Well-balanced Faces Research Articles

Assessment of facial golden proportions among central Indian population.

Aim:This study aimed to identify and establish the facial and smile proportions in young adults and to compare the results with ideal or divine proportions, compare the proportions of males and females included in our study population and compare them with those established for Caucasian and Japanese populations.Materials and Methods:Two hundred participants (164 females, 36 males) with Angle's class I malocclusion (M.O). and well-balanced faces were selected and photographed in the frontal repose position. Analysis was done in Adobe Photoshop software. Statistical analysis was done using the Statistical Package for the Social Sciences version 17.0. (IBM Corporation Armonk, New York, United States).Results:Results suggested that females are more near to ideal ratios and males are more deviated from the ideal ratios. The proportions of males and females were not considerably different from each other. In Indian population, upper 3rd facial height (TR-LC) was increased and mid-face height (LC-LN) was decreased; in lower 3rd of the face, LN-CH was slightly increased in comparison to CH-ME. In facial widths, outer canthal width (LC-LC) was greater in the Indian population and mouth width (CH-CH) was normal. When compared with Indian population, Japanese participants had wider noses, outer canthal distance, and bitemporal width.Conclusion:It was concluded that significant difference was found between the proportions of the Indian population and ideal ratio. When Indian population was compared with Japanese and Caucasian populations, some parameters of facial proportions showed significant difference, which leads to the need for establishing standardized norms for various facial proportions in Indian population.

Tek Taraflı Dudak Damak Yarıklı Bireylerde Modifiye Gerçek Dikey Çizginin Konumunun Değerlendirilmesi

Objective: To compare the facial anteroposterior projection parameters of unilateral complete cleft lip and palate (UCCLP) patients with non-cleft (NC) individuals having well-balanced faces using Arnett and Gunson Module and determine the capability of modified true vertical line (mTVL) to depict the true extent of retrognathism in UCCLP patients was aimed. Material and Methods: Arnett and Gunson Analysis was used in the evaluation of standard cephalometric headfilms of 30 UCCLP individuals and 30 NC patients with pleasing facial profile between the ages of 17-19 years, taken in natural head position. Projection values relative to true vertical line (TVL, in NC individuals) or modified true vertical line (mTVL, in UCCLP) were measured. Second measurements were done relative to a line that is parallel to the TVL/mTVL but passing through the geometric center of sella turcica (sTVL). Independent samples t-test was used to compare the projections values of the groups. Results: Significantly greater projection values were acquired for Gb, Or, CB, SP, NB, A, Mx1, Md1, LLA, Pog' (p≤0.0001), B' (p≤0.001) and NT (p≤0.05) distances in UCCLP patients (using mTVL) compared to NC individuals (using TVL). On the other hand, projection values of Or, SP, NT, Mx1, ULA (p≤0.0001), A (p≤0.001), NB, A'(p≤0.001) and Gb, CB, Md1, LLA (p≤0.05) showed significant inadequacies in UCCLP patients when measurements were carried out relative to sTVL. Conclusion: This preliminary study showed that mTVL obtained by carrying the subnasale point 3 mm forward was still deficient in varying amounts depending on the severity of the midfacial retrognathism.

Cephalometric Hard and Soft Tissue Norms for Sudanese Adults

Introduction: Cephalometric norms of various populations show differences between diverse ethnic and racial groups. Thus, numbers of cephalometric norms have been established for different ethnic groups.Objective: To assess skeletal, dental and soft tissue features in a sample of well-balanced face of Sudanese university students.Materials & method: Lateral cephalographs were taken from 18-25 years old 35 male and 38 female Sudanese university students with balanced facial profile and Class I occlusion with no previous orthodontic treatment. Fourteen angular and five linear measurements, and facial index were recorded according to Husund analysis. Male and female mean values were compared statistically using Student t-test.Result: Statistically significant differences were noted between both genders especially in skeletal variables SNA˚, SNB˚, SNPg˚, ML- NSL˚, NL-NSL˚, UFH, LFH and dental variable I -Ī. Holdaway angle showed no significant difference between the genders. Skeletally, maxilla and mandible of the Sudanese sample were more prognathic compared to Caucasians and Arabs but less prognathic than the Africans. Dentally, maxillary and mandibular incisors were more proclined compared to Arabs and Caucasians. Soft tissue analysis showed more lip protrusion in Sudanese adults.Conclusion: The study offered normative cephalometric standards for Sudanese adults, which were specific for each gender group. The normative values showed that the Sudanese sample lied between African and Arab values which might suggest that the studied sample had an Afro-Arabian mixture.

Facial Soft Tissue Cephalometric Norms in a Central Indian Ethnic Population

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

Comparative study of the soft tissue of young Japanese-Brazilian, Caucasian and Mongoloid patients

To determine the normality mean values in the soft tissue cephalometric measurements of young Japanese-Brazilian, with normal occlusion and to compare the results of the variables with compatible samples of young Caucasians and Mongoloids. Forty radiographs of young Caucasians, 32 of Japanese-Brazilians and 33 of Mongoloids were used. The three samples presented individuals with normal occlusion and well-balanced face. The samples were divided by gender due to the soft tissue characteristics and to facilitate comparison. The following statistical tests were performed: Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) with p < 0.05. The Japanese-Brazilian sample of females showed thinner soft tissues in the nasion region and smaller nose when compared to the Caucasians. The Mongoloid sample showed thinner tissues in the supramentonian and pogonion regions. In males, the Japanese-Brazilians had thinner tissues in the nasion region; thicker lower lip and supramentonian region in comparison to the Caucasian sample. For the Mongoloid, soft tissue was thicker in the glabella and ANS-Sn regions. It is necessary to use specific soft tissue standards for this mixed race.

Assessment of the mandibular symphysis of Caucasian Brazilian adults with well-balanced faces and normal occlusion: the influence of gender and facial type

OBJECTIVE: This study aimed to establish cephalometric reference values for mandibular symphysis in adults. Dentoalveolar, skeletal and soft tissue variables were measured considering the influence of gender and facial type. METHODS: The sample consisted of sixty cephalometric radiographs of white Brazilian adult patients, with a mean age of 27 years and 6 months, who had not undergone orthodontic treatment and who presented well-balanced faces and normal occlusion. The sample was standardized according to gender (30 males and 30 females) and facial type (20 were dolichofacial, 20 mesofacial and 20 brachyfacial). RESULTS: The results showed that male and female symphyses are similar, except for symphyseal height, which was greater in males. In terms of facial type, the dolichofacial group presented narrower symphysis in dentoalveolar and basal areas, with a more accentuated lingual dentoalveolar inclination. CONCLUSION: The brachyfacial group showed broader symphysis in the dentoalveolar and basal areas and a greater buccal dentoalveolar inclination. The projection of the chin was 6.67 mm below the subnasal vertical line and there was no significant difference between the genders or facial types.

Comparison of Wits appraisal among different ethnic groups.

Objectives:The Wits values for various ethnic groups are different and the applicability of the norms described in these analyses to different populations is difficult. The objectives of this study were to establish the normal values of Wits appraisal in a sample from the western region of Saudi Arabia and to evaluate the existence of gender dimorphism. Also, to compare the results with previously published Wits values.Materials and Methods:A total of 66 lateral cephalometric digital radiographs of Saudi patients from the western region (25 males and 41 females, mean age 19.32±8.16 years and 20.88±8.77 years, respectively). All subjects had angle class-I occlusion, well-balanced faces, all premolars had erupted and in occlusion, and no history of orthodontic treatment. Tracing was performed using the VistadentOC® software.Results:Wits mean values were greater in males (−0.73±2.48) than females (1.79±2.06), with significant gender difference (P<0.001). Comparisons with previously published showed that there is a significant differences between ethnic groups, especially in females’ data.Conclusion:Wits appraisal appears to be gender-specific and ethnicity-specific for female values.

Evaluation of the nasolabial angle of the Komarapalayam population

Esthetic features are different from one race to another, and this should be considered during the treatment planning. The great variance in soft tissue drape of the human face complicates accurate assessment. The nose–lip–chin relationships are exceedingly important in determining the facial esthetics. One important soft tissue parameter in orthodontic diagnosis is the nasolabial angle. The purpose of this study was to establish norms for nasolabial angle as proposed by Fitzgerald for the Komarapalayam population. Normative data for the three nasolabial parameters were produced from a sample of 40 (20 male and 20 female) adults determined by the authors to have well-balanced faces. Mean and standard deviation values from this pooled sample demonstrated a lower border of the nose to Frankfort horizontal plane angle of 18° ± 7°, upper lip to Frankfort horizontal plane angle of 98° ± 5°, and nasolabial angle of 116° ± 10°. No statistically significant difference was demonstrated between the values for men and women in this study, but men did have a slightly larger nasolabial angle.

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

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

Comparison of conventional lateral cephalograms with corresponding CBCT radiographs

PurposeThis study was performed to assess the compatibility of cone beam computed tomography (CBCT) synthesized cephalograms with conventional cephalograms, and to find a method for obtaining normative values for three-dimensional (3D) assessments.Materials and MethodsThe sample group consisted of 10 adults with normal occlusion and well-balanced faces. They were imaged using conventional and CBCT cephalograms. The CBCT cephalograms were synthesized from the CBCT data using OnDemand 3D software. Twenty-one angular and 12 linear measurements from each imaging modality were compared and analyzed using paired-t test.ResultsThe linear measurements between the two imaging modalities were not statistically different (p>0.05) except for the U1 to facial plane distance. The angular measurements between the two imaging modalities were not statistically different (p>0.05) with the exception of the gonial angle, ANB difference, and facial convexity.ConclusionTwo-dimensional cephalometric norms could be readily used for 3D quantitative assessment, if corrected for lateral cephalogram distortion.

Ethnic differences in dentofacial relationships of Turkish and Saudi young adults with normal occlusions and well-balanced faces

The aims of the present study were (1) to determine ethnic differences in craniofacial dimensions between Turkish and Saudi populations and (2) to identify possible gender differences between males and females, based on a sample of untreated young adult subjects with normal occlusions and well-balanced faces. In total, 163 cephalometric radiographs were traced and evaluated to compare untreated adults of Turkish and Saudi ethnicity. The Turkish group comprised 86 subjects; 45 females and 41 males. The Saudi group comprised 77 subjects; 39 females and 38 males. For statistical evaluation, an independent-samples t-test was performed. The Turkish sample had a more retrognathic maxilla and mandible (p<0.001 for SNA and SNB) and a more vertical direction of facial development (p<0.001), with Turkish males having more retrusive lips (p<0.001). Distinctive ethnic differences were found in craniofacial structures between Turkish and Saudi young adults. It is appropriate to consider these aesthetic differences when a Turkish or a Saudi patient is being evaluated during routine diagnosis and treatment planning.

Angular Photogrammetric Comparison of the Soft-Tissue Facial Profile of Kenyans and Chinese

The purpose of this study was to determine the average angular dimensions that define the normal soft-tissue facial profiles of black Kenyans and Chinese and compare them with each other and with values proposed for whites. Standardized facial profile photographs, taken in natural head position, of 177 black Kenyans and 156 Chinese with normal occlusion and well-balanced faces were analyzed for 12 angular parameters. Two-sample t-tests were used to determine sex and racial differences. Kenyan and Chinese averages were compared with proposed white values using 1-sample t-tests. Eight parameters in Kenyans and 7 in Chinese showed sex differences. All angles, except for facial convexity, nasal dorsum, and inferior facial height, were different between Kenyans and Chinese. Kenyan and Chinese averages for all parameters were different from proposed white average, except for facial convexity. Nasolabial and mentolabial angles showed large individual variability and racial differences. The study demonstrated many differences in average angular measurements of the facial profiles of black Kenyans, Chinese, and white standards. Orthodontists, maxillofacial and plastic surgeons, and other clinicians working in the craniofacial region should bear these in mind when setting aesthetic treatment goals for patients of different races. Mean values from this study can be used for comparison with similar records of subjects with same ethnicity.

Ethnic differences in the soft tissue profiles of Turkish and European-American young adults with normal occlusions and well-balanced faces

The aim of this study was to evaluate soft tissue differences between Turkish and North American adults by comparing two sample populations with ideal occlusion and well-balanced faces. Lateral cephalometric radiographs of 117 Anatolian Turkish adults (65 female and 52 male, mean age: 23.9 ± 2.8 years) were compared with a sample of 116 adults of European-American ancestry (64 female and 52 male, mean age: 25.0 ± 6.8 years). The cephalometric analyses of Holdaway, Epker, and Legan and Burstone were performed using Dolphin Image Software 9.0. Thirty-two measurements (27 linear and 5 angular) were analysed. For statistical evaluation, independent samples t-tests were performed. Distinct differences were found between the two samples in facial convexity, upper lip position and length, lower lip position, chin prominence, and chin thickness. Vertical proportional findings were similar between groups. Ethnic differences were found between Turkish and North American adults in the soft tissue profile. It is appropriate to consider these differences during routine diagnosis and treatment planning of a Turkish patient or an American patient of European ancestry.

Cephalometric Norms for Indian Adults using Digital Posteroanterior Analysis

ABSTRACT Introduction Facial and radiographic records in orthodontics are based on the profile. Aim of this study is to establish norms from digital posteroanterior (PA) cephalograms for Indian adults. Materials and methods The subjects included 45 Indian men and 55 Indian women, mean age 25 to 30 years. Subjects had ideal occlusion and a well-balanced face. About 12 linear measurements were determined using digital radiograph. Results There was statistically significant difference between male and female samples. Comparison between the Indian men and women indicated larger measurements for men. Conclusion According to these results new PA clinical norms are presented to Indian orthodontists for diagnosis and planning. Abbreviations ANS—Anterior nasal spine, A3-B3—Upper and lower canine right side, 3A-3B—Upper and lower canine left side Me—Menton.

Comparison of craniofacial characteristics of typical Chinese and Caucasian young adults

The purpose of this study was to determine the cephalometric norms of typical Chinese young adult subjects with normal occlusions and well-balanced faces and to compare these norms with those derived from a matched Caucasian sample. Lateral cephalograms of 65 untreated Chinese adults (25 males, mean age 19.3 ± 3.0 years and 40 females, mean age 20.3 ± 3.4 years) were compared with a sample of 90 untreated Caucasian adults (30 males, mean age 24.1 ± 5.7 years and 60 females, mean age 22.9 ± 5.2 years). Each lateral cephalogram was traced and digitized, and conventional cephalometric analyses were applied. Independent sample t-tests were used to compare the values between the two ethic samples. Smaller midfaces and shorter mandibles were observed in Chinese young adults compared with those of Caucasians. The average value of lower anterior face height (ANS-Me) was longer in the Chinese females than that in the Caucasian females (P < 0.001). A greater vertical dimension also was seen in Chinese males compared with Caucasian males when evaluated by analysis of the facial axis angle (P < 0.05). The upper and lower lips were more protrusive in the Chinese, and a more convex facial profile was seen compared with the Caucasian sample. Significant differences in hard and soft tissue characteristics were found between Chinese and Caucasian young adults with normal occlusions and well-balanced faces. Gender and racial/ethnic differences must be taken into consideration during orthodontic diagnosis and treatment planning for the individual patient.

Analysis of the soft tissue profile in Croatians with normal occlusions and well-balanced faces

The aim of the study was to test the hypothesis that there is no difference between the soft tissue profile of Croatian and white North American adults. Facial profile photographs were taken of 110 Croatians (52 males and 58 females) with normal occlusions and well-balanced faces (age 22-29 years). The findings were also compared with a white Brazilian group. An independent Student's t-test (P < 0.05) was used to compare the soft tissue parameters of Croatians with those of North Americans and to assess gender differences. The soft tissue profile measurements that showed significant gender dimorphism (P < 0.001) were the true vertical line [(TVL)-nasal tip (NT)] and TVL-point B, indicating that the males had slightly greater nasal prominence (mean difference: 1.32 mm) and deeper labial sulci (mean difference: 2.04 mm) compared with the females. The upper lip was the same for both genders (1.25 mm), while the lower lip was 0.97 mm more prominent in females than in males. All soft tissue variables, except TVL-NT showed significant differences between Croatian and white American female subjects (P = 0.096). For male subjects, nasolabial angle was the only variable that showed no statistically significant difference between the two populations. A universal standard of facial aesthetic is not applicable to diverse white populations. These differences should be considered in diagnosis and treatment planning for Croatians, together with their individual characteristics.

A new concept for the cephalometric evaluation of craniofacial patterns (multiharmony)

Orthodontists commonly specify the alignment of the teeth and jaws by means of a set of k angles and their relationship with each other. Each individual can thus be visualized as a point in k-dimensional space. Individuals regarded as having an ideal occlusion and well-balanced face, form a cloud of points that is termed the 'norm' population. Individuals far from the cloud require orthodontic intervention. In this study, a method is presented--the multiharmony method (MHM), which assists in treatment planning. With multiple regression analysis, the expected value that each angle should take in a norm individual when the remaining angles are given is estimated. The residual difference between the measured angle and its expected value then indicates the deviation from a harmonic appearance in the respective angle. The MHM was applied to a data set of 134 Korean individuals identified as the norm population (Class I, mean age: 19.6 years) and to 87 patients (Class III, mean age: 21.2 years). From the number and size of the residuals, the two populations could be separated almost completely. Almost all patients showed residuals larger than any residual in the norm population (sensitivity: 99 per cent), whereas 90 per cent of all norm individuals showed no extreme residuals. The MHM can also be used to assist in visualizing different treatment effects, thereby assisting the orthodontist in choosing the best course of treatment for each patient.

Eye fixations when viewing faces

There is disagreement in the literature about the relative importance of the mouth and the teeth to facial attractiveness. Few investigators use objective measures for quantifying which facial features are important and their order of importance. Objective measures of the relative importance of a facial feature are in what order, for how long and how often viewers look at it. The authors conducted a study to determine the hierarchy and length of time study participants spent viewing features in facial images. The participants were 50 young adults. The authors used a pupillary-corneal reflection technique to measure viewers' eye movements when they were viewing images of faces after orthodontic treatment was completed. The authors took the measurements again after a two-week interval. They quantified eye fixations for six areas of interest: eyes, ears, nose, mouth, chin and other. The variables measured were the location of the first fixation, the location of the area of maximum fixation duration and the location of the area receiving the maximum number of fixations. Intraobserver variability among the participants was high for most of the variables assessed (kappa < 0.30). For the smile image, first fixation, the most frequent and the longest fixations were other, eye, nose, mouth, ear and chin, in that order. The mouth, even the smiling mouth, received less than 10 percent of the viewers' visual attention. Viewers' visual fixations on images of well-balanced faces do not preferentially go to any single facial feature. The mouth attracts only a small part of visual attention in well-balanced faces.

Analysis of cephalometrics for orthognathic surgery: Determination of norms applicable to Rajasthani population.

AimsTo determine the hard tissue surgical cephalometric norms statistically and geometrically in well-balanced faces having clinically acceptable facial profile in the Rajasthan population. To compare the cephalometric analyses of Rajasthanis males and females and to compare the craniofacial pattern of Rajasthani population with Caucasian norms.Materials and Methods:Lateral cephalograms of 200 subjects (100 males and 100 females) in the age group of 18–25 years, class I malocclusion and acceptable facial profile were obtained. Cephalometric analysis was performed and studied.Results:The study revealed that parameters, such as all horizontal skeletal parameters, PNS-N, PNS-ANS, Ar-Go, Go-Pg and upper OP to HP angle show no statistical significant difference between Rajasthani males and females. When comparing Rajasthani males and Caucasian males, the study suggested statistically significant difference in the mean values of parameters, such as PTM-N, L1-MP, 6-MP, Go-Pog, B-Pog, Ar-Go-Gn, U1 to NF and L1 to MP. When comparing Rajasthani females and Caucasian females, the study revealed no statistically significant difference between the mean values of parameters, such as N-A-Pg, N-A, N-B, L1-MP, Ar-Go-Gn, upper OP to HP angle and AB-OP and rest of the parameters showed highly significant difference between Caucasian females and Rajasthani females.Conclusion:This study indicates that Rajasthani population has a bimaxillary protrusion with predominant tendency toward horizontal growth pattern of the mandible and this tendency is further exaggerated in females. Rajasthani females also showed an increased length of the anterior cranial base, maxilla and mandible and in dental parameters they showed increased maxillary dental height and both Males and females showed decreased mandibular dental height.

A 3-dimensional method for analyzing facial soft-tissue morphology of patients with jaw deformities

Traditional cephalometric radiographs can analyze facial soft-tissues 2 dimensionally. Because they cannot provide information about the nose, lips, cheeks, and mouth, another method is needed to analyze these soft tissues. We introduce a new method for analyzing the 3-dimensional (3D) shape and size of facial soft-tissue morphology. A 3D average face model was constructed based on 3D computed tomography images of Japanese male and female adult volunteers who had well-balanced faces and normal occlusions. To test the feasibility of evaluating the quantitative effects of surgery, preoperative and postoperative 3D computed tomography images of facial soft tissues of 1 man and 1 woman were superimposed on the average faces. This quantitative assessment provided a comprehensive evaluation of the characteristics that separate size and shape. It was possible to view the superimposed images from any desired angle on a personal computer. This method provides easy-to-understand information for patients and appears to be useful for clinical diagnosis and pretreatment and posttreatment soft-tissue morphologic evaluations of patients with jaw deformities.