|
|
 
 |
| ORIGINAL ARTICLE |
|
| Year : 2021 | Volume
: 13
| Issue : 6 | Page : 1474-1477 |
|
|
Alterations in integumental facial dimensions after orthodontic treatment
Toshi Toshi1, Madhukar Vashishtha2, Amit Chaddha3, Shakeel Ahmed Galagali4, Dipti Gopalakrishnan5, Ruchi Saini6, Priyadarshini Rangari7
1 Senior lecturer, Dept of Periodontics, Buddha Institute of dental sciences and hospital, Patna, Bihar, India
2 Associate Professor, Department Of Otorhinolaryngology, Head And Neck Surgery, Rama Medical College, Hospital And Research Center, Mandhana, Kanpur Uttar Pradesh, India
3 Assistant Professor, Department Of Otorhinolaryngology, Government Medical College, Azamgarh, Uttar Pradesh, India
4 professor, Department Of Orthodontics, Al Ameen Dental College And Hospital, Athani Road, Vijaypur, Karnataka, India
5 Department of Dentistry, Medeor International Hospital, Al Ain, United Arab Emirates
6 Department Of Orthodontics Dentofacial Orthopaedics, IDST Dental College And Hospital, Modinagar, Ghaziabad, Uttar Pradesh, India
7 Associate professor, Department of Dentistry, Sri Shankaracharya Medical College, Bhilai, Durg, Chhattisgarh, India, India
| Date of Submission | 26-Mar-2021 |
| Date of Decision | 20-Apr-2021 |
| Date of Acceptance | 09-May-2021 |
| Date of Web Publication | 10-Nov-2021 |
Correspondence Address:
Dipti Gopalakrishnan
Department of Dentistry, Medeor International Hospital, Al Ain
United Arab Emirates
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jpbs.jpbs_257_21
 Abstract | | |
Background: It is documented that the facial profile changes, morphology changes, and continued facial growth in early adults and late adolescents. Aims: The present trial was aimed to quantitatively assess the changes in facial growth from adolescents to adults. Materials and Methods: In the present study, 16 facial distances (transverse) and craniocaudal facial distances were measured, and growth changes were assessed. The collected data were subjected to statistical evaluation, and the results were formulated. Results: Upper face width was statistically significantly increased in males than females from posttreatment to recall with the P < 0.0001. The decrease in outer canthus was seen in females as compared to males, which was statistically significant with the P < 0.0001. An increase in mouth width was seen in both males and females with higher in females. Conclusion: The present study showed an increase in facial dimensions in both genders with age where transverse changes were higher than the craniocaudal alterations.
Keywords: Craniocaudal dimensions, growth, orthodontics, soft-tissue profile, transverse dimensions
How to cite this article:
Toshi T, Vashishtha M, Chaddha A, Galagali SA, Gopalakrishnan D, Saini R, Rangari P. Alterations in integumental facial dimensions after orthodontic treatment. J Pharm Bioall Sci 2021;13, Suppl S2:1474-7 |
How to cite this URL:
Toshi T, Vashishtha M, Chaddha A, Galagali SA, Gopalakrishnan D, Saini R, Rangari P. Alterations in integumental facial dimensions after orthodontic treatment. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Aug 8];13, Suppl S2:1474-7. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1474/330046 |
| Introduction | |  |
Facial changes are observed in humans throughout their lives to some extent or other. About the later phases of growth and development in adults are described in detail with the anthropometric data available which shows the continuous growth and development throughout life.[1] The growth and alteration in the facial dimensions in adolescents are well documented in the literature. However, the data regarding the alterations in the facial dimensions in adults are scarce in the existing literature. This can be due to the lack of available data to assess these changes in adult humans.[2] Few studies in the literature, however, document the facial profile changes, morphology changes, and continued facial growth in early adults and late adolescents.[3]
Controversy exists to date, concerning changes in soft tissues following orthodontic treatment of retraction for cases with bimaxillary protrusion. Majorly the studies done on facial growth seen in the adult subjects rely on the cross-section studies.[4] Cross-section studies show that alteration noticed in subjects of different ages is the reflection of how an individual grows. However, in cross-section studies, the subjects are evaluated only once, hence, no information can be extracted regarding growth. Longitudinal studies are required to assess actual changes in growth rate which are relatively very few in this area.[5]
Before, during, and after orthodontic treatment, various data in terms of the radiograph, dental casts, and photographs are recorded for the information purpose. These can serve as important data to evaluate the changes in growth observed over a while.[6] These photographs taken for the orthodontic purpose mainly help to evaluate growth changes in adolescents as orthodontic treatment is mainly taken in adolescents. The availability of the photographs from frontal view for a long recall period can provide a unique opportunity to assess the long-term changes in facial growth in adults, especially in soft-tissue profiles.[7] Hence, the present trial was aimed to quantitatively assess the changes in facial growth from adolescents to adults.
| Materials and Methods | | |
One hundred and twenty participants were screened who had frontal facial photographs to assess the soft-tissue transitions from adolescent to adult age. The photographs were taken from the department of orthodontics from posttreatment to the long-term follow-up period for at least 5 years following orthodontic treatment. The participants were 14 years–18 years treated with edgewise technique irrespective of the malocclusion. The inclusion criterion for the study was the availability of frontal facial photographs from the period of orthodontic posttreatment phase to the final recall of a minimum of 5 years. The final participants were 86 participants including both genders.
In the present study 16, facial distances (transverse) were assessed and calculated including face width (upper, midface, and lower). Upper face width was measured from left zygion to right, midface width from left Otobasion to the right, and lower face width from left to right Gonion. Outer and inner canthus width was measured from left exocanthion to right (ExL to ExR) and from left endocanthion to right (EnL to EnR), respectively. Alar width was measured from left alare to right, mouth width from left chelion to right.
Craniocaudal facial distances measured were upper face height, lower face height, and total face height were, respectively, measured as the distance from ExL to ExR with subnasale (Ex to Sn), Sn to menton (Sn toMe), and left exocanthiom to right with Me. Height of upper lip and lower lip were, respectively, measured as the distance from Sn to Labrale Superius (Sn to Ls) and from stomion (St) to Me. St height was a distance from Sn to St. Exposure of lower lip and upper lip was measured, respectively, as the distance from St to Labrale Inferius (St to Li) and from Ls to St. The chin height was measured from Li to Me from Li to Me. Collected data were subjected to the statistical evaluation, and the results were formulated.
| Results | | |
The age distribution of the study samples at posttreatment and recall is summarized in [Table 1]. It was seen that in males the mean age at the time of treatment completion was 15.33 ± 1.64 which at last recall was 23.23 ± 4.59 with an average posttreatment to recall-duration of 7.10 ± 3.86. Concerning females, these values at posttreatment and recall, respectively, were 15.22 ± 2.43 and 23.14 ± 4.32 with a mean posttreatment to recall value of 7.23 ± 4.16 years.
Facial ratios and their descriptive analysis are described in [Table 2] and [Table 3] concerning all the assessed 16 parameters and facial dimensions. Upper face width was significantly increased in males than females from posttreatment to recall with the P < 0.0001. Outer canthus which was measured from ExL to ExR showed a decrease with the age with the inner canthus width which was measured from the EnL to EnR with more decrease in inner canthus width. The decrease in outer canthus was seen in females as compared to males, which was statistically significant with the P < 0.0001. Inner canthus width decrease was greater in males with a P = 0.0942 and 0.0229 in females and males showing statistically nonsignificant results. Alar width did not show changes in males and females at two evaluated periods within the total change of 0.000 ± 0.028 and P = 0.8584.
However, the difference in mouth width was statistically nonsignificant with a respective P = 0.0001 and 0.0728 in females and males, respectively. The chin height increased in both males and females from posttreatment to recall period with statistically significant P < 0.0001. Lower lip exposure changes in both males and females showed statistically significant results at all the time intervals with the P < 0.0001. Lower lip height values showed a statistically significant increase in males with respective values of 0.076 ± 0.07 and 0.081 ± 0.009 at posttreatment and recall with the P < 0.0001. Upper lip height showed statistically significant changes with a value of 0.016 ± 0.033.
| Discussion | | |
Larger changes were seen in male subjects with the facial width in the mid-face and lower face region. It was also seen that greater changes were seen in males than females and early aging than older. Upper face width was significantly increased in males than females from posttreatment to recall with the P < 0.0001. These findings were in agreement with the study of Farkas et al.[8] in 2004 where the authors reported a significant change in upper face width in both genders with age. This can be attributed to an increase in masseter thickness.
The decrease in outer canthus was seen in females compared to males, which was statistically significant with the P < 0.0001. Inner canthus width decrease was greater in males with a P = 0.0942 and 0.0229 in females and males showing statistically nonsignificant results. Alar width did not show changes in males and females at two evaluated periods within the total change of 0.000 ± 0.028 and P = 0.8584. These findings were consistent with the findings of Ferrario et al.[9] in 2001 where authors reported age-related effect on eye inclination showing medial and down movement in outer canthus.
Difference was statistically nonsignificant in mouth width with a respective P = 0.0001 and 0.0728 in females and males, respectively. A similar increase was shown by the study of Ferrario et al.[10] in 2000; however, they showed significant results. Chin height increased in both males and females from posttreatment to recall period with statistically significant P < 0.0001. Chin height increase was also reported by Bradshaw[11] in 2002 where authors mentioned an increase in vertical distance from skeletal to soft tissue Me.
Lower lip exposure changes in both males and females showed statistically significant results at all the time intervals with the P < 0.0001. Lower lip height values showed a statistically significant increase in males with respective values of 0.076 ± 0.07 and 0.081 ± 0.009 at posttreatment and recall with the P < 0.0001. Upper lip height showed statistically significant changes with a value of 0.016 ± 0.033. These findings were in agreement with studies of Ferrario et al.[10] in 2000 and Bradshaw[11] in 2002. in 2004 where the author reported tall and narrow lips in youths.
| Conclusion | | |
Within its limitations, the present study showed an increase in facial dimensions in both genders with age where transverse changes were higher than the craniocaudal alterations. Furthermore, the difference was seen in the lower facial height, lip exposures, and chin height. The magnitude and growth timings differ in both genders.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Ergun-Longmire B, Wajnrajch M. Growth and growth disorders. In: New M, editor. www. endotext.org, Pediatric Endocrinology. 2010.  |
| 2. | Orben A, Tomova L, Blakemore SJ. The effects of social deprivation on adolescent development and mental health. Lancet Child Adolesc Health 2020;4:634-40. |
| 3. | Heydenrych I. The treatment of facial asymmetry with botulinum toxin: current concepts, guidelines, and future trends. Indian J Plast Surg 2020;53:219-29. |
| 4. | Sundareswaran S, Vijayan R. Profile changes following orthodontic treatment of class I bimaxillary protrusion in adult patients of Dravidian ethnicity: A prospective study. Indian J Dent Res 2017;28:530-7. [ PUBMED] [Full text] |
| 5. | Freitas BV, Rodrigues VP, Rodrigues MF, de Melo HV, Dos Santos PC. Soft tissue facial profile changes after orthodontic treatment with or without tooth extractions in Class I malocclusion patients: A comparative study. J Oral Biol Craniofac Res 2019;9:172-6. |
| 6. | Rischen RJ, Breuning KH, Bronkhorst EM, Kuijpers-Jagtman AM. Records needed for orthodontic diagnosis and treatment planning: A systematic review. PLoS One 2013;8:e74186. |
| 7. | Mattos CT, Marquezan M, Chaves IB, Martins DG, Nojima LI, Nojima MC. Assessment of facial profile changes in Class I biprotrusion adolescent subjects submitted to orthodontic treatment with extractions of four premolars. Dental Press J Orthod 2012;17:132-7. |
| 8. | Farkas LG, Eiben OG, Sivkov S, Tompson B, Katic MJ, Forrest CR. Anthropometric measurements of the facial framework in adulthood: Age-related changes in eight age categories in 600 healthy white North Americans of European ancestry from 16 to 90 years of age. J Craniofac Surg 2004;15:288-98. |
| 9. | Ferrario VF, Sforza C, Colombo A, Schmitz JH, Serrao G. Morphometry of the orbital region: A soft-tissue study from adolescence to mid-adulthood. Plast Reconstr Surg 2001;108:285-92. |
| 10. | Ferrario VF, Sforza C, Schmitz JH, Ciusa V, Colombo A. Normal growth and development of the lips: A 3-dimensional study from 6 years to adulthood using a geometric modal. J Anat 2000;19:415-23. |
| 11. | Bradshaw DW. Long-term Changes in the Integumental Profile Following Orthodontic Treatment. M.D.S Thesis, Department of Orthodontics, University of Tennessee, Memphis; 2002. |
[Table 1], [Table 2], [Table 3]
|
