Korean J Orthod.  2022 Mar;52(2):150-160. 10.4041/kjod.2022.52.2.150.

Customized maxillary incisor position relative to dentoskeletal and soft tissue patterns in Chinese women: A retrospective study

Affiliations
  • 1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China

Abstract


Objective
To provide reliable prediction models based on dentoskeletal and soft tissue variables for customizing maxillary incisor positions and to optimize digitalized orthodontic treatment planning.
Methods
This study included 244 Chinese women (age, 18–40 years old) with esthetic profiles after orthodontic treatment with fixed appliances (133 in group I: 1° ≤ The angle between the nasion [N]-A point [A] plane and the N-B point [B] plane [ANB] ≤ 4°; 111 in group II: 4° < ANB ≤ 7°). Dental, skeletal, and soft tissue measurements were performed on lateral cephalograms of the participants. Correlation and multiple linear regression analyses were used to determine the influence of dentoskeletal and soft tissue variables on maxillary incisor position.
Results
The ideal anteroposterior position of the maxillary incisor varied between sagittal skeletal patterns. The position of the maxillary incisor correlated with the sagittal discrepancy between the maxilla and the mandible (ANB), protrusion of the midface, nasal tip projection, development of the chin, and inclination of both the maxillary and mandibular incisors. Distance from the maxillary central incisor to nasion-pogonion plane predicted using multiple linear regression analysis was accurate and could be a practical measurement in orthodontic treatment planning.
Conclusions
Instead of using an average value or norm, orthodontists should customize a patient’s ideal maxillary incisor position using dentoskeletal and soft tissue evaluations.

Keyword

Customized maxillary incisor position; Dentoskeletal and soft tissue patterns; Cephalometrics; Mathematical approach

Figure

  • Figure 1 Reference planes and landmarks used in this study. Reference planes: Frankfort horizontal plane (FH), a plane passing through the porion and orbitale; Esthetic plane (EP), a plane passing through the pronasale and tangent to the chin; Mandibular plane (MP), a plane passing through the menton and tangent to the posterior portion of the lower border of the mandible; Np, a line passing through the nasion and perpendicular to the FH plane; Ap, a line passing through the A point and perpendicular to the FH plane; G’ vert, a line passing through the glabella and perpendicular to the FH plane; Sn vert, a line passing through the subnasale and perpendicular to the FH plane. Landmarks: S, sella; N, nation; Or, orbitale; P, porion; Go, gonion; A, A point; B, B point; Pog, pogonion; Me, menton; ANS, anterior nasal spine; PNS, posterior nasal spine; Prn, pronasale; Sn, subnasale; Ls, labrale superius; Li, labrale inferius; G’, glabella; Pog’, pogonion of soft tissue; Me’, menton of soft tissue.


Reference

References

1. Hayashida H, Ioi H, Nakata S, Takahashi I, Counts AL. 2011; Effects of retraction of anterior teeth and initial soft tissue variables on lip changes in Japanese adults. Eur J Orthod. 33:419–26. DOI: 10.1093/ejo/cjq095. PMID: 20966067. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=80051699549&origin=inward.
Article
2. Lu W, Zhang X, Mei L, Wang P, He J, Li Y, et al. 2020; Orthodontic incisor retraction caused changes in the soft tissue chin area: a retrospective study. BMC Oral Health. 20:108. DOI: 10.1186/s12903-020-01099-2. PMID: 32295586. PMCID: PMC7160892. PMID: fc4f4769b9134a62b239f59df8d574ff. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85083478396&origin=inward.
Article
3. Tweed CH. 1946; The Frankfort-mandibular plane angle in orthodontic diagnosis, classification, treatment planning, and prognosis. Am J Orthod Oral Surg. 32:175–230. DOI: 10.1016/0096-6347(46)90001-4. PMID: 21022281. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0005711278&origin=inward.
Article
4. Downs WB. 1948; Variations in facial relationships; their significance in treatment and prognosis. Am J Orthod. 34:812–40. DOI: 10.1016/0002-9416(48)90015-3. PMID: 18882558. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=50349135777&origin=inward.
Article
5. Steiner C. 1960; The use of cephalometrics as an aid to planning and assessing orthodontic treatment: report of a case. Am J Orthod. 46:721–35. DOI: 10.1016/0002-9416(60)90145-7. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0037717574&origin=inward.
6. McNamara JA Jr. 1984; A method of cephalometric evaluation. Am J Orthod. 86:449–69. DOI: 10.1016/S0002-9416(84)90352-X. PMID: 6594933. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0021697748&origin=inward.
Article
7. Arnett GW, Jelic JS, Kim J, Cummings DR, Beress A, Worley CM Jr, et al. 1999; Soft tissue cephalometric analysis: diagnosis and treatment planning of dentofacial deformity. Am J Orthod Dentofacial Orthop. 116:239–53. DOI: 10.1016/S0889-5406(99)70234-9. PMID: 10474095. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0033194329&origin=inward.
8. Andrews LF. 2000; Andrews WA. The six elements of orofacial harmony. Andrews J. 1:13–22. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0033194329&origin=inward.
9. Tian K, Li Q, Wang X, Liu X, Wang X, Li Z. 2015; Reproducibility of natural head position in normal Chinese people. Am J Orthod Dentofacial Orthop. 148:503–10. DOI: 10.1016/j.ajodo.2015.05.017. PMID: 26321348. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84941333846&origin=inward.
Article
10. El Asmar R, Akl R, Ghoubril J, El Khoury E. 2020; Evaluation of the ideal position of the maxillary incisor relative to upper lip thickness. Am J Orthod Dentofacial Orthop. 158:264–72. DOI: 10.1016/j.ajodo.2019.08.015. PMID: 32746976. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85088950899&origin=inward.
Article
11. Zarif Najafi H, Oshagh M, Khalili MH, Torkan S. 2015; Esthetic evaluation of incisor inclination in smiling profiles with respect to mandibular position. Am J Orthod Dentofacial Orthop. 148:387–95. DOI: 10.1016/j.ajodo.2015.05.016. PMID: 26321336. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84941367574&origin=inward.
12. Zhang X, Mei L, Yan X, Wei J, Li Y, Li H, et al. 2019; Accuracy of computer-aided prediction in soft tissue changes after orthodontic treatment. Am J Orthod Dentofacial Orthop. 156:823–31. DOI: 10.1016/j.ajodo.2018.11.021. PMID: 31784016. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85075462129&origin=inward.
Article
13. Gu Y, McNamara JA Jr, Sigler LM, Baccetti T. 2011; Comparison of craniofacial characteristics of typical Chinese and Caucasian young adults. Eur J Orthod. 33:205–11. DOI: 10.1093/ejo/cjq054. PMID: 20709723. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=79956068194&origin=inward.
Article
14. Chong HT, Thea KW, Descallar J, Chen Y, Dalci O, Wong R, et al. 2014; Comparison of White and Chinese perception of esthetic Chinese lip position. Angle Orthod. 84:246–53. DOI: 10.2319/031213-212.1. PMID: 23914821. PMCID: PMC8673809. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84896774081&origin=inward.
Article
15. Kuhn M, Markic G, Doulis I, Göllner P, Patcas R, Hänggi MP. 2016; Effect of different incisor movements on the soft tissue profile measured in reference to a rough-surfaced palatal implant. Am J Orthod Dentofacial Orthop. 149:349–57. DOI: 10.1016/j.ajodo.2015.08.017. PMID: 26926022. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84959386827&origin=inward.
16. Cao L, Zhang K, Bai D, Jing Y, Tian Y, Guo Y. 2011; Effect of maxillary incisor labiolingual inclination and anteroposterior position on smiling profile esthetics. Angle Orthod. 81:121–9. DOI: 10.2319/033110-181.1. PMID: 20936964. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=78649535868&origin=inward.
Article
17. Huang YP, Li WR. 2015; Correlation between objective and subjective evaluation of profile in bimaxillary protrusion patients after orthodontic treatment. Angle Orthod. 85:690–8. DOI: 10.2319/070714-476.1. PMID: 25347046. PMCID: PMC8611736. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84937031586&origin=inward.
Article
18. Ricketts RM. 1960; Cephalometric synthesis: an exercise in stating objectives and planning treatment with tracings of the head roentgenogram. Am J Orthod. 46:647–73. DOI: 10.1016/0002-9416(60)90172-X. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=50549173210&origin=inward.
19. Khosravanifard B, Rakhshan V, Raeesi E. 2013; Factors influencing attractiveness of soft tissue profile. Oral Surg Oral Med Oral Pathol Oral Radiol. 115:29–37. DOI: 10.1016/j.oooo.2012.03.021. PMID: 22858016. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84870870537&origin=inward.
Article
20. Ricketts RM. 1968; Esthetics, environment, and the law of lip relation. Am J Orthod. 54:272–89. DOI: 10.1016/S0002-9416(68)90278-9. PMID: 5238879. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0014273614&origin=inward.
Article
21. Lee YJ, Park JT, Cha JY. 2015; Perioral soft tissue evaluation of skeletal Class II Division 1: a lateral cephalometric study. Am J Orthod Dentofacial Orthop. 148:405–13. DOI: 10.1016/j.ajodo.2015.03.033. PMID: 26321338. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84941339197&origin=inward.
Article
22. Blanchette ME, Nanda RS, Currier GF, Ghosh J, Nanda SK. 1996; A longitudinal cephalometric study of the soft tissue profile of short- and long-face syndromes from 7 to 17 years. Am J Orthod Dentofacial Orthop. 109:116–31. DOI: 10.1016/S0889-5406(96)70172-5. PMID: 8638557. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0030075748&origin=inward.
23. Andrews WA. 2008; AP relationship of the maxillary central incisors to the forehead in adult white females. Angle Orthod. 78:662–9. DOI: 10.2319/0003-3219(2008)078[0662:AROTMC]2.0.CO;2. PMID: 18302465.
Article
24. Scott Conley R, Jernigan C. 2006; Soft tissue changes after upper premolar extraction in Class II camouflage therapy. Angle Orthod. 76:59–65. DOI: 10.1043/0003-3219(2006)076[0059:STCAUP]2.0.CO;2. PMID: 16448270.
25. Ghaleb N, Bouserhal J, Bassil-Nassif N. 2011; Aesthetic evaluation of profile incisor inclination. Eur J Orthod. 33:228–35. DOI: 10.1093/ejo/cjq059. PMID: 20716642. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=79957814728&origin=inward.
Article
26. Chirivella P, Singaraju GS, Mandava P, Reddy VK, Neravati JK, George SA. 2017; Comparison of the effect of labiolingual inclination and anteroposterior position of maxillary incisors on esthetic profile in three different facial patterns. J Orthod Sci. 6:1–10. DOI: 10.4103/2278-0203.197387. PMID: 28197396. PMCID: PMC5278578. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85063040873&origin=inward.
Article
27. Hernández-Sayago E, Espinar-Escalona E, Barrera-Mora JM, Ruiz-Navarro MB, Llamas-Carreras JM, Solano-Reina E. 2013; Lower incisor position in different malocclusions and facial patterns. Med Oral Patol Oral Cir Bucal. 18:e343–50. DOI: 10.4317/medoral.18434. PMID: 23229262. PMCID: PMC3613890. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84874832690&origin=inward.
28. Soh J, Chew MT, Wong HB. 2005; A comparative assessment of the perception of Chinese facial profile esthetics. Am J Orthod Dentofacial Orthop. 127:692–9. DOI: 10.1016/j.ajodo.2004.02.018. PMID: 15953894. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=20444403678&origin=inward.
Article
29. Alkadhi RM, Finkelman MD, Trotman CA, Kanavakis G. 2019; The role of lip thickness in upper lip response to sagittal change of incisor position. Orthod Craniofac Res. 22:53–7. DOI: 10.1111/ocr.12257. PMID: 30549432. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85059167179&origin=inward.
Article
30. Schlosser JB, Preston CB, Lampasso J. 2005; The effects of computer-aided anteroposterior maxillary incisor movement on ratings of facial attractiveness. Am J Orthod Dentofacial Orthop. 127:17–24. DOI: 10.1016/j.ajodo.2003.11.025. PMID: 15643410. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=11844249425&origin=inward.
Article
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