Download INTRODUCTION The human face is a living mirror held out to the

INTRODUCTION
The human face is a living mirror held out to the world. The face has the power to attract, charm, brighten
and seduce. A common expression is
‘I may forget a name, but I’d never forget a face’.
The subject of facial esthetics is pre-eminently important to Orthodontists. We tend to forget that the
ultimate source of our esthetic value should be from the population, not just our subjective opinion.
Anthropometry is the measurement of human individuals. The study of anthropometry is the study of human
body measurements to assist in understanding human physical variation and aid anthropological classification.
The assessment of facial dimensions is of prime importance in medical and dental fields in diagnosis and
treatment planning. For many years Farkas applied direct anthropometry technique for studying facial
morphology. This approach has been applied to study facial growth and to compare different phenotype norms of
population.
Anthropometry has the advantage of being inexpensive, simple to be applied and relatively noninvasive.
Anthropometric studies performed with various populations have detailed the relationship between the
landmarks of the face. Race specific anatomic data can be useful for planning surgical procedures. Over the
years, because of visual and other media, aesthetic standards have changed. Currently, orthodontic procedures
and maxillofacial surgery are performed on a heterogeneous mix of races and ethnic groups. Therefore, a single
canon of esthetic group is not appropriate.(1)
BRIEF RESUME OF INTENDED WORK
6.1 Need for the study
1
Cephalometric measurement cannot be performed for screening purpose. Therefore Orthodontist usually
has to use either photographic or anthropometric measurements.
2
The standards of beauty could vary considerably among persons as well as racial groups. It is essential
for clinician to develop the concept of normal for a particular racial group. Since different ethnic groups have
different anthropometric proportions, it is necessary to develop these norms for Indian population. Hence this
study was undertaken to evaluate the Indian anthropometric norms in the craniofacial region, which will prove
useful to Orthodontists, Maxillo-facial and plastic surgeons.
3
Anthropometry is shown to be useful in Orthodontic research and Reconstructive surgery where the soft
tissue morphology of the face can be studied more reliably than comparison from radiograph.
6.2 Review of literature:
1.
This study was done to determine the prevalence of three different face types among Turkish
young adults based on facial indices, to assess and compare the vertical and horizontal dimensions for each type
and to establish anthropometric norms for Turkish adults. In this study a total of 173 healthy young adults (83
females and 90 males) 17 to 25 years of age were examined. Using anthropometric landmarks, 8 horizontal and
10 vertical direct measurements were made with a millimetric compass. The result showed that using facial
indices, 59 of the 173 subjects were classified as euryprosopic, 49 as mesoprosopic and 65 as leptoprosopic. In
the total evaluation of both groups, all the parameters were higher in the males except forehead height 1 and 2. A
comparison of face types in females and males separately showed no significant difference between parameters.
They concluded that the data present in this study may help Plastic Surgeons and Orthodontists to objectively
determine the relationship between facial structures for different face types.(1)
2)
This study was done to establish the craniofacial anthropometric norms of young adult (18- 25
years) Malaysian Indians. The study group consisted of convenient samples of 100 healthy volunteers with equal
number of female and male subjects who had no history of mixed racial parentage. Twenty-two linear
measurements were taken twice from 28 landmarks over six craniofacial regions. The result showed minimum
measurements are always contributed by the female Indian except for the nose height (n-sn), (left) eye fissure
length (ex-en), upper vermilion height (ls-sto), and lower vermillion height (sto-li), there is a gender difference in
all the measurements except the (left) eye fissure height (independent –t-test p< 0.05).The Malaysian Indians
exhibit some North American White Caucasian features in all regions. The cephal index indicated a
brachycephalic or relatively short wide head with a tendency towards mesocephaly. From the low nasal index the
Malaysian Indian females have a nose that is narrow or leptorrhin similar to North American White Caucasians.
The lower value of the upper lip height to mouth width index in the Indian females indicate a relatively shorter
upper lip height compared to mouth width, also similar to the North American White Caucasians.(2)
3)
This study was done to compare the aesthetic facial proportions of southern Chinese women
with published average and ideal values for white women .In this study 100 Chinese women between the ages of
18 and 40 years who had not undergone previous facial surgery were chosen at random, and their aesthetic facial
proportions were measured from 5x7- in photographs. Comparisons were made with similar reported
measurements for the white face. The result showed that the major facial differences observed in the Chinese
face were the wider intercanthal distance, the wider nasal base, a different profile of the lower face and
differences in the eyelids. The Chinese nose was less prominent, the alae were more flared, the nostrils were
more horizontally oriented, the alar-columellar relationship were different and the nasal tip was less defined.(3)
4)
This study was conducted in view of the importance of anthropometric indices of the face in
forensic medicine, surgery, paediatrics and medical imaging. This descriptive and cross-sectional study was set
up to determine and compare the face shapes in Fars and Turkman ethnic groups of 808 normal 17 to 20 yearsold males and females in Gorgon, North Iran (Fars group 407, male 200 and female 207; Turkman group 401,
male 198 and female 203). The length and width of faces were determined by using classic cephalometry
technique with Martin spreading calipers, and the shape of faces in the ethic group of Fars and Turkman in both
sexes was compared. The result showed the dominant type of face in both the native Fars and Turkman females
was euryprosopic (37.7 and 51.7 percentage, respectively). The dominant type of face shape in the native Fars
and Turkman males was mesoprosopic (44amd 38.4 percent, respectively). They concluded the ethnic factor has
an effective role on head phenotype in North of Iran.(4)
5)
This study was done to describe a methodical way of examining the head and face. Orthodontists
use dental and facial keys to diagnose and to treat malocclusions. Dental keys are given much weight in the
determination of treatment and facial keys are not used by some Orthodontists and sparingly by others. In
contrast to this, the authors established 19 facial keys based on anthropologic criteria for frontal and profile
examination as a part of Orthodontic diagnosis and treatment planning. With this analysis, normal facial traits are
maintained and abnormal characteristics are corrected with orthodontics and surgery. Information from facial
examination of the patient dictates which procedure result in optimal cosmetics with class I function. (5)
6.3Objectives of the study:
The objectives of this study are:
•
To analyze various facial measurements in local North Karnataka population and establish anthropometric
norms.
•
To compare male and female norms of North Karnataka population.
•
To compare these norms with the norms of North American Caucasians.
•
To derive clinicial implications which will be useful to Orthodontists, Maxillo-facial and Plastic Surgeons.
7
MATERIALS AND METHODS:
7.1 SOURCE OF DATA
The study will be conducted in the Department of Orthodontics, AL-BADAR Dental College and Hospital,
Gulbarga.
The study sample will be obtained from the local population North Karnataka. A total of 140 subjects will be
selected for the study. The sample will comprise of 70 males and 70 females.
7.2 METHOD OF COLLECTION OF DATA
Primary Selection Criteria
a. All persons with no previous history of craniofacial trauma, surgery or congenital anomalies, no
significant medical history, orthodontic or prosthodontics treatment.
b. All the subjects who have completed their active physical growth (Age group of 18-30 years)
c. The sample will include both male and female sexes in equal numbers to evaluate the significant
morphological differences between them.
d. All patients will be from North Karnataka.
METHOD OF STUDY
After the anthropometric landmarks are identified, direct measuremenst will be performed for each subject.
Measurements will be recorded in the 5 regions of cranio-facial complex, and 5 indices derived from those
measurements.
Measurements recorded from cranio-facial complex are from Head, Face, Orbits, Nose, Lips and Mouth
Indices are
Morphologic facial height x 100
1.
Morphologic facial index =
2.
Cephalic index =
3.
Jugo − mandibular index = Breath of bizyzomatic arch
4.
Lip index =
5.
Relative chin height index =
Bizygomatic width
Maximum head breadth x 100
Maximum head length
Bigonial breadth x 100
Height of the integumental lips x 100
Lip length
Height of the lower face x 100
Morphologic facial height
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE
CONDUCTED ON PATIENTS OR OTHER HUMAN OR ANIMALS? IF SO DESCRIBE BRIEFLY.
Consent will be taken and facial measurements will be made on human subjects.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3?
Yes
REFERENCES:
1) Sehar Gunduz Arslan, Celal Genc, Bahadur Odabas, Jalen Devecioglu Kama “Comparison of Facial
proportions and anthropometric norms among Turkish young Adults with different Face type”
[Aesthic plastic surgery (2008) 32:2 34-242]
2) WC Ngeow, S T Aljunid “Craniofacial anthropometric norms of Malaysians Indians”[Indian journal
of Dental Research(2009) 20:3 313-319]
3) Roland Song Teck Sim “Comparison of the aesthetic Facial Proportion of southern Chinese and white
women[Arch facial plastic surgery(2002) 2].
4) Jahanshahi M, GolalipiourM J, Heidari k “The effect of ethnicity on facial anthropometry in Northern
Iran[Singapore med J (2008);49(11):940-943]
5) G William Arnett and Robert T Bergman“Facial keys to Orthodontic diagnosis and treatment
planning”-part-II [Am J Orthod, (1971);60: 175-183].
.