Facial Soft Tissue Thickness in Forensic Facial Reconstruction: Is it enough if Norms Set?

Abstract

Facial reconstruction relies on the relationships between the facial features, subcutaneous soft tissues and underlying bony structure of the skull. If there is no clue for potential identity because of impossibility to compare questioned remains with possible familiar material, in such cases one of the last chances is to recreate ante mortem appearance by face reconstruction. Many of the soft tissue thickness values are significantly different from those reported for comparable groups, suggesting that individuals from different geographical areas have unique facial features thus requiring population-specific values. This literature review attempts to throw some light on the important aspects that has to be taken into consideration while setting norms of soft tissue thickness among various populations. To name a few are the differences among different skeletal malocclusions, differences in soft tissue thickness and the rate of tissue change among both men and women at different age groups.

Male and Female Characteristics of Facial Soft Tissue Thickness in Different Orthodontic Malocclusions Evaluated by Cephalometric Radiography

“…Lateral cephalometric radiography, which generates a lateral cephalogram, shows dental, skeletal, and soft tissue profiles, and is used to determine dental and skeletal relationships, with the aim of planning orthodontic treatment [ 33 ]. More contemporary methods for determining FSTT have recently been developed [ 14 , 23 ], including computed tomography (CT) scanning [ 35 ], cone beam CT (CBCT) [ 17 , 19 ], ultrasonography [ 4 ], and magnetic resonance imaging (MRI) [ 18 , 22 ]. Needle puncture measurements of FSTT have been reserved for cadaveric studies [ 21 ].…”

“…Aggarwal and Singla reported on the presence of significant differences between men and women, and men had increased values for FSTT for the labrale superius, labrale inferius, pogonion and menton, compared with women, and recommended that this difference should be taken into consideration when planning orthodontic therapy [ 30 ]. Hamid and Abuaffan [ 4 ], Ramesh et al [ 5 ], Chen et al [ 22 ], Atashi et al [ 38 ], and Masoumeet et al [ 17 ] have all shown differences in FSTT between men and women, but have given the explanation as being due to the influence of body mass index (BMI). Karnaket et al [ 27 ], and Maurya et al [ 39 ] found significant differences between men and women in the area of the labrale superius and pogonion.…”

“…Face contours are traditionally considered to be a result of the position of basic hard (dental and skeletal) tissue followed by the soft tissue. However, current trends show a shift of the paradigm from the conventional analysis of hard tissues, to include soft tissue [ 5 ]. Muscles, subcutaneous fat, soft tissue, and skin, can develop proportionately and disproportionately in relation to corresponding skeletal structures [ 6 ].…”

“…Standard values of FSTT and other rules based on anatomy are used for facial reconstruction, but FSTT values are usually used for determining the thickness of tissue that lies on predetermined landmarks of the skull [ 5 ]. Knowing the quantitative distribution of FSTT in different areas is a necessary factor for creating recognizable facial contours on an unknown skull [ 17 , 18 , 22 , 23 ].…”

“…Recent research from different parts of the world has shown that soft tissue thickness closely corresponds to sagittal malocclusions [ 9 , 14 , 24 – 28 ]. There is still controversy over the influence of sex on FSTT, and most authors believe that there are significant differences between men and women in FSTT [ 2 , 5 , 8 , 25 , 26 , 29 – 31 ]. However, other authors refute these differences [ 16 , 20 , 32 , 33 ].…”