Growth patterns of the nasolabial region: a morphometric study.

Age-related growth changes in the nasolabial region were analyzed through six measurements taken between 1 year and 18 years of age in 1,593 North American Caucasians. By 1 year of age, the length of the cutaneous portion of the upper lip and the width of the nose showed the highest levels of development compared with their adult size, 80.3 and 79.5%, respectively. By 5 years, the developmental level of the nasolabial region except nasal tip protrusion approached their maturation level. Our nasal measurements indicated that growth of the nose between 5 and 18 years was significantly greater than that of the upper lip, which revealed significantly greater growth increments between 1 and 5 years of age. The cutaneous upper lip height reached its adult size in 3-year-old females (12.7 mm) and 6-year-old males (14.4 mm). Nose width and height were fully developed in females by age 12 and in males by age 14 or 15. Rapid growth occurred in the upper lip, nose height, and nasal tip protrusion between the ages of 1 and 4 years. Knowledge of these age-related morphologic variations within the nose and upper lip may be useful in planning the time and type of reconstructive surgery and in anticipating further change in the operated regions after the surgical reconstruction.     

Growth changes in the soft tissue facial profile

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.     

Morphologic changes in the upper airway structure following surgical correction of mandibular prognathism

The purpose of this study was to investigate morphologic changes in oropharyngeal structures in mandibular prognathic patients after orthognathic surgery. The study consisted of 25 patients (12 males and 13 females) with mandibular prognathism who underwent surgical and orthodontic treatment. A set of 4 standardized lateral cephalograms were obtained from each subject preoperatively and at 3 months, 6 months, and 1 year postoperatively. Morphologic changes in upper airway structures were evaluated longitudinally by gender. Parameters of the anteroposterior width of the pharynx significantly decreased at 3 and 6 months in both genders, and these parameters tended to rebound to the preoperative values 1 year postoperatively in females, but not in males. The hyoid bone significantly descended inferiorly 1 year postoperatively in males, while there were no significant changes in females. The distance between the hyoid bone and the third vertebra gradually decreased in males postoperatively; however, there were no significant changes in females. The cross-sectional area of the hypopharynx significantly decreased 1 year postoperatively in males, but not in females. These results indicate that the upper airway morphology changed differently in males and females following surgery. To compensate for skeletal changes following surgery, it appears that males and females responded in different ways to preserve a functional upper airway.     

First premolar extraction effects on upper airway dimension in bimaxillary proclination patients

Abstract Objective: To determine how orthodontic treatment with first premolar teeth extracted and the associated arch dimensional changes in bimaxillary proclination patients affect the upper airway dimensions. Materials and Methods: Pre- and postorthodontic treatment cephalograms and dental casts of 40 bimaxillary proclination patients (ages ranged between 18 and 23?years) were used for this study. Patients were all treated with extraction of the four first premolars. Cephalometric radiographs were used to measure airway dimensions, and dental casts were used to measure the changes in the arch dimensions. A paired t-test was used to detect differences at P < .05. Results: The results showed statistically significant reductions in tongue length (P < .05), posterior adenoids thickness (AD2-H) (P < .05), upper and lower incisor inclination, and lower incisor to A-Pog line (P < .001). Considering the dental cast results, statistically significant reductions in upper arch length, lower arch length, and lower intermolar width were also found (P < .001). The only statistically significant increase was recorded for the upper intercanine width (P < .001). Conclusions: Extraction of the first premolars for the treatment of bimaxillary proclination does not affect upper airway dimensions despite the significant reduction in tongue length and arch dimensions.     

Dynamics of a smile in different age groups

Objective:To evaluate smile in different age groups and to detect gender differences in smile.Materials and Methods:Digital videographic records of 241 randomly selected subjects were obtained for smile analysis. The subjects were divided into four groups by age (15–20 years, 21–30 years, 31–40 years, and 41–50 years). Each group was further subdivided by gender. After 41 subjects were excluded, the smile dimensions of 200 subjects were analyzed by two-way multivariate analysis of variance (MANOVA) with Duncan''s multiple range post hoc test.Results:All dynamic measurements (change in upper lip length, upper lip thickness, commissure height, and intercommissural width from rest to smile) decreased with age in both males and females. Changes in upper lip length and commissure height on smiling were greater in males as compared with females of the same age groups. Changes in intercommissural width on smiling were greater in females as compared with males in all age groups.Conclusion:Smile changes with increase in age, and the changes differ between males and females. Females had a wider smile as compared with males of similar age groups.     

Differences between high- and low-angle subjects in arch form and anterior crowding from 23 to 33 years of age

The aim of this study was to compare changes in arch width and length in high- and low-angle subjects. The material comprised the cephalograms and study models of 17 males and 15 females with a high-angle and 12 males and 16 low-angle females. The age of the subjects at the first examination (T1) was 22 years 10 months and 22 years 8 months in the high-angle groups, 22 years 5 months and 22 years 8 months in the low-angle subjects, respectively, for males and females. The second assessment (T2) was 10 years and 9 years 10 months later in the high-angle and, 10 years 3 months and 9 years 10 months in the low-angle groups, respectively. Statistical analysis of changes for each group during the observation period T1-T2 was undertaken using a paired t-test, and the differences between the groups with two-sample t-tests. The findings showed a general reduction in upper and lower arch length, an increase of intermolar width, and a decrease of intercanine width in both genders. Anterior perimeter and anterior space in both angles decreased in both males and females. The mean changes were small, but with large individual differences. There were no significant differences between the genders or the high- and low-angle groups in the changes, except that the female high-angle group had a statistically significant (P = 0.05) greater decrease in mandibular arch length than the low-angle female group.     

正畸患者对姿势位微笑上唇位置的审美评价

目的调查正畸患者对姿势位微笑时上唇位置高度的主观美学评价,探讨不同年龄、性别正畸求治人群是否存在微笑美学的审美差异,以期为正畸临床提供美学参考依据。方法选取理想男、女姿势位微笑面下1/3照片各1张,利用Photoshop软件对上唇位置进行变动,形成男、女微笑系列图片各11张,设计临床电子调查问卷。随机选择于山东大学口腔医院进行正畸治疗的患者300名,由患者选出最美的姿势位微笑图片3张,进行统计学分析。结果不同年龄组患者对微笑唇位置的审美有显著性差异(P<0.05),相对于青年组,中青年组和中年组更倾向于较低的上唇位置;不同性别组患者对微笑唇位置的审美差异无统计学意义(P>0.05)。结论不同正畸患者对姿势位微笑上唇位置的审美偏好有差异,微笑的审美受到年龄的影响,医生在诊治过程中应充分考虑不同年龄患者的审美期望。     

非综合征唇腭裂患者与骨性Ⅰ类人群的上气道对称性分析研究

目的 对非综合征唇腭裂患者与骨性Ⅰ类人群的上气道对称性进行三维分析对比研究。方法 选择非综合征唇腭裂患者51例(男性37例,女性14例,平均年龄(17.40±5.93)岁)和骨性Ⅰ类人群53例(男39例,女14例,平均年龄(17.40±6.07)岁),拍摄锥形束CT,应用Dolphin 3D 11.9软件进行三维测量分析,采用SPSS 25.0软件包进行独立样本t检验对比两者上气道对称性。结果 单侧唇腭裂患者上气道鼻咽段和腭咽段为不对称结构(P<0.05),其患侧横截面直径小于健侧;而双侧唇腭裂患者及骨性Ⅰ类人群,其上气道鼻咽和腭咽段为基本对称结构(P>0.05)。结论 单侧唇腭裂患者的上气道横截面直径中,有患侧偏向健侧的趋势,应注重其患侧的通气及呼吸情况。     

Three-dimensional lip morphology in skeletal Class I malocclusion with labial inclination of the upper central incisors

PurposeThe purpose of the present study was to examine the three-dimensional (3D) lip morphology in cases of skeletal Class I malocclusion with labial inclination of the upper central incisors.Materials and methodsThirty-five Japanese patients with malocclusion were divided into 2 groups: 20 patients (Test group; 9 males and 11 females; 7 years 5 months–14 years 2 months) who exhibited Class I malocclusion with labial inclination of the upper central incisors and 15 patients (Control group; 7 males and 8 females; 8 years 0 month–14 years 4 months) who exhibited skeletal Class I malocclusion with standard inclination of the upper central incisors. The 3D morphology of the facial soft tissue was recorded using a 3D surface-imaging device for both groups. The differences in the lip morphology variables between the Test and Control groups were then analyzed statistically.ResultsThe central, right and left upper lip inclination angle in the lateral and three-quarter views in the Test group were significantly larger than those in the Control group. The upper lip base area, protrusion surface area, protrusion volume, and protrusion depth were significantly increased compared with the Control group, as were also the lower lip protrusion volume and depth. However, no significant differences in the lower lip base area and surface area were determined between the Test and Control groups.ConclusionsThe upper lip wholly showed labial inclination and forward protrusion in Class I malocclusion with labial inclination of the upper central incisors.     

8～12岁无鼾儿童上气道发育的X线头影测量研究

目的本研究对处于生长发育高峰期的无鼾少年儿童进行观察测量,旨在探讨年龄、颅颌面结构及周围软组织发育对上气道的影响。方法本研究样本为混合纵向资料。包括73组志愿者资料（男36例,女37例）,按年龄分为五组：8岁组、9岁组、10岁组、11岁组及12岁组。志愿者均进行整夜多导睡眠监测以排除睡眠障碍儿童,并进行头颅侧位片拍摄及测量,结果进行方差分析。结果上气道鼻咽部PNS-R（P=0．003）、UPW（P=0．001）均在8～11岁随年龄增长而增长,而在11～12岁出现下降趋势;腺样体在8～9岁间出现明显减小趋势,而在10岁后表现出增大趋势;腭咽部SPP-SPPW（P=0．01）在8～9岁间出现明显增长;UMPW及舌咽部PAS随年龄无显著性变化;SPT（P=0．05）、TGL（P=0．oo）、TGH（P=O.00）及CoMe（P=0．oo）均在10岁后表现为明显增长;v_LPw、H—CVP（P=0．00）在10岁后显著性增长。在颌骨垂直方向上N-ANS、N-Me、Co-Go随年龄增长而出现显著增大（P=0.00）。结论上气道鼻咽部生长主要受腺样体影响;舌体及软腭的生长可能会限制腭咽及舌咽部气道的生长;舌骨随年龄变化相对于脊椎向前移动可能是喉咽部气道增长的主要原因之一。     

年轻男性无鼾症错(牙合)患者上气道大小与牙颌结构的关系

目的探讨年轻成年男性无鼾症错畸形患者上气道大小与牙颌结构的相关性。方法52例男性无鼾症的错畸形患者(年龄18~24岁,平均19岁),正畸治疗前拍摄头颅定位侧位片,选择有代表性的牙颌结构测量参数为自变量,以上气道间隙参数为因变量,进行两者间的逐步回归统计学分析。结果软腭后气道间隙(SPAS)与下颌矢向位(SNB角)、前颅底长度(S-N)、舌骨矢向位(H-C3距)呈正相关;软腭尖后气道间隙(MAS)与H-C3距、SNB角呈正相关,与下切牙倾斜度(L1-MP角)呈负相关;舌根后气道间隙(IAS)与SNB角、H-C3距、S-N距呈正相关,与L1-MP角呈负相关。结论年轻成年男性无鼾症错畸形患者上气道大小与牙颌结构及舌骨位置密切相关。     

不同性别骨性Ⅱ类无鼾青少年患者的上气道、舌骨及牙颌软硬组织差异性研究

目的:比较不同性别12～16岁青少年上气道、舌骨及牙颌软硬组织差异及其相关性，为临床制定具有性别差异的诊疗参考。方法:选择70例骨性Ⅱ类青少年患者，男女比例为1∶1，年龄、垂直骨面型严格匹配。用Invivo 5进行三维重建并测上气道、舌骨及牙颌软硬组织指标，进行独立样本 t检验及Pearson相关性分析。 结果:男、女性患者舌咽体积分别为[(6.68±2.71) cm 3、(5.36±1.73) cm 3， P＝0.019]，男、女性患者舌骨垂直距离分别为[(101.56±16.72) mm、(92.44±19.11) mm, P＝0.037]，具有统计学意义。男、女性Y轴角、NP-FH、RH、PFH、AFH、FHR、OP-SN、IOB、U1-E、Sn-G均有统计学意义。男性上气道与颌骨有显著相关性，女性上气道与牙齿角度及软组织有显著相关性。 结论:男性舌咽体积更大，牙颌软硬组织趋向于 平面平整且上唇及颏部靠前的水平生长型。临床上制定不同性别的诊疗方案时，男性趋向于着重考虑颌骨指标对上气道及舌骨的影响，女性着重考虑牙性指标对上气道及舌骨的影响，旨在逐步建立反映不同性别患者特征的颌骨及牙性指标，为预判不同性别患者治疗后上气道形态及舌骨位置的改变提供一定参考依据。     

140名山西籍青年人微笑美学定性指标初步分析

目的:分析山西籍青年人姿势微笑位美学定性指标,探讨性别对微笑特征的影响,为前牙美学区域修复治疗提供参考依据.方法:选取20～30岁个别正常(牙合)140例受试者,男68例,女72例,平均年龄25.6岁.采用视频录像的方式记录姿势微笑位的整个过程,使用计算机软件获取姿势微笑位图像.对微笑线、微笑弧、上唇曲度、上颌前牙与下...     

不同性别骨性Ⅱ类无鼾青少年患者的上气道、舌骨及牙颌软硬组织差异性研究

目的:比较不同性别12～16岁青少年上气道、舌骨及牙颌软硬组织差异及其相关性，为临床制定具有性别差异的诊疗参考。方法:选择70例骨性Ⅱ类青少年患者，男女比例为1∶1，年龄、垂直骨面型严格匹配。用Invivo 5进行三维重建并测上气道、舌骨及牙颌软硬组织指标，进行独立样本 t检验及Pearson相关性分析。 结果:男、女性患者舌咽体积分别为[(6.68±2.71) cm 3、(5.36±1.73) cm 3， P＝0.019]，男、女性患者舌骨垂直距离分别为[(101.56±16.72) mm、(92.44±19.11) mm, P＝0.037]，具有统计学意义。男、女性Y轴角、NP-FH、RH、PFH、AFH、FHR、OP-SN、IOB、U1-E、Sn-G均有统计学意义。男性上气道与颌骨有显著相关性，女性上气道与牙齿角度及软组织有显著相关性。 结论:男性舌咽体积更大，牙颌软硬组织趋向于 平面平整且上唇及颏部靠前的水平生长型。临床上制定不同性别的诊疗方案时，男性趋向于着重考虑颌骨指标对上气道及舌骨的影响，女性着重考虑牙性指标对上气道及舌骨的影响，旨在逐步建立反映不同性别患者特征的颌骨及牙性指标，为预判不同性别患者治疗后上气道形态及舌骨位置的改变提供一定参考依据。     

Closure of cleft lips with Pfeifer's wave line technique does not inhibit upper lip growth: A retrospective study

The aim of this study is to describe the growth of the upper lip after reconstruction with a Pfeifer wave-line incision in patients with unilateral and bilateral cleft lip and palate (CL/P) in the long term.This was a longitudinal, monocentric, retrospective study. Metric standardized lip length measurements were taken annually from the age of 6 months to the age of 16 years. Defined anatomical points were determined which describe the lip length from the nasal entrance to the highest point of the Cupid's bow. The lip length of the unaffected side in unilateral cleft patients was taken as control.A total of 234 patients with cleft lip with/without cleft palate (CL/P) were included in the study. At the time of the primary surgery, the medial sides in unilateral clefts were 2–4 mm and the lateral sides 1.5–2 mm shorter than the normal unaffected side (p≤0.001). Two main periods of growth, one during childhood (first to sixth years) and one during adolescence (12th–16th years) were seen. At the age of 16 years, the end of the observation period, the lip length in unilateral clefts resulted in a clinically not noticeable shortening of the cleft side (0.37±0.26 mm). There was no correlation between lip length development and primary cleft width at the time of primary cleft lip surgery at 6 months. The upper lip in patients with bilateral clefts developed symmetrically without any obvious asymmetry. Both sides showed a lip length difference of 0.1±0.05 mm at the age of 16 years (p=0.1). Compared to the upper lip length of the control group, bilateral clefts showed a slight tendency toward a longer upper lip (p=0.52).Within the limitations of the study it seems that when lip length development is a priority in cleft lip surgery, Pfeifer wave-line procedure is good option to achieve symmetric results in unilateral and bilateral cleft lip surgery and, therefore, is a relevant option among a variety of other techniques.     

The extraction of permanent second molars and its effect on the dentofacial complex of patients treated with the Tip-Edge appliance

The aim of this investigation was to assess the dentofacial changes in a group of patients consecutively treated with Tip-Edge appliances and the extraction of four permanent second molars by one specialist orthodontic practitioner. Before and after treatment lateral cephalograms and study cast measurements of 45 individuals, 26 females (mean age 13.8 years) and 19 males (mean age 13.9 years), were collated and statistically analysed. Cephalometric variables that exhibited, before treatment, significant sex differences, included SNA, SNB (both smaller in males, P < 0.05) and U1-NA degrees (P < 0.05), nasolabial angle (P < 0.05), and upper lip length P < 0.01 (all larger in males). After treatment, sex differences were demonstrated for SNA (smaller in males, P < 0.05), mandibular length (P < 0.01), upper face height (P < 0.05), lower face height (P < 0.01), anterior face height (P < 0.001), posterior face height (P < 0.01), nasolabial angle (P < 0.05), and upper lip length and thickness (P < 0.001; all larger in males). For the cast analysis, before treatment differences indicated larger values for males than females for lower arch inter-canine, premolar, and molar widths, arch depth (all P < 0.05), tooth size, and arch length (P < 0.01). Similar findings were noted in the upper arch except for inter-canine and premolar arch width. Despite most arch variables displaying sex differences, no gender effect was found for irregularity or crowding parameters. The same variables exhibited significant sex differences and changes after treatment (except tooth size, lower arch depth, and upper arch inter-canine width). Overall, the pattern of correction exhibited by the subjects included dental, skeletal, and soft tissue changes. Males tended to have greater mean increases in mandibular skeletal and soft tissue variables compared with females. Both males and females had increases in most dental arch variables measured from the study casts. Both sexes demonstrated a small uprighting, but statistically non-significant distalizing of the buccal segments. The lower incisors in the sagittal plane revealed a mean tendency to remain in their pre-treatment positions, with some individual variation. Overall, the treatment results were considered favourable, but case selection appeared to bias towards Angle Class I skeletal patterns of average to slightly reduced facial height, overbite and overjet < or = 4 mm, lip competence, no incisor protrusion, and moderate tooth size to arch length discrepancy (3-3.5 mm lower arch, 1 mm upper arch). Further evaluation of third molar eruption responses may provide insight into appropriate timing of second molar extractions.     

阻塞性睡眠呼吸暂停综合征患者舌后区上呼吸道CT测量

目的 对阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome,OSAS)患者和健康人的舌体及舌后区上呼吸道的CT测量资料进行对比研究。方法 OSAS患者共59例，年龄与性别相近的健康成年人57名，采用螺旋CT对上呼吸道进行连续扫描，观察2组舌后区上呼吸道形态学的差异，测量并比较舌后区气道和舌体各测量参数的差别。结果 患者多表现为气道前后径大于左右径、颏舌肌分离、舌根与软腭接触和舌正中切迹。患者组舌后区上呼吸道的横截面积、左右径明显小于对照组；咽侧壁软组织厚度、舌体宽度、颏舌肌宽度、舌骨舌肌宽度和舌体横截面积均明显大于对照组；呼吸道前后径、咽后壁软组织厚度和舌体长度与对照组相比无明显变化。结论 OSAS患者舌后区上呼吸道较健康对照组狭窄，除咽侧壁软组织增厚外，颏舌肌、舌骨舌肌和舌体宽度的增加也是造成舌后区上呼吸道狭窄的主要原因。     

Soft tissue profile in Anatolian Turkish adults: Part I. Evaluation of horizontal lip position using different soft tissue analyses.

This study investigated cephalometrically the horizontal lip position of Anatolian Turkish adults using the soft tissue analyses of Steiner, Ricketts, Burstone, Sushner, Holdaway, and Merrifield. Ninety-six adults (55 females, mean age, 21.63 years; 41 males, mean age, 22.45 years) with Angle Class I occlusal relationships were selected from the dentistry students at the University of Istanbul and called the dentally normal group. Their lateral cephalometric radiographs were analyzed, and 44 subjects (21 females, mean age, 21.35 years; 23 males, mean age, 21.41 years) with normal anteroposterior (ANB angle, 2 degrees +/- 2 degrees ) and vertical (SN-MP angle, 32 degrees +/- 5 degrees ) skeletal relationships were selected from the dentally normal group and called the dentally and skeletally normal group. Ten linear and 6 angular measurements were analyzed on each radiograph, and the significance of the differences between the groups was studied by means of the Mann-Whitney U test. The results of this study indicate that in Anatolian Turkish adults (1) the upper and lower lips were retrusive according to the norms of Steiner and Ricketts; (2) both the upper and lower lip values were within the normal range according to Burstone's B line; (3) the upper lip was protrusive and the lower lip was retrusive compared with the norms developed by Sushner for a black population; (4) the value for the lower lip was similar to the standard proposed by Holdaway, while the values for the nasal prominence and the H angle were greater than Holdaway's norms; and (5) the Z angle was smaller than the norm established by Merrifield.     

Upper airway features of unilateral cleft lip and palate patients in different growth stages

Objectives:To compare growth-related changes of skeletal and upper airway features of unilateral cleft lip and palate subjects (UCLP) with non-cleft control (NCC) subjects by using lateral cephalograms.Materials and Methods:The sample comprised 238 subjects, collected cross-sectionally, divided into 2 groups: 94 with UCLP, and 144 NCC, subdivided into 4 groups according to their growth stages by using cervical vertebral maturation stage (CVMS). The subgroups were defined as early childhood (stage 1), prepubertal (stage 2: CVMS I and II), pubertal (stage 3: CVMS III and IV), and postpubertal (stage 4: CVMS V and VI).Results:The maxilla was more retrognathic at stages 2, 3, and 4 in females with UCLP. The mandible was more retrognathic in UCLP at stage 1 in males, and stages 2 and 3 in females. ANB (angle between NA plane and NB plane) was significantly smaller in UCLP subjects at stage 4 for both sexes. A vertical growth pattern was seen in UCLP subjects except males at stages 2 and 3, and females at stage 2. Posterior airway space was significantly narrower at all stages in males and after stage 1 in females. Middle airway space was significantly wider at all stages in females and after stage 1 in males. Epiglottic airway space was significantly narrower in males at stage 3.Conclusions:Age- and sex-dependent differences in skeletal morphology and upper-airway widths of the UCLP subjects were identified when compared with controls.     

Relationship of the functional oropharynx to craniofacial morphology.

The association between the functional oropharyngeal airway (defined as the minimal sagittal dimension at right angles to the airstream) and craniofacial morphology was investigated using 16 craniofacial variables taken from lateral cephalometric radiographs. The sample consisted of 70 subjects (31 males and 39 females) 10 to 13 years of age. There was no difference in ages between males and females, and no correlation with age except upper face height. Oropharyngeal airway was positively correlated with length of the mandible (Gon-Men), the distance between the third cervical vertebra and the hyoid bone (C3-Hy), and cranial base angle (NSBa). Although short mandibular length is a characteristic finding in patients with obstructive sleep apnea, none of the subjects in this study had this diagnosis.