls. TMD severity appeared to increase with the increase in interincisal angle and the decrease in both Shimbashi number and radiographic CEJ-CEJ value. Conclusion: These findings indicate that radiographic evaluation of cephalograms is a reliable indicator of presence and degree of TMD, and the severity of TMD increases with the degree of reduction in VDO.

Effects of Different Head Positioning Methods on Facial Soft Tissue Analysis Using Stereophotogrammetry

The purpose of this study was to compare the sagittal tilt of the head in different head positioning techniques using an inclinometer and facial stereophotogrammetric measurements. The study was carried out in 45 participants (26 female, 19 male). Participants' head positioning was obtained with dynamic walking, Frankfort horizontal plane (FHP'), self-balance plus mirror, and subjective photographic positioning methods. All pitch values were recorded by an inclinometer and stereophotogrammetric images were obtained. Facial analysis included distances of the glabella (G'), pronasale (Pn), soft tissue A point (A'), upper lip (Ls), lower lip (Li), soft tissue B point (B)', and soft tissue pogonion (Pog') to the true vertical line (TVL) and face height and lip length measurements. Participants' head positions were observed to be more forward in the FHP' head positioning technique compared with other methods, whereas a more backward head position was recorded with subjective head positioning, and the difference was significant (P<.001). There were no relevant differences in pitch values between the self-balance plus mirror and dynamic walking methods. G'-TVL (P<.000), Pn-TVL (P<.029), A'-TVL (P<.039), Ls-TVL (P<.001), Li-TVL (P<.037), B'-TVL (P<.003), and Pog'-TVL (P<.000) in the profile view and face height, lower face height, and lower lip length values in the frontal view (P<.001) differed significantly by head positioning method. The dynamic walking and self-balance plus mirror head positioning methods offered similar and advisable natural head position results, whereas FHP' head positioning was questionable for an accurate determination of natural head position. Facial soft tissue measurements, such as face height, lower face height, lower lip length, and projection of structures such as the G', Pn, lips, and chin, varied based on head positioning method.