New diagnostic tenet of the esthetic midface for clinical assessment of anterior malar projection

Abstract

Objective: To determine whether a visual classification of anterior malar support using vector relationships is supported by cephalometric analysis. Materials and Methods: Forty white subjects between the ages of 10 and 12 years, without craniofacial syndromes or previous orthodontic treatment, were equally divided into groups based on visual assessment of negative and positive vector relationships. Group A comprised 20 subjects (10 male, 10 female) exhibiting a positive vector relationship. Group B comprised 20 subjects (10 male, 10 female) displaying a negative vector relationship. Sella-nasion-orbitale (SNO) angulations were measured to evaluate the subjects' anteroposterior position of the malar eminence relative to the cranial base. Gender differences and significant differences in SNO measurements between groups A and B were assessed with Mann-Whitney U-tests. Results: There was no statistically significant difference between genders. SNO angulations in the negative vector group were smaller than the positive vector controls by an average of 6.0 degrees, and the difference was highly significant (P , .0001). Conclusion: Compared with subjects exhibiting a positive vector relationship, individuals displaying a negative vector relationship had significantly reduced malar support. Anterior malar projection can be effectively classified through visual assessment of vector relationships. (Angle

Validity of Visual Vector Relationship for the Clinical Assessment of Anterior Malar Projection and the Changes Observed in Facemask Therapy Patients” – A Retrospective Stud

“…This also causes visible bags and a more aged appearance. 9 The results of the present study demonstrated the effects of face mask therapy and validity of visual vector relationship for clinical assessment of malar prominence. But further radiographic examinations are required to evaluate the extent of malar deficiency mainly when surgical correction of the defect is in the treatment.…”

“…1 Additionally, skeletal structures of the midface are difficult to assess in lateral cephalograms, and this has led orthodontists to focus entirely on the premaxilla for classification of maxillary skeletal development. 4 Hence this study seeks to determine whether visual classification of anterior malar projection using vector relationship is supported by cephalometric analysis and to know the effects of face mask therapy on visual relationship. Thus, the null hypothesis of the study is that there is no statistically significant difference between face mask therapy and visual vector relationship subjects.…”

Test-retest reliability of smile tasks using three-dimensional facial topography

“…7 There seems to be little doubt that the conventional smile analysis described here is clinically significant to achieve improved esthetics. However, recent 3D research [24][25][26] Figure 6. Three-dimensional representations of the point clouds of average human faces (right lateral views) for the rest posture (left), posed smile (middle), and maximum effort smile (right).…”

“…For example, 3D facial changes after a Wassmund osteotomy 24 or bilateral sagittal split osteotomy 25 demonstrated an increase in malar projection at rest and while smiling in concert with improvement of soft tissue descent. [24][25][26] In the same way, it is assumed that the movement of the lip can be changed after orthodontic treatment. Thus, evaluating the soft tissue configuration of the face both at rest and during a facial expression is essential to achieve the correct diagnosis in combined surgical orthodontics.…”

Assessment of anterior malar projection using visual photographs and lateral cephalograms: A comparative study

“…This has led orthodontists to focus entirely on the premaxilla for classification of maxillary skeletal development. [ 6 ] Furthermore, there is no agreement among the authors on the best method to assess and quantify the midfacial hypoplasia. Thus, the aim of this study was to determine whether visual classification of anterior malar projection using vector relationships is supported by cephalometric analysis.…”