ABSTRACT
The purpose of this study was to describe the changes in five soft tissue parameters that are commonly used by orthodontic practitioners in their diagnosis and treatment planning as well as in their evaluation of profile changes that occur with growth and orthodontic treatment. The subjects in this study were 20 males and 15 females for whom lateral cephalograms were available between 5 and 45 years of age. The parameters evaluated were two angles of facial convexity, the Holdaway soft tissue angle, and the relationship of the upper and lower lips to Rickett's esthetic line. Descriptive statistics for the absolute and incremental changes were collected on a yearly basis between 5 and 17 years of age as well as at early (25 years) and middle (45 years) adulthood. Growth profile curves were constructed for each parameter to describe the age-related changes in the five parameters for both males and females. The analysis of variance was used to compare the absolute and incremental changes both longitudinally and cross-sectionally. Significance was predetermined at P =.05. The present findings indicated that (1) in general, the changes in males and females were similar in both magnitude and direction. On the other hand, the timing of the greatest changes in the soft tissue profile occurred earlier in females (10 to 15 years) than in males (15 to 25 years); (2) the angle of soft tissue convexity that excludes the nose expressed little change between 5 and 45 years; (3) the upper and lower lips became significantly more retruded in relation to the esthetic line between 15 and 25 years of age in both males and females; the same trends continued between 25 and 45 years of age; (4) the Holdaway soft tissue angle progressively decreased between 5 and 45 years of age. It is important for clinicians to be aware of these changes when planning the orthodontic treatment of the still growing adolescent patients because the changes might influence the extraction/nonextraction decision.
Subject(s)
Face/anatomy & histology , Maxillofacial Development , Adolescent , Adult , Age Factors , Cephalometry , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , Orthodontics, Corrective/methods , Patient Care Planning , Reference Values , Reproducibility of Results , Sex FactorsABSTRACT
The purpose of this study is to describe the changes in six soft-tissue parameters that are commonly used by orthodontists in their diagnosis and treatment planning as well as in the evaluation of profile changes that occur with growth and orthodontic treatment. The parameters evaluated were two angles of facial convexity, the Holdaway soft-tissue angle, Merrifield's Z angle, and Rickett's esthetic line and lip relationships. The subjects of this study consisted of 20 males and 15 females for whom lateral cephalograms taken between the ages of 5 and 25 years were available. Descriptive statistics for the absolute and incremental changes are presented on a yearly basis between the ages of 5 and 17 years and at adulthood. Growth profile curves were constructed for each parameter, and regression equations were developed to describe the age-related changes in the six parameters for both males and females. The present findings indicated that the male and female growth profile curves were significantly different, except for the angle of facial convexity (excluding the nose) and Merrifield's Z angle. One of the conclusions that can be derived from this investigation is that the two angles of soft-tissue facial convexity, the Holdaway soft-tissue angle, and Merrifield's Z angle do not behave in a similar manner with age. Therefore, the clinician needs to use a number of soft-tissue parameters to better evaluate the soft-tissue profile. A limited number of cephalometric standards have been identified for each parameter. These standards can be used by the orthodontist as representative of the change between the age of 5 years and adulthood. This should enable the orthodontist to treat the patient to soft-tissue norms that are age- and sex-specific, rather than to an adult standard.