scholarly journals Validity of a Manual Soft Tissue Profile Prediction Method Following Mandibular Setback Osteotomy

2007 ◽  
Vol 01 (04) ◽  
pp. 202-211 ◽  
Author(s):  
Olga - Elpis Kolokitha

ABSTRACTObjectives: The aim of this study was to determine the validity of a manual cephalometric method used for predicting the post-operative soft tissue profiles of patients who underwent mandibular setback surgery and compare it to a computerized cephalometric prediction method (Dentofacial Planner). Lateral cephalograms of 18 adults with mandibular prognathism taken at the end of presurgical orthodontics and approximately one year after surgery were used.Methods: To test the validity of the manual method the prediction tracings were compared to the actual post-operative tracings. The Dentofacial Planner software was used to develop the computerized post-surgical prediction tracings. Both manual and computerized prediction printouts were analyzed by using the cephalometric system PORDIOS. Statistical analysis was performed by means of t-test.Results: Comparison between manual prediction tracings and the actual post-operative profile showed that the manual method results in more convex soft tissue profiles; the upper lip was found in a more prominent position, upper lip thickness was increased and, the mandible and lower lip were found in a less posterior position than that of the actual profiles. Comparison between computerized and manual prediction methods showed that in the manual method upper lip thickness was increased, the upper lip was found in a more anterior position and the lower anterior facial height was increased as compared to the computerized prediction method.Conclusions: Cephalometric simulation of post-operative soft tissue profile following orthodonticsurgical management of mandibular prognathism imposes certain limitations related to the methods implied. However, both manual and computerized prediction methods remain a useful tool for patient communication. (Eur J Dent 2007;1:202-211)

1993 ◽  
Vol 30 (5) ◽  
pp. 454-468 ◽  
Author(s):  
Rolf S. Tindlund ◽  
Per Rygh

During the last 15 years, cleft lip and palate (CLP) patients with maxillary deficiency in the care of the Bergen CLP team have undergone an interceptive orthopedic treatment phase during the deciduous and mixed dentition period. The present study includes 68 patients who received maxillary transverse expansion by use of a modified quad-helix appliance and 98 cases given maxillary protraction by a facial mask. All cases were treated until an acceptable normal occlusion was attained. Lateral cephalograms were taken immediately before and after the active treatment periods. Sagittal changes of the soft-tissue profile during transverse expansion and protraction were analyzed separately for unilateral complete cleft lip and palate (UCLP) patients and bilateral complete cleft lip and palate (BCLP) patients. The soft-tissue profiles of the groups were compared to growth changes of noncleft age-matched children (NORM group). During the short period of maxillary transverse expansion (mean period, 3.5 months) no significant change of the soft-tissue profile was found, except in the protrusion of the lower lip in the BCLP group. During the period of maxillary protraction (mean periods, 12 months in the UCLP group and 15 months in the BCLP group) the soft-tissue profile improved significantly by reducing the characteristic tendency towards a concave profile in CLP patients with maxillary deficiency. Significant Increases of the sagittal maxillomandlbular lip relation (angle SS-N-SM: mean Increase, 2.5 degrees) and the Holdaway-angle (H-angle: mean increase, 3.0 degrees) were found to be similar in the UCLP and BCLP groups. However, the use of different reference lines for evaluation of treatment effects upon the soft-tissue profile resulted in conflicting findings suggesting that anteriorly situated reference lines are more suitable for the evaluation of CLP patients. Thus, the esthetic line (E.line) indicated a favorable position of the lips after treatment; the subspinale-pogonlon line (ss.pg) revealed an Improved soft-tissue profile; the soft-tissue-facial line (N.PG) showed a retruded nose and upper lip; whereas basal references such as the nasion-sella line (NSL) and the occlusal-line perpendicular (OLP) mainly showed major differences between the CLP groups and the NORM groups.


2021 ◽  
Vol 2 (3) ◽  
pp. 92-99
Author(s):  
Ayman Salman Al-Shakhs ◽  
Hayder Abdallah Hashim

Background: The general tendency of facial soft tissue response toward incisors retraction could be expected in various malocclusions. However, different initial malocclusion no doubt leads to differences in this response. Material and method: This retrospective study consisted of thirty-seven pre- and posttreatment lateral cephalographs belongs to adolescent female with mean age of 15.03 years. The twenty-four landmarks (skeletal, dental, soft tissue) were located and horizontal and vertical reference planes were used. Sixteen linear and six angular measurements were evaluated statistically. The pretreatment and posttreatment lateral cephalograms were superimposed on best fit cribriform plate of the ethmoid to analyze soft tissue facial profile changes after orthodontic treatment. Results: The three methods of error indicated that measurements were valid and reliable. The Labrale superius retraction exhibited the best predictability among upper lip components (Sn, Ss), whereas the lower lip showed better predictability and correlation than the upper lip. The upper and the lower lips revealed relatively similar mean retraction value (2.92 mm) and (2.6 mm) although the upper incisors retracted more (5.25 mm) than the lower incisors (2.86 mm). Conclusion: The upper incisors to Labrale superius ratio (1.99:1, UIP:Ls) exhibited the highest correlation (r=0.55**) among the other established ratios. The lower incisors to Labrale inferius ratio was (1.13:1, LIP: Is) with significant correlation (r=0.44**), whereas no significant correlation was observed with Labrale superius (r=0.27).


2011 ◽  
Vol 139 (7-8) ◽  
pp. 439-445
Author(s):  
Tatjana Tanic ◽  
Zorica Blazej ◽  
Vladimir Mitic

Introduction. Orthodontic treatment of dento-skeletal anomalies is generally based on the correction of teeth and jaws relationship, while it is expected that soft facial tissue spontaneously adapts to therapeutically achieved relationship and to accompany hard tissue changes. Objective. To establish facial soft tissue thickness conditioning by the presence of dento-skeletal anomalies. Methods. The study was performed at the Dental Clinic of Nis, and involved the analysis of cephalometric rendgenograms in 121 patients, aged 12-18 years, with no previous orthodontical treatment. According to dento-skeletal relationship between teeth and jaws the patients were divided into four groups; class I (control group), class II of division 1, class II of division 2 and class III. The standard analysis of dento-skeletal profile was done according to Steiner and soft tissue profile according to Burstone was done in all. Results. The patients of class II/1 had a significantly thinner upper lip (t=2.650; p<0.05) and thinner upper lip sulcus (t=1.999; p<0.05). The patients of class II/2 had a significantly thicker upper lip (t=2.912; p<0.01), while those of class III had a significantly thinner lower lip (t=3.900; p<0.001). Conclusion. The thickness of facial soft tissue considerably influences facial profile appearance in persons with a dento-skeletal anomaly. Not only do soft tissues adapt to the existing jaws relationship, but can also camouflage present anomalies.


2008 ◽  
Vol 78 (2) ◽  
pp. 317-323 ◽  
Author(s):  
Omur Polat-Ozsoy ◽  
Aylin Gokcelik ◽  
Ahu Güngör-Acar ◽  
Beyza Hancioglu Kircelli

Abstract Objective: To evaluate the soft tissue changes associated with the pendulum appliance that was supported with a K-loop buccally and to compare these treatment changes with a cervical headgear group. Materials and Methods: The records of 30 patients having skeletal Class I, dental Class II malocclusions were divided to two groups. Group 1 consisted of 7 girls, 8 boys (mean age, 15.0 ± 3.4 years), and Group 2 consisted of 10 girls, 5 boys (mean age 14.2 ± 2.9 years). The first group was treated with a pendulum appliance that was supported with a K-loop buccally, and the second group was treated with cervical headgear. Lateral cephalograms were taken at the beginning of treatment and at the end of distal molar movement. Treatment changes within the groups were analyzed using the paired t-test, and between group changes were analyzed with the independent t-test. Results: The results showed that the pendulum/K-loop appliance had no significant effect on skeletal and dental variables and soft tissue A point, upper lip thickness, and sagittal upper lip position relative to the E plane. A significant difference for the change in Vp-Ls distance was found in patients in the pendulum/K-loop group (P &lt; .05). Patients in the cervical headgear group showed significant retrusion in skeletal, dental, and soft tissue measurements (P &lt; .05). Conclusions: The pendulum/K-loop appliance produces distal molar movement without causing any significant changes in the sagittal or vertical positions of either the jaw or the soft tissue profile.


2017 ◽  
Vol 21 (3) ◽  
pp. 162-166
Author(s):  
Smaragda Kavvadia ◽  
Sossani Sidiropoulou-Chatzigianni ◽  
Georgia Pappa ◽  
Eleni Markovitsi ◽  
Eleftherios G. Kaklamanos

SummaryBackground/Aim: Class III malocclusion case are considered complex problems associated with unacceptable esthetics. The purpose of the present study was to assess the characteristics of the soft tissue profile and investigate the possible gender differences in adult Greeks with Class III malocclusion. Material and Methods: The material of the study comprised of 57 pretreatment lateral cephalograms of adult patients with Class III malocclusion aged 18 to 39 years. Eleven variables were assessed. The variables were measured and the mean, minimum and maximum and standard deviations were calculated. Parametric and non-parametric tests were used to compare males and females patients. Results: The total sample was characterized by concave skeletal profile. Male patients exhibited greater nose prominence and superior sulcus depth, longer distance from subnasale to the harmony line, more concave profile, thicker upper lip and larger upper lip strain. Conclusions: Many significant differences were noted in soft tissue characteristics between males and females with skeletal Class III malocclusion, suggesting possible gender dimorphism.


2021 ◽  
Vol 54 (3) ◽  
pp. 132
Author(s):  
Hilda Fitria Lubis ◽  
Maureen Olivia

Background: Soft tissue analysis is essential in treatment planning to ensure proportional, balanced, and harmonious soft tissue at the end of treatment. Several factors influence the variations, such as age and gender. Soft tissue profile analysis is usually studied from a lateral view. Purpose: The study aimed to determine whether there were differences in the average values of linear and angular measurement of the soft tissue profiles of the middle and lower third of the face between Chinese males and females high school students using lateral photometry. Methods: The samples were 100 lateral photographs (50 male and 50 female) of Chinese high school students at W.R. Supratman 1 and 2 in Medan. All samples were collected based on the inclusion and exclusion criteria obtained from secondary data. The linear and angular measurements were measured using Software Corel Draw 2019 and analysed statistically using an independent t-test and the Mann-Whitney test. Results: The inferior facial third, length of the lower lip, and prominence of the upper lip were, on average, greater in males, whereas in the prominence of pogonion, nasolabial angles, and nasofrontal angles were greater, on average, for females. Conclusion: There were significant gender differences in Chinese high school students in the inferior facial third, length of the lower lip, prominence of the upper lip, nasolabial angle, and nasofrontal angle, whereas there is no significant difference between genders in the prominence of the pogonion.


2019 ◽  
Vol 9 ◽  
pp. 230-234
Author(s):  
Nishanthi Vithanaarachchi ◽  
L. S. Nawarathna

Context: Comprehensive cephalometric analysis plays a significant role in orthodontic diagnosis and treatment planing and variety of cephalometric standards have been developed for different populations. It is important to develop standard cephalometric norms for different populations. Aims: The aim of this study was to develop cephalometric standards for Sri Lankan Sinhalese adolescents with Class I malocclusion and to test the hypothesis that there are racial differences in cephalometric measurements between Sri Lankan and Caucasian norms. Setting and Design: Cross sectional , hospital based, descriptive study. Materials and Methods: Lateral cephalograms were obtained from 33 males (aged 15.7 ± 1.99 years) and 42 females (aged 15.6 ± 2.29 years). Inclusion criteria were healthy individuals with normal growth and development, straight facial profile, average vertical facial proportions, full complement of dentition (excluding third molars), normal overjet and overbite, Class I incisor, canine and molar relationship, and no crossbite in the anterior/posterior region. Eight angular and four linear measurements were analyzed in skeletal, dental, and soft-tissue assessment. Statistical Analysis Used: Statistical analysis was performed using the statistical software R 3.5.0. Results: In the dentoalveolar assessment, the Sri Lankan subjects had a significantly proclined upper (UI to N-A = 23.28) and lower incisor (LI to N-B = 6.56 mm and 28.3) inclinations compared with the Caucasian norms. In the assessment of soft-tissue profile, both upper (1.66 ± 2.7mm) and lower lip (2.8 ± 2.6mm) protrusions were slightly increased than the norms of the Steiner analysis, and these findings were clinically significant. There were no apparent differences in relation to anteroposterior and vertical skeletal relationship when compared with Caucasian norms. Conclusions: The results of the present study suggested that Sri Lankan Sinhalese adolescents with Class I occlusion are likely to present greater incisor proclination than Caucasians. Key Messages: The present study suggested that Sri Lankan Sinhalese adolescents are likely to present greater incisor proclination than Caucasians in Class 1 malocclusion.


2020 ◽  
Vol 10 ◽  
pp. 178-184
Author(s):  
Mustafa Nasar ◽  
Donald J. Ferguson ◽  
Johnny Joung-Lin Liaw ◽  
Laith Makki ◽  
Nikhilesh R. Vaid

Objectives: The objective of the study was to evaluate the validity of five soft-tissue profile planes to actual horizontal lower lip changes following treatment of severe bimaxillary protrusion patients with vertical maxillary excess using extra-alveolar miniscrews. The null hypothesis was no differences in the incremental changes of horizontal lower lip changes from pre-treatment to post-treatment of the five methods compared to actual changes. Materials and Methods: Seventy adults were treated orthodontically with extractions for bimaxillary protrusion and “gummy” smile using extra-alveolar miniscrews. Lower lip horizontal position was assessed with pre- and post-treatment lateral cephalograms and five commonly used soft-tissue reference lines were used to measure horizontal lower lip treatment change. Results: Compared to actual therapeutic lower lip horizontal retraction (4.38 mm), soft-tissue references Ricketts’ E-line (3.89 mm) and Steiner’s S-line (3.88 mm) demonstrated no statistical difference (P > 0.05) from actual change. The five profile plane measures showed moderately high to high intercorrelations among themselves, but none of them were related to the actual amount of anteroposterior lip change that occurred. None of the five soft-tissue measurements showed a statistically significant difference (P > 0.05) between subgroups with least and greatest lower lip retraction. Conclusion: Under conditions of maximum lower lip retraction, Rickett’s E-line and Steiner’s S-line were fair measures of horizontal lower lip change. Although actual lower lip change and soft-tissue reference plane changes were correlated poorly, intercorrelations among the five soft-tissue references planes were moderately high. None of the five soft-tissue measurements was able to discriminate (P > 0.05) between treatments with least and greatest lower lip retraction. It may be concluded that Rickett’s E-line and Steiner’s S-line soft-tissue profile references are valid when there is considerable therapeutic retraction (4+ mm) of the lower lip.


2012 ◽  
Vol 140 (7-8) ◽  
pp. 412-418
Author(s):  
Tatjana Tanic ◽  
Zorica Blazej ◽  
Vladimir Mitic

Introduction. Different malocclusions indicate different thickness of facial soft tissue. Objective. The aim of the study was to establish the differences in the thickness of facial soft tissue profile in persons with dentoskeletal Class II/1 and II/2 relationship. Methods. In the study we used cephalometric rendgenograms profile analysis of 60 patients aged 12-18 years of the Dental Clinic in Nis who had not previously undergone orthodontical treatment. According to the dentoskeletal jaws relations the patients were divided into two groups with Class II division 1 and Class II class division 2. In all of them the standard dentoskeletal profile analysis by Steiner and soft tissue profile analysis by Burston was done. The obtained findings were statistically analyzed and the comparison between the studied groups was performed. Results. The results indicated the following: in the patients with Class II/1 relationship there was a significantly thinner upper lip (t=5.741; p<0.0001), thinner upper lip sulcus (t=3.858; p<0.001) and significantly thinner lower lip (t=2.009; p<0.05) in relation to the patients with Class II/2. Compensatory effect in the Class II/1 patients was more distinctive in females, as their soft tissue profiles were thicker. In Class II/2 patients this relationship was in favor of males. Conclusion. The facial soft tissue profile indicated significant differences in the thickness dependant on the type of malocclusion and gender. Because of their great variability and a significant participation in the formation of the profile, while planning orthodontic therapy, it is necessary to pay them full attention, with obligatory analysis of the dentoskeletal profile.


1991 ◽  
Vol 17 (1) ◽  
pp. 10-21
Author(s):  
Ram Nanda ◽  
◽  
Hanspeter Meng ◽  
Sunil Kapila ◽  
Jolande Goorhuis ◽  
...  

Longitudinal growth changes in the soft tissue profile of 40 caucasians between the ages of 7 and 18 were studied. The sample consisted of 17 males and 23 females who had Class I dentitions and balanced faces at age 7 and 18 years. None of the subjects received any orthodontic treatment. Cephalometric radiographs were available, as a rule, on a yearly basis. Soft tissue thickness, measured at the nose, upper lip, lower lip and chin, as well as the length of the upper and lower lip, all increased by varying amounts over the period of the study. Females acquired more growth as a percentage of their adult size (at age 18) than males in all variables except the angle of inclination of the skeletal chin which increased more in males. The largest increase in relative size was noted in the nose measurements. In males, the nose had not attained adult size even at age 18. Upper lip length growth, on the other hand, in both males and females was complete by the 15th year. The difference between male and female lip length growth was clinically significant; the average aggregate increase in upper and lower lips combined in males was 6.9 millimeters compared to 2.65 millimeters in females. The total gain in thickness at laberale superius was over four times as much in males as in females and continued to increase in males even at age 18. The change in thickness of the soft tissue at pogonion was not large, an average of 2.4 millimeters in males and 1.5 millimeters in females. The major contribution to the anterior growth of the chin was translatory, contributed largely by growth in the skeletal length from pogonion to pterygomaxillary plane.


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