Vertical Facial Height Research Articles

Factors Related to Relapse After Mandibular Setback Surgery With Minimal Presurgical Orthodontics

The aims of this study were to compare the presurgical conditions, surgical changes, and postsurgical changes in patients with skeletal Class III malocclusion with different degrees of horizontal relapse after mandibular setback surgery (MS) with minimal presurgical orthodontics (MPO) and to identify the factors contributing to this relapse. For this retrospective study, 33 consecutive patients who underwent MS-MPO were selected. Lateral cephalograms were taken preoperatively (T0), 1month after surgery (T1), and at orthodontic debonding (T2). Patients were divided into low relapse (LR; n=18; relapse, <1mm) and high relapse (HR; n=15; relapse, >2mm) groups based on the cephalometric distance of mandibular horizontal relapse. Paired t test, independent t test, and Pearson correlation analysis were used to evaluate surgical (T0 to T1) and postsurgical (T1 to T2) changes in the skeletodental variables and to explore the relation between surgical changes and horizontal relapse. Compared with the LR group, the HR group exhibited more upward movement with counterclockwise rotation of the mandible from T1 to T2. The HR group presented at T0 with a more prognathic mandible, greater vertical facial height, and a positive overbite. In addition, the HR group presented more posterior movement with clockwise rotation of the mandible, increased overjet, and decreased overbite from T0 to T1. Horizontal relapse of the mandible was positively correlated with the amount of setback and clockwise rotation of the mandible and the change in overjet and was negatively correlated with the change in overbite. Mandibular instability was related to the extent of setback and clockwise rotation of the mandible, decreased overbite, and increased overjet during MS-MPO.

Cephalometric Assessment of Changes in Vertical Facial Height Following Extraction of Mandibular Second Premolars in Adult Long-face Patients with Skeletal Open Bite: A Case Series

Cephalometric Assessment of Changes in Vertical Facial Height Following Extraction of Mandibular Second Premolars in Adult Long-face Patients with Skeletal Open Bite: A Case Series

Effect of Naso-respiratory Obstruction with Mouth Breathing on Dentofacial and Craniofacial Development

Objective: To evaluate the effects of mouth breathing on craniofacial and dentofacial development during childhood in comparison to nasal breathing in malocclusion patients.Materials &amp; Method: A retrospective study done at SOA University. Cephalometric parameters and clinical variables of 90 pediatric patients who had undergone orthodontic treatment were reviewed. Study group included 40 pediatric patients who suffered from signs and symptoms of nasal obstruction, and control group included 50 patients who were normal nasal breathers. Dental and craniofacial parameters were compared between nasal breathers and mouth breathers using clinical and cephalometric records.Result: The mouth breathers had backward and downward rotation of mandible with increased overjet, increased mandibular plane angle, higher palatal plane, and constriction of upper and lower arches at the level of cuspids and first molars when compared with nasal breathers group. The prevalence of posterior cross bite was observed greater in mouth breathers group (40%) than the nose breathers (20%) (p =0.006). Abnormal lip-to-tongue anterior oral seal was seen more in the mouth breathers group (55%) than in nose breathers group (25%) (p = 0.05).Conclusion: Naso-respiratory obstruction with mouth breathing during growth periods in children has a greater tendency for clockwise rotation of growing mandible, with an irregular increase in anterior lower vertical face height and decreased posterior facial height.

Vertical Facial Height and its Correlation with Skeletal Pattern Among Young Nigerian Orthodontic Patients

Vertical Facial Height and its Correlation with Skeletal Pattern Among Young Nigerian Orthodontic Patients

Growth and Development of Craniofacial Structures in Patients at Different Ages With Unrepaired Submucous Cleft Palate

Submucous cleft palate (SMCP) is a particular subtype of cleft palate deformity; research related to the craniofacial features of patients with SMCP is comparatively rare. The study objective was to perform a cephalometric comparison of the craniofacial features of patients with SMCP and non-cleft controls at different ages. The sample in this cross-sectional study was composed of 2 groups: SMCP patients and non-cleft controls. The primary predictor variables were study group (cleft and non-cleft) and age. Age was divided into 3 groups. The outcome variables of interest were craniofacial measurements. The measurements used reflect cranial length, cranial angle, maxillary sagittal length and protrusion, maxillary vertical height, pharyngeal depth, facial height, mandibular length and protrusion, mandibular plane angle, and intermaxillary relation. Adjusted cephalometric craniofacial measurements between the groups were compared in 3 age groups using generalized linear models after being adjusted for age and gender. The study included 60 SMCP patients and 60 non-cleft controls.SMCP patients and non-cleft controls were divided into 3 subgroups: those aged 5 to 7years, those aged 9 to 11years, and those aged 18 to 30years. Patients with SMCP at age 5 to 7years showed a shortened cranial base length, maxillary sagittal length and height, and bony pharynx depth. Patients with SMCP at age 9 to 11years showed a smaller maxillary sagittal length and bony pharynx depth and an inharmonious jaw relationship. Patients with SMCP at age 18 to 30years showed a smaller maxillary sagittal length and height and an inharmonious jaw relationship. SMCP is associated with progressive maxillary retrognathism and reduced profile convexity from childhood to adulthood.

Cephalometric evaluation of the effect of dynamax and monoblock appliances on vertical facial height in patients with distal malocclusion

The most common abnormality in orthodontics is distal malocclusion. The patient will benefit more if is treated during active growth phase. Various types of functional appliances are used in order to control maxillary and mandibular growth. In this article we compared vertical changes in mandibular position as a result of 3 different distal malocclusion treatment methods. To this end, groups consisting of, 17 patients treated with dynamax appliance, 17 patients treated with Monoblock appliance, 16 patients treated with a Monoblock-Headgear combination were created. Research has shown that, treatment with removable functional appliances results in parallel downward positioning of mandible; treatment with semiremovable appliances results in backward and downward rotation of mandible and that the extraoral appliances are useless to control the lower facial height.

Comparison of the Pendulum appliance and the Jones Jig: A prospective comparative study.

Objective:To compare two molar distalization devices, the Pendulum appliance (PA) and the Jones Jig (JJ) in dental Class II patients.Materials and Methods:Pretreatment and postdistalization lateral cephalograms and study models of 20 subjects (6 males, 14 females) Class II malocclusion subjects were examined. PA and JJ group both consisted of 10 patients each with a mean pretreatment age of 12 years 1 month for females and 12 years 5 months for males. The PA and the JJ appliance were activated once in a month until Class II molar relationship was corrected to a super Class I molar relationship in both groups. Initial and final measurements and treatment changes were compared by means of Paired t-test.Results:Maxillary first molar distalized an average of 3.85 mm in the PA and 2.75 mm in the JJ between T1 and T2; rate of molar distalization was 1.59 mm/month for PA, and the JJ appliance averaged 0.88 mm/month, distal molar tipping was greater in PA (6.2°) than in the JJ (3.9°). Average mesial movement of the premolars was 2.2 mm with PA and JJ both. JJ showed a greater rotation of first molars after distalization as compared to PA. The increase in vertical facial height was also greater for JJ as compared to PA.Conclusions:Both the appliances were effective in molar distalization with PA requiring less distalization time (16 days less than JJ). Some adverse effects were noted with both which one should strive to control.

Facial profile and maxillary arch dimensions in unilateral cleft lip and palate children in the mixed dentition stage.

Objectives:The aim of this study was to evaluate the vertical and sagittal facial profile and maxillary arch width, depth, and length of patients with unilateral cleft lip and palate (UCLP) and to compare them with healthy noncleft children in the mixed dentition stage (7–13 years).Materials and Methods:This study is conducted at Hospital Universiti Sains Malaysia. UCLP group comprised 48 patients with nonsyndromic UCLP who have had the lip and palate repaired, whereas the control group comprised 48 healthy noncleft cases. The lateral cephalometrics measurements were used to determine the vertical height, sagittal depth of the face, and cranial base length and angle. Maxillary arch dimensions were measured on the study cast including arch width, depth, and length.Results:Vertical facial height and sagittal depth measurements showed a significant decrease (P < 0.05) in the mean growth pattern in UCLP group. The anterior cranial base length (S-N) was shorter in UCLP children (P < 0.001), while Ba-N length had no significant difference (P = 0.639). Nasion-Sella Tursica-Basion angle was significantly higher in the UCLP group (P = 0.016). Dental arch width with reference to canine-to-canine and first premolar-to- first premolar distance was significantly larger in control (P = 0.001).Conclusion:Mean vertical and sagittal facial dimensions in the UCLP children who do not undergo orthodontic treatment are significantly lesser in all directions of growth than healthy noncleft children. The maxillary dental arch had a normal depth but constricted in width and arch length.

Association between anterior alveolar dimensions and vertical facial pattern among Saudi adults.

ObjectiveTo establish the anterior alveolar dimensions among a sample of Saudi subjects with different vertical facial heights.Materials and methodsLateral cephalometric radiographs of 63 Saudi subjects (30 males and 33 females) were included in this retrospective study. The sample was divided into high angle (SN-MP ⩾ 39°), low angle (SN-MP ⩽ 28°) and average angle (30° < SN-MP < 37°) groups. The anteroposterior and vertical dimensions of the alveolus surrounding the root apex of upper and lower incisors were calculated.ResultsThe anterior alveolar dimensions exhibited significant differences (p < 0.05) between the different vertical facial height groups. The males and females demonstrated significant differences (p < 0.05) in the anterior alveolar dimensions for the same vertical jaw relationship.ConclusionsBoth gender and the vertical jaw relationship can be factors for different height and thickness of the anterior alveolus. Clinicians must be aware of differences in the anterior alveolar dimensions for safe and sound orthodontic tooth movement.

Cranial base topology and basic trends in the facial evolution of Homo

Facial prognathism and projection are important characteristics in human evolution but their three-dimensional (3D) architectonic relationships to basicranial morphology are not clear. We used geometric morphometrics and measured 51 3D-landmarks in a comparative sample of modern humans (N = 78) and fossil Pleistocene hominins (N = 10) to investigate the spatial features of covariation between basicranial and facial elements. The study reveals complex morphological integration patterns in craniofacial evolution of Middle and Late Pleistocene hominins. A downwards-orientated cranial base correlates with alveolar maxillary prognathism, relatively larger faces, and relatively larger distances between the anterior cranial base and the frontal bone (projection). This upper facial projection correlates with increased overall relative size of the maxillary alveolar process. Vertical facial height is associated with tall nasal cavities and is accommodated by an elevated anterior cranial base, possibly because of relations between the cribriform and the nasal cavity in relation to body size and energetics. Variation in upper- and mid-facial projection can further be produced by basicranial topology in which the midline base and nasal cavity are shifted anteriorly relative to retracted lateral parts of the base and the face. The zygomatics and the middle cranial fossae act together as bilateral vertical systems that are either projected or retracted relative to the midline facial elements, causing either midfacial flatness or midfacial projection correspondingly. We propose that facial flatness and facial projection reflect classical principles of craniofacial growth counterparts, while facial orientation relative to the basicranium as well as facial proportions reflect the complex interplay of head-body integration in the light of encephalization and body size decrease in Middle to Late Pleistocene hominin evolution. Developmental and evolutionary patterns of integration may only partially overlap morphologically, and traditional concepts taken from research on two-dimensional (2D) lateral X-rays and sections have led to oversimplified and overly mechanistic models of basicranial evolution.

Reliability of Nasofacial Analysis Using Rhinobase® Software.

Rhinoplasty is a constant challenge for the surgeon, where the correct evaluation of facial aesthetic parameters allows harmonic changes appropriate for each patient. The aim of this study was to compare the preoperative and postoperative results of nasofacial analysis, performed by Rhinobase® software (indirect anthropometry) compared with direct anthropometry (caliper), in patients undergoing aesthetic rhinoplasty. The authors assessed the reliability of using Rhinobase® software for measuring nasofacial characteristics in 20 individuals (18 F, 2 M). In each patient, the nasofacial analysis was performed before and after surgery. Two raters performed indirect anthropometry on each image on two separate occasions. Intrarater and interrater reliability for most indirect anthropometric measurements had intraclass correlation coefficients greater than 0.8. Regarding intermethod reliability, Pearson correlation coefficients ranged from 0.6 to 0.9 for most measurements. The highest correlation was found in interalar width, chin vertical, and lower facial height. The Cronbach's α coefficient calculated for all measurements was 0.8. The Rhinobase® software is an easy and safe method for facial analysis. This study provides evidence of high reliability for several nasofacial measurements. The nasofacial analysis allows an accurate preoperative evaluation, surgical planning, and analysis of outcomes in rhinoplasty and may be a useful tool for both novice and experienced surgeons. 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.

Effect of short one-third lower face toward mastication performance in Deutero Malay

The one-third lower face height belongs to ideal proportion, ratio 1:1:1, of vertical face height. The one-third lower face height could be influenced by mastication. The one-third lower face height that shorter than normal ratio is generally followed by deep bite which may lead to temporomandibular disfunction even so eustachian tube disfunction, this condition may interfere mastication function, which can be measured by mastication performance. The research objective was to determine the effects of short lower face height to the mastication performance based on overbite. The research method was a cross-sectional study with epidemiology survey type. Research subjects 12-15 years old junior high school with Deutero Melayu Sub races in Bandung. Sampling technique used multistage random sampling by determining the size of the sample based on potluck sample and gained 24 children (group 1) with the normal ratio of vertical face height and 27 children with short lower facial height which were 11 children overbite normal (group 2) and 16 children deep bite (group 3). Mastication performance by 20 times chewing artificial test food then followed by sieving test. Mastication performance value represented by the median particle size (MPS) and the distribution of the particle distribution (b). The results of average MPS and b between group 1, 2 and 3 used statistical analysis MPS with ANOVA test which Fhit=5.56 and pvalue=0.0075, b which Fhit=3.41 and pvalue=0.0430 showed significant differences. Continued with group T test MPS (value = 0.0925) dan b (value = 0.2076) between group 1 and 2 showed a non significant differences. While between group 1 and 3 showed a highly significant differences in MPS (value = 0.0037 and  = 0,01) and a significant differences in b (value = 0.0141 and  = 0,05). Conclusions of this study were children with short lower face height and normal overbite did not decrease the mastication performance while children with deep bite decrease the mastication performance.

Vertical facial height and its correlation with facial width and depth

IntroductionThe aim of the present study was to evaluate how vertical facial height correlates with mandibular plane angle, facial width and depth from a three dimensional (3D) viewing angle.MethodsIn this study 3D cephalometric landmarks were identified and measurements from 43 randomly selected cone beam computed tomography (CBCT) images of dry skulls from the Weisbach collection of Vienna Natural History Museum were analyzed. Pearson correlation coefficients of facial height measurements and mandibular plane angle and the correlation coefficients of height-width and height-depth were calculated, respectively.ResultsThe mandibular plane angle (MP-SN) significantly correlated with ramus height (Co-Go) and posterior facial height (PFH) but not with anterior lower face height (ALFH) or anterior total face height (ATFH). The ALFH and ATFH showed significant correlation with anterior cranial base length (S-N), whereas PFH showed significant correlation with the mandible (S-B) and maxilla (S-A) anteroposterior position.ConclusionsHigh or low mandibular plane angle might not necessarily be accompanied by long or short anterior face height, respectively. The PFH rather than AFH is assumed to play a key role in the vertical facial type whereas AFH seems to undergo relatively intrinsic growth.

SINGLE-APPOINTMENT FABRICATION OF INTERIM IMMEDIATE DENTURE: A CLINICAL REPORT

Objective: An immediate complete denture is fabricated before the extraction of all teeth. It has several advantages such as preservation of esthetics, muscular tone, normal speech and reduction of post-operative pain. This report describes a method of using patient's current fixed partial denture (FPD) for single-appointment construction of interim immediate denture. Case: We used patient's existing maxillary FPD for single-appointment fabrication of an interim immediate denture; which was delivered to the patient after the extraction of his remaining maxillary teeth. Conclusion: Within a short time, an interim immediate denture can be fabricated for patients to preserve occlusion, vertical facial height and facial appearance until the fabrication of final prosthesis.

Maintenance of Implant Hybrid Prostheses: Clinical and Laboratory Procedures

Fixed implant hybrid prostheses have been used for the last 40+ years in the treatment of edentulous patients. These prostheses have provided long-term masticatory function for thousands of patients. The original treatment protocol included fabrication of cast metal frameworks that fit accurately on the restorative platforms or abutments and/or endosseous implants. Frameworks were designed to splint implants together; they also provided retention and support for the functional and esthetic portions of the fixed hybrid prostheses. Initially, edentulous patients were treated with maxillary complete dentures and mandibular fixed, hybrid prostheses. Denture teeth were used in both prostheses. Over the span of many years, occlusal surfaces of the denture teeth in the mandibular prostheses exhibited signs of occlusal abrasion and wear, sometimes completely abrading the teeth and denture bases, resulting in framework exposures. Ultimately, this resulted in decreased chewing efficiency and loss of vertical facial height. Patients would then return to clinicians and ask for retreatment. In certain instances, the underlying frameworks would have to be remade. This involved replicating the original series of appointments and significant additional expense to patients and clinicians alike. The protocol presented in this article avoids having to remake the most expensive portion of fixed implant prostheses--the frameworks. The protocol identifies the clinical and laboratory procedures involved in using existing frameworks and replacing preexisting denture bases and denture teeth, with minimal inconvenience to patients.

Comparison of the upper, middle, and lower vertical facial height between Down syndrome and normal children

Introduction: Down syndrome (DS) is a common genetic disorder also known as Trisomy 21.DS individuals have specific physical dysmorphism especially the face. The most common features and problems associated with Down’s syndrome are characteristic facial features, cognitive problems, congenital heart disease, hearing problems, short stature, thyroid problems and Alzheimer’s disease. This study aims to determine the differences of the vertical facial height measurement (UFH, MFH and LFH) between DS and regular (R) children. Methods: The study is a Cross-sectional analytical. Subjects are 6-13 years of age, with a total of 20 DS children (10 males; 10 females) of selected Sekolah Luar Biasa-C (SLB- Cs) and 160 R school children (80 males; 80 females) from selected Sekolah Dasar Negeri (SDNs) in Kota Bandung. Subjects selected using the three levels Multi stage cluster sampling. Measurements taken were upper, middle and lower facial height with each measurement taken three times. Data was analysed using the t-test and p-value. Results: UFH in DS males are 5.623, 5.986, 6.352, 6.396, 6.585, 6.747,7.109; MFH 3.325, 3.456, 3.457, 3.646, 3.611, 3.720, 3.716 and LFH are 4.163, 4.283, 4.235, 4.771, 4.850, 4.979, 5.132. UFH in R males are 5.924, 6.029, 6.223, 6.362, 6.476, 6.725, 6.903, 7.366; MFH 3.942, 3.998, 4.103, 4.148, 4.175, 4.247, 4.463, 4.534 and LFH 4.509, 4.658, 4.882, 5.058, 5.167, 5.450, 5.532, 5.606. In DS females UFH are 5.745, 5.912, 5.986, 6.394, 6.339, 6.778; MFH 3.575, 3.704, 3.711, 3.768, 3.749, 3.865 and LFH 4.49, 4.552, 4.646, 4.909, 5.034, 5.039. UFH for R females 6.062, 6.167, 6.243, 6.308, 6.476, 6.515, 6.799, 6.965; MFH 3.700, 3.863, 3.981, 4.084,4.091, 4.116, 4.191, 4.221 and LFH 4.576, 4.702, 3.764, 4.998, 5.156, 5.326, 5.374, 5.552 (in cm). Conclusion: There are significant differences with the MFH and LFH between DS and R children and UFH differences is non significant between these two populations.

The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients

To determine the effect of mouth breathing during childhood on craniofacial and dentofacial development compared to nasal breathing in malocclusion patients treated in the orthodontic clinic. Retrospective study in a tertiary medical center. Clinical variables and cephalometric parameters of 116 pediatric patients who had undergone orthodontic treatment were reviewed. The study group included 55 pediatric patients who suffered from symptoms and signs of nasal obstruction, and the control group included 61 patients who were normal nasal breathers. Mouth breathers demonstrated considerable backward and downward rotation of the mandible, increased overjet, increase in the mandible plane angle, a higher palatal plane, and narrowing of both upper and lower arches at the level of canines and first molars compared to the nasal breathers group. The prevalence of a posterior cross bite was significantly more frequent in the mouth breathers group (49%) than nose breathers (26%), (P = .006). Abnormal lip-to-tongue anterior oral seal was significantly more frequent in the mouth breathers group (56%) than in the nose breathers group (30%) (P = .05). Naso-respiratory obstruction with mouth breathing during critical growth periods in children has a higher tendency for clockwise rotation of the growing mandible, with a disproportionate increase in anterior lower vertical face height and decreased posterior facial height.

Nonextraction treatment of a skeletal Class III malocclusion

This case report describes the nonsurgical, nonextraction therapy of a 16-year-old boy with a skeletal Class III malocclusion, a prognathic mandible, and a retrusive maxilla. He was initially classified as needing orthognathic surgery, but he and his parents wanted to avoid that. The Class III malocclusion was corrected with a rapid palatal expander and a maxillary protraction mask followed by nonextraction orthodontic treatment with fixed appliances, combined with short Class III and vertical elastics in the anterior area. The height of the maxillary alveolar process and the vertical face height were slightly increased with treatment. Class I molar and canine relationships were achieved, and the facial profile improved substantially.

Skeletofacial morphology of attractive and nonattractive faces.

The aim of this study was to answer the question: Is facial beauty related to specific skeletofacial morphology? Thirty attractive (25 females, 5 males) and 32 nonattractive (11 females, 21 males) subjects were compared. Facial attractiveness was assessed by the aid of en-face facial photographs. Skeletofacial morphology was determined using lateral head films. The radiographs were analyzed with respect to sagittal and vertical jaw relationships, facial height, profile convexity, and lip position. The relationship between the skeletofacial variables and "divine" facial proportions was evaluated with a facial disproportion index in the transverse and vertical plane. When comparing attractive with nonattractive females, the attractive females had a larger ANB angle and Wits-appraisal (P < .05 and P < .001, respectively), the soft tissue profile was more convex (P < .01), and the distances of the upper and lower lips to the "Esthetic Line" (E-line) were smaller (P < .01). When comparing nonattractive females with nonattractive males, the males had a larger Wits-appraisal (P < .01), the soft tissue profile was more convex (P < .01), and the distances of the upper and lower lips to the E-line were smaller (P < .01). A significant correlation (P < .05) between the skeletofacial variables and the transverse and vertical facial disproportion indices was found only for the ML/NL angle (transverse: r = -0.73, and vertical: r = 0.68) and for the posterior facial height (transverse: r = 0.80). It could be concluded that facial beauty in frontal view is related only to a minor degree to specific skeletofacial morphology in lateral view.

Pharyngeal airway dimensions after chin cup treatment in Class III malocclusion subjects

The objective of this study was to examine if chin cup therapy have any adverse effect on the sagittal pharyngeal dimensions in Class III malocclusion patients. Twenty patients (10 girls and 10 boys; mean age 10.31 +/- 1.15 years) with skeletal Class III malocclusion, and an untreated control group (8 girls and 10 boys, mean age 9.89 +/- 1.55 years) were evaluated. The chin cup appliance and an occlusal bite plate with 600 grams totally was used for 9.78 +/- 0.93 months. Linear, angular and area measurements were evaluated on the cephalometric radiographs taken before and after observation and treatment periods. Treatment changes showed significant increases in maxillary forward position, effective length of the maxilla and the mandible, and vertical facial height measurements. The mandible showed a clockwise rotation revealed by the decrease in SNB and the increase in mandibular plane angles. Significant increase in the nasopharyngeal area was found when the treatment and control groups were compared. The nasopharyngeal airway area was affected by chin cup treatment, without any adverse effect on the pharyngeal airway dimensions in the short term.