Clinical facial analysis (cfa) for orthodontists
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Clinical facial analysis (CFA) for orthodontists and maxillofacial surgeons By Mohammed Almuzian University of Glasgow, 2012
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Transcript of Clinical facial analysis (cfa) for orthodontists
Clinical facial analysis (CFA) for orthodontists and maxillofacial surgeons
By Mohammed AlmuzianUniversity of Glasgow, 2012
What is Clinical Facial Analysis?It is the method utilized by clinician for evaluating and judging the patient‘s face; to define its proportions, volume, appearance, symmetry, and visible
deformities. (Biondi, 2005)
To whom CFA might be beneficial?
Methods of CFA
Direct examination
Clinical photographs
Non Radiographical 3D imaging methods
Conventional & 3D x-ray imaging.
Is CFA parameters are standard?
Racial background
Cultural difference
Gender
Personal preference
Clinician philosophy
Importance of CFA
• To diagnose and classify the deformities especially for border line cases.
• To plan the treatment approach that mainly addresses the patient concerns and complaints.
• To predict the treatment outcomes, stability & prognosis.
When CFA should be performed?
Thorough CFA Initial CFA
Observation stage
Questionnaire stage
Steps in CFA
Positioning the patient • NHP (developed by.., tested by…, described by…. • Centric relation• Relaxed lip position, BOWB (bite opening wax bite)
indicated in………• First tooth contact (wax bite , deprogramming splint)Then 1. Frontal view analysis, 2. Profile view analysis, 3. 45 degree view analysis for profile-frontal shared features.
Frontal view analysis
Vertical analysis of the frontal viewFacial typeVertical heightsLip assessment
Facial type
(Naini 2008)
Vertical analysis of the frontal view
Vertical heights
Vertical analysis of the frontal view
1. upper third 2. middle third 3. lower third • Upper lip• Lower lip and chin• Interlabial gap
Bell et al 1980 Fish and Epker 1981Ricketts et al 1979Farkus 1984
Lip assessment (LAMP),
miniesthetic analysis
• Line, • Activity• Morphology• Position
Mossy 1981Fish & Epker 1981Naini 2008
Vertical analysis of the frontal view
Frontal view analysis
Transverse analysis of frontal viewVertical reference lines (Facial midline, Rule of fifths)Skeletal base assessment(Maxillary & Mandibular)Smile analysis
Dental factors
Transverse analysis of frontal view
Vertical reference linesFacial midlineRule of fifths
Naini 2008Arnett and McLaughlin 2004Sheen, 1978
Transverse analysis of frontal view
Skeletal base assessment
Mandibular assessment Chin jaw line
Maxillary assessment Sclera show
Paranasal hollowing
Naini 2008Hunt & Ruge 1983
Transverse analysis of frontal view
Smile analysis
• The smile arc• Width of smile• Incisor and
gingival show (Posed, social smile)
Naini 2008
Transverse analysis of frontal view
Dental factors
• Overbite• Occlusal plane
(Upper, lower, anterior posterior)
• Maxillary dental midline
• Mandibular dental midline
Profile analysis
Total soft tissue profile analysisAnalysis of the high midfaceAnalysis of the maxillary areaAnalysis of the mandibular area
Facial profile analysis
Total soft tissue profile analysis
Angle of convexity , Burstone 1968, 11-30 degree .
Nasomental angle (Total facial angle) 160 degree
Burstone 1965Moshiri et al, 1982Powell et al 1984
Facial profile analysis
Analysis of the high midface
• Soft tissue glabella • Orbital rim • Check bone contour
Fish & Epker 1981
Facial profile analysis
Analysis of the maxillary area
• Nasal base (Meridian line)
• Nasal projection (TVL)Anteroposterior lip position (TVL, E line, S line, H line) • Relationship of upper
lip to nose
Gonzales-Ulloa 1966Arnett & Bergman 1993
Ricketts 1979Steiner 1966Holdaway 1983Fish & Epker 1981
Facial profile analysis Analysis of the mandibular area
1 .Anteroposterior lip position (TVL, E line, S line)
2 .Relationship of lower lip to chin
3. Anteroposterior chin positionBass aesthetic analysis Facial vertical
Holdaway angleProfile line or Z angle
4. Relationship of chin to submental area• Lip-chin-submental plane • Submental plane length
Gonzales-Ulloa 1966Arnett & Bergman 1993
Ricketts 1979Steiner 1966Bass, 2003Merrifield, 1966Moshiri et al, 1982
Dental Appearance: Micro-Esthetics.
Tooth ProportionsWidth Relationships and the "Golden Proportion "
Height-Width RelationshipsGingival Heights, Shape and Contour
ConnectorsEmbrasures: Black TrianglesTooth Shade and Color
Thank you
