Quantifying the Selection of Maxillary Anterior Teeth Using Extraoral Anatomical Landmarks.

BACKGROUND:  Regardless of skin color, age, sex, or other factors, all beautiful faces follow the divine proportion. Proportions of face components appear to play a role in facial attractiveness. AIM:  The study determines the correlation between the mesiodistal width of anterior maxillary teeth, inter-canthal distance, inter-alar distance, and inter-commissural distance as a criterion for selecting anterior maxillary teeth. MATERIAL AND METHODS: A cross-sectional study was carried out at the institutional level with a sample size of 200 participants with 100 male and 100 female participants. Inter-canthal distance, inter-alar distance, and inter-commissural distance were measured using the digital caliper and a customized silver scale to measure the mesiodistal width of anterior maxillary teeth. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 24.0 (IBM Corporation, Chicago, USA). Pearson's correlation test calculated the correlation coefficient, and the level of significance was kept at p<0.05. RESULT: The width of the maxillary anterior and the inter-canthal gap showed a strong positive correlation, the inter-alar difference and the mesiodistal width of anterior teeth showed a moderately positive correlation, and the estimated inter-commissural width and the mesiodistal width of anterior teeth showed a strong positive correlation (p<0.05). CONCLUSION:  These parameters are correlated to the dimensions of the tooth size and can act as a guide while selecting the teeth for future rehabilitation treatment when the natural teeth are lost.

Prenatal Alcohol Exposure and the Facial Phenotype in Adolescents: A Study Based on Meconium Ethyl Glucuronide.

Here, we explore the effects of prenatal alcohol exposure (PAE) in adolescence. We investigated associations between meconium ethyl glucoronide (EtG) and facial malformation. For 129 children (66/63 male/female; M = 13.3, SD = 0.32, 12-14 years), PAE was implemented by newborn meconium EtG and maternal self-reports during the third trimester. Cognitive development was operationalized by standardized scores (WISC V). The EtG cut-off values were set at ≥10 ng/g (n = 32, 24.8% EtG10+) and ≥112 ng/g (n = 20, 15.5% EtG112+). The craniofacial shape was measured using FAS Facial Photographic Analysis Software. EtG10+- and EtG112+-affected children exhibited a shorter palpebral fissure length (p = 0.031/p = 0.055). Lip circularity was smaller in EtG112+-affected children (p = 0.026). Maternal self-reports were not associated (p > 0.164). Lip circularity correlated with fluid reasoning (EtG10+ p = 0.031; EtG112+ p = 0.298) and working memory (EtG10+ p = 0.084; EtG112+ p = 0.144). The present study demonstrates visible effects of the facial phenotype in exposed adolescents. Facial malformation was associated with a child's cognitive performance in the alcohol-exposed group. The EtG biomarker was a better predictor than maternal self-reports.

Morphometric analysis of the palpebral fissure and canthal distance in Serbian young adults / Análisis morfométrico de la fisura palpebral y la distancia cantal en adultos jóvenes serbios

SUMMARY: Frontaly and anteriorly the orbit is closed by a skin-muscular closure of eyelids. The eyelids limit the palpebral fissure, which is subject to geographical, racial, and age variations. As a part of the face, eyelids and palpebral fissure play a very important role in the attractiveness of the individual, but al so in the diagnosis of certain local and systemic pathological processes. The aim of the study was to perform a morphometric analysis of the palpebral fissure in a young population without pathological conditions and syndromes. The study was conducted on 90 subjects (45 male and 45 female) aged 19.28±0.69 years. Subjects were photographed with a Nikon D3400 camera, and the morphometric parameters were measured with the ImageJ 1.48v software. Statistical analysis of the data was performed in Windows Excel. The measurements in the study were the distance between the mid-points of both pupils, distance between both external canthi, distance between both internal canthi, palpebral fissure width and palpebral fissure height at three points. The average height of the palpebral fissure to the right is 9.35±1.55 mm and to the left is 9.41±1.56 mm. The average width of the palpebral fissure on the right is 27.05±1.71 mm and on the left is 27.18±1.68 mm. It was found that there was some difference in the measured parameters, however, this difference was not statistically significant.

RESUMEN: El músculo orbicular de los ojos se encuentra en la cara, delante de la órbita y debajo de la piel. Los párpados limitan la fisura palpebral, la abertura natural, sujeta a variaciones geográficas, raciales y de edad. Los párpados y la fisura palpebral juegan un papel importante en la estética de las personas, pero también en el diagnóstico de ciertos procesos patológicos locales y sistémicos. El objetivo del estudio fue realizar un análisis morfométrico de la fisura palpebral en una población joven sin enfermedades o condiciones patológicas. El estudio se realizó en 90 sujetos (45 hombres y 45 mujeres) de 19,28 ± 0,69 años. Los sujetos fueron fotografiados con una cámara Nikon D3400, y los parámetros morfométricos se midieron con el software ImageJ 1.48v. El análisis estadístico de los datos se realizó en Windows Excel. Se midieron la distancia entre los puntos medios de ambas pupilas, la distancia entre ambos cantos laterales, la distancia entre ambos cantos mediales, el ancho de la fisura palpebral y la altura de la fisura palpebral en tres puntos. La altura promedio de la fisura palpebral a la derecha fue 9,35 ± 1,55 mm y a la izquierda fue 9,41 ± 1,56 mm. El ancho promedio de la fisura palpebral a la derecha era 27,05 ± 1,71 mm y a la izquierda era 27,18 ± 1,68 mm. Se determinó una diferencia leve en los parámetros medidos, sin embargo, esta diferencia no fue estadísticamente significativa.

3D-Analysis of Mouth, Nose and Eye Parameters in Children with Fetal Alcohol Syndrome (FAS).

Background: Fetal alcohol spectrum disorder (FASD) is a developmental disorder with severe negative lifetime consequences for the affected person. Numerous diagnostic methods for facial assessment in FAS exist, but most of them are based on subjective evaluations. Our aim was therefore to find objective methods for the verification of FAS(D). Methods: 58 children (28 FAS; 30 controls) were examined prospectively. 3D facial scans were performed for each child and facial parameters at the mouth, nose and eye regions were measured and compared between the groups. Results: Significant differences could be found for the distance between right and left sulcus nasi at the transition point to the philtrum (p < 0.001), for the inner canthal distance (p = 0.001) as well as for the right and left palpebral fissure length (p < 0.001). No significant difference between the FAS and control children could be found for the measurements of mouth breadth (p = 0.267) and breadth between the left and right alares nasi (p = 0.260). Conclusions: Measurements of mouth breadth and nose breadth for the alares nasi are not suitable for FAS diagnosis. In contrast, digital contactless measurements of the distance between the right and left sulcus nasi at the transition point to the philtrum, as well as the inner canthal distance and palpebral fissure length of the left and right eyes, showed significant differences when comparing children with FAS to healthy controls. These measurements could thus be additional objective means for the verification of FAS.

Normal interpupillary, inner canthal distance and outer canthal distance in a normal population of Pakistan.

OBJECTIVE: This study was conducted to quantify the normal indices of anthropometric measures related to ophthalmology including Interpupillary distance (IPD), Inner canthal distance (ICD), Outer canthal distance (OCD) in a normal, healthy Pakistani population. METHODS: This is a cross sectional study. Total 500 patients were chosen randomly but 499 were included in this study. Patients were selected randomly in an outpatient department of Jinnah Post Graduate Medical Centre Karachi, over the period of five months. IPD, ICD & OCD all measurements were taken with the help of plastic rule by only one researcher to minimize chances of error as much as possible. IPD was reconfirmed from auto refractometer while ICD and OCD readings were taken twice by occluding one eye of researcher to reduce error. Participants were divided into four categories on basis of: Age, Gender, ethnicity and geographical location. Patients were further categorized on basis of Ethnicity to Urdu Speaking, Sindhi, Punjabi, Pathan, and others. Moreover, four age groups were drawn ranging from 15-24 years, 25-44 years, 45-64 years and 65 years and greater. RESULTS: Our study comprised a total of 499 patents of which 272(54.5%) were males, and 227(45.5%) were females. The mean age of the participants was 39.3 ± 14.5 years. The mean values for the IPD, ICD and OCD in mm were 61.8 ± 6.2, 30.9 ± 2.9 and 85.2 ± 6.6 respectively. A statistically significant difference was observed between IPD, ICD and OCD Indices among male and female study participants (p<0.001, p=0.043, p<0.001). While comparing the IPD, ICD and OCD indices amongst the different ethnic groups, we found no statistically significant difference (p=0.09. p=0.28, p=0.06). Overall, there was no correlation between the age and other variables i.e. IPD, ICD, OCD, (r = 0.07, p = 0.085), (r = 0.005, p = 0.906), (r = -0.08, p = 0.058). CONCLUSION: This work has recommended normative values of IPD, ICD and OCD in Pakistani population on the basis different variables including gender, age, and ethnicity.

Determination of mesiodistal width of maxillary anterior teeth using inner canthal distance.

BACKGROUND: Selection of appropriately sized maxillary anterior teeth is one of the important aspects of complete denture prosthodontics. In the past several methods have been proposed, but little consensus on an effective method for anterior teeth selection has been reached. Inner canthal distance is one of the reliable anatomic dimension that may provide a valid approach to anterior teeth selection. This study was aimed to ascertain the co-relation between inner canthal distance (ICD) and combined mesiodistal width of maxillary anterior teeth. METHOD: This study was conducted in Army Dental Centre (R & R) Delhi Cantonment between Aug 2006 to Mar 2008. Eight hundred dentate Indian subjects of four different ethnic group; Such as Rajputs, Marathas, Sikh and Tamilian. 100 males and 100 females from each race under the age group of 18-30 years formed the subjects of study. The ICD and mesio-distal width of maxillary anteriors were measured using Digital Vernier Caliper. The Data obtained was statistically analyzed. RESULTS: A consistent ratio of 1.61 was found between ICD and combined mesiodistal width of maxillary anteriors in all four ethnic group. The mean value showed no statistically significant difference between sex. The variation in the ratio between the ethnic groups was negligible. CONCLUSION: The findings of the study indicated that, to select the combined mesiodistal width of maxillary anterior teeth, ICD of the required patient should be multiplied by 1.61. This ratio was consistent with all the four ethnic groups irrespective of sex.

A cross-sectional clinical study on shape of nose inner-canthal distance and geometric progression as predictors for width of the maxillary incisor teeth.

OBJECTIVES: The objective of this study is to evaluate the relationship of anatomical landmarks of the face and geometric progression as predictors for the width of the maxillary incisor teeth. MATERIALS AND METHODS: The central incisor width (CIW), lateral incisor width (LIW), inner-canthal distance (ICD) and inter-alar distance (IAD) from a total of 150 subjects were measured clinically. The width of the root of the nose (WRN) was measured on standard photographs of the subjects. Student t-test has been used to find the significance of parameters between male and female. Pearson correlation has been used to find any relation of the parameters. RESULTS: The IAD and the WRN measurements suggest that the shape of the nose is wider and more triangular in males. The mean maxillary CIW and ICD was significantly higher in males than females. CONCLUSION: The proportion of IAD to WRN seems to be a reliable guide for deciding the proportion of the maxillary central and LIW. The ICD, when multiplied by a decreasing function value of the geometric progression term 0.618 and divided by 2, was a reliable predictor of the maxillary CIW.

A novel EFNB1 mutation in a patient with craniofrontonasal syndrome and right hallux duplication.

Craniofrontonasal syndrome (CFNS, MIM #304110) is a rare X-linked dominant developmental disorder that shows paradoxically greater severity in affected females than in affected males. Our female patient with frontonasal dysplasia, craniosynostosis and additional malformations was consistent with CFNS. EFNB1, which encodes a member of the ephrin family of transmembrane ligands for Eph receptor tyrosine kinases, is the only gene in which mutation is known to cause CFNS. Here, we describe 402T>C, a novel de novo mutation on EFNB1. This mutation results in substitution of highly conserved isoleucine at 134th residue to threonine.

Craniofacial anthropometry in a young Nigerian population: the canthal distances / Antropometría craneofacial en una población joven de Nigeria: distancia cantal

The measurement of craniofacial parameters have clinical, forensic and anthropologic significance. Local data on inner canthal and outer canthal distances and the canthal index may reveal the pattern of differential growth in craniofacial features resulting from factors such as sex, diet and genetic distinctions. In the present study, we provide normative data on canthal distances in a Nigerian population which has not been studied previously, utilizing a study design which optimises the effect of age and minimise bias and confounding than previous studies in Nigerian groups. The mean inner canthal distance was 1.85 +/-0.30cm and 2.07 +/- 0.29cm (males vs. females, p= 0.000); mean outer canthal distance, 10.39 +/- 0.56cm and 10.40 +/- 0.98cm (males vs. female, p= 0.899). The results were found to be considerably lower than what has been reported among Nigerian groups.

La medición de parámetros craneofaciales tiene importancia clínica, forense y antropológica. Los datos locales sobre la distancia cantal interna y cantal externa y el índice cantal puede revelar el patrón de crecimiento diferencial en las características craneofaciales como resultado de factores como el sexo, la dieta y las diferencias genéticas. En el presente estudio, se proporcionan datos normativos sobre la distancia cantal en una población de Nigeria que no ha sido estudiada previamente, utilizando un diseño de estudio que optimiza el efecto de la edad, como también minimiza el sesgo y la confusión de estudios anteriores en los grupos de Nigeria. La media de distancia cantal interna fue de 1,85 +/- 0,30cm y 2,07 +/- 0,29cm (hombres v/s mujeres, p = 0,000), mientras que la media de distancia cantal externa fue 10,39 +/- 0,56cm y 10,40 +/- 0,98cm (hombres v/s mujeres, p = 0,899). Los resultados de este estudio son considerablemente más bajos que lo que se han reportado previamente para los grupos nigerianos.