青少年姿势位微笑与头影测量指标的相关分析

目的对比普通人与正畸医生对姿势位微笑的审美观异同，研究面部软硬组织与姿势位微笑的关系。方法用Canon EOS 50D数码照相机拍摄60名（男30名，女30名）个别正常胎的青少年面部正面照片数张，由正畸医生和普通人用视觉模拟尺度（VAS）评判美的微笑，并测量头颅侧位片的相关数据，最后经SPSS13．0统计软件进行统计学分析。结果1）正畸医生与普通人的微笑主观评分差异有统计学意义；2）正畸医生对姿势位微笑的主观评分高低与SNA角和SNB角呈负相关，与U1-L1角呈正相关；普通人对姿势位微笑的主观评分高低与MP角、PP—MP角和颏唇沟角呈正相关。结论1）正畸医生与普通人对姿势位微笑的审美观有差异，在正畸临床诊治患者的过程中，医患双方需加强沟通；2）正畸医生在诊治患者的过程中应关注患者面部侧貌的凸度及其面下1／3的协调美观。     

骨性Ⅱ类面型患者的性别对软组织侧貌评价的影响

目的 研究正畸治疗中骨性Ⅱ类面型患者的性别对软组织侧貌评价的影响。方法 选取南京医科大学附属口腔医院2016—2020年所收治的正畸骨性Ⅱ类面型患者30例,男性15例,女性15例,年龄18~36岁。收集每位患者矫治前自然头位的剪影照片并拍摄CBCT。应用Photoshop软件对30张照片进行修改,隐藏暴露性别特征的头发、睫毛、喉结等特征,获得去除性别特征的剪影照片;将CBCT合成的头颅侧位片与自然头位剪影照片重叠获得自然头位的头颅侧位片。将30张去除性别特征的剪影照片和30张未去除性别特征的剪影照片（标明性别）随机打乱,分别制作成幻灯片,间隔5 s自动播放。邀请非专业人员对两组幻灯片分别进行打分。收集整理数据将去除性别特征组分为高分组与低分组,使用Holdaway分析法定点测量各项指标,独立样本t检验比较各指标间差异。结果 去除性别特征组整体平均分、男性组平均分、女性组平均分均较未去除性别特征组低,差异有统计学意义（P＜0.05）。去除性别特征组中,男性所得评分明显高于女性（P＜0.05）。高、低分组与评分相关的测量指标为A点凸度、上唇基部厚度、颏唇沟深度和颏部厚度（P＜0.05）。结论 骨性Ⅱ类面型患者的性别对软组织侧貌的评价存在影响,男性去掉性别特征的侧貌轮廓较女性更易被普通人群接受。影响侧貌评价的美学指标为A点凸度、上唇基部厚度、颏唇沟深度、颏部厚度。     

140名山西籍青年人微笑美学定性指标初步分析

目的:分析山西籍青年人姿势微笑位美学定性指标,探讨性别对微笑特征的影响,为前牙美学区域修复治疗提供参考依据。方法:选取20~30岁个别正常140例受试者,男68例,女72例,平均年龄25.6岁。采用视频录像的方式记录姿势微笑位的整个过程,使用计算机软件获取姿势微笑位图像。对微笑线、微笑弧、上唇曲度、上颌前牙与下唇的关系、微笑宽度进行定性分析。使用Pearson chi-square检验分析性别组间微笑指标,微笑定性指标之间采用Spearman相关分析。结果:在总体样本中,中微笑线(59.3%)、平行微笑弧(71.4%)、笔直上唇曲线(51.4%)、上前牙与下唇不接触(72.9%)以及微笑宽度显示至第二前磨牙(54.3%)较为常见。除了微笑线(P=0.040)和上颌前牙与下唇的接触关系(P=0.039)以外,其它定性指标在性别间无统计学差异。微笑线和上前牙与下唇的接触关系相关、微笑宽度和上前牙与下唇的接触关系相关(P<0.05)。结论:中微笑线、平行微笑弧、笔直上唇曲度、上前牙与下唇不接触以及微笑宽度显示至第二前磨牙的微笑特征在受试者中占比较高。微笑线和上颌前牙与下唇的接触关系差异在性别组间有统计学意义,女性较男性显示更高的微笑线,易出现下唇覆盖上颌前牙的唇齿关系。笑线越高,上前牙与下唇的接触关系越易出现覆盖关系;笑线越低,上前牙与下唇的接触关系越易出现不接触关系。微笑时牙齿显露数量少,上前牙与下唇的接触关系越易出现覆盖关系;微笑时牙齿显露数量多,上前牙与下唇的接触关系越易出现不接触关系。     

正畸患者对侧貌面型审美偏好的调查研究

目的:调查正畸患者对软组织侧貌面型的审美偏好,并探索不同年龄和性别的患者是否存在审美差异,为临床矫治提供参考.方法:根据面突角建立男女侧貌渐变模型,采用电子问卷形式,随机调查203例患者[平均(19.2±6.0)岁,男70例,女133例]对下颌后缩的容忍边界值、下颌前突的容忍边界值和最满意的侧貌面突度.采用SPSS17.0软件包对数据进行统计描述和秩和检验.结果:正畸患者对男女侧貌面突度的可接受范围分别为168°～180°、160°～172°,最满意的侧貌面突度分别为172°、168°.不同性别组患者的审美差异无统计学意义(P＞0.05).不同年龄组患者的审美差异有统计学意义(P＜0.05),成年组患者对下颌后缩的容忍边界值、男性下颌前突的容忍边界值和男性最满意侧貌突度较未成年组患者大.结论:患者对侧貌面型均存在可接受范围和最满意侧貌,但对侧貌面型的审美偏好有差异;患者对侧貌面型的审美观受年龄影响,不受性别影响.     

正常牙合人群口周软组织增龄性变化的研究

目的:探讨正常牙合人群口周软组织在休息位与微笑位时随年龄变化特征。方法:选择15~49岁个别正常牙合者240例,进行面像拍摄,应用Smile Measure软件测量其口周软组织。结果:各年龄组间进行两两比较,组间差异有意义的测量项目有休息位上唇长度、微笑位上唇长度、休息位上唇厚度、微笑位上唇厚度、休息位口角宽度、口角宽度变化量、上颌切牙暴露量、上下唇间隙、微笑指数、颊旁间隙(P＜0.05)。同一年龄组不同性别进行两样本t检验,差异有意义的测量项目有休息位上唇长度、微笑位上唇长度、上唇长度变化量、休息位口角宽度(P＜0.05)。微笑高度进行卡方检验, G1、G2、G3、G4组高中低位微笑类型男女性别差异均具有统计学意义(P＜0.05)。结论:随年龄增长,上唇长度变长,嘴唇变薄,微笑时口角变宽,颊旁间隙变大,更趋于低位微笑。相同年龄人群的唇齿关系具有性别差异。     

侧貌美观评价的调查初探

目的 分析侧貌美观评价的差异,为iF畸临床治疗提供参考.方法 制作27张男性侧貌剪影图:以下面高比为54%、ANB角为3°的志愿者头颅侧位X线片为Ⅰ类骨面型正常图片,使骨性下面高比按2%(1倍标准差,1s)依次递增或递减,直至下面高比的变化量为±4倍标准差(±4s),连M Ⅰ类骨面型正常图片共得到9张剪影图.将Ⅰ类骨面型正常图片的ANB角改为6°和-1°,得到Ⅱ类骨面型正常图片和Ⅲ类骨面型正常图片,重复上述步骤得到Ⅱ类骨而型剪影图9张和Ⅲ类骨面型剪影图9张.选择4组调查对象:患者组(成年错骀患者,30例)、家长组(未成年错(牙合)患者的家长,30人)、本科生组(非医学专业本科生,26人)和正畸医师组(34人),对27张剪影图的美观程度进行评分,比较剪影图的得分差异和各组调查对象的评分差异,以及性别、年龄对评分结果 的影响.结果 27张剪影图得分的差异有统计学意义(P<0.05),其中Ⅱ-1s剪影图得分(6.68±1.99)最高,Ⅲ-4s剪影图得分(2.20±1.62)最低;4组评分的差异有统计学意义(P<0.05),正畸医师组对Ⅰ类正常剪影图评分(6.94±1.58)最高,患者组对Ⅱ-1s剪影图评分(6.76±2.14)最高,家长组对Ⅱ正常剪影图评分(7.08±1.68)最高,本科生组对Ⅱ类正常剪影图评分(6.42±2.02)最高;4组一致对Ⅲ-4s剪影图评分最低.不同性别、年龄评分者的评分结果 比较,差异无统计学意义(P>0.05).结论 垂直向不调对中国男性侧貌美观有影响,且与垂直向异常程度、矢状向骨面型相关.Ⅲ类骨面型对男性侧貌美观的负面影响最大.4组调查财象对颜面侧貌的审美标准有差异,非正畸专业人士更认同偏Ⅱ类骨面型.审美观不受性别、年龄的影响.     

恒牙初期Ⅱ类1分类错患者唇形的研究

目的通过对Ⅱ类1分类错患者唇侧位形态的研究,分析不同生长型和性别对唇侧位形态的影响。方法选取145例恒牙初期Ⅱ类1分类错患者为研究对象,在其正畸治疗前拍摄的头颅定位侧位片上测量上下唇侧面的长度和厚度,分别采用t检验和单因素方差分析比较不同性别和不同生长型患者唇形态的差异。结果恒牙初期Ⅱ类1分类错患者中,男性的上下唇长度均大于女性（P<0.05）,男性上下唇的厚度与女性的差异无统计学意义（P>0.05）;不同生长型患者的上唇侧位形态无明显差异,而水平生长型患者的下唇外翻较垂直生长型患者更明显。结论性别及生长型对恒牙初期Ⅱ类1分类错患者的唇侧位形态有影响。     

姿势性微笑的三维测量分析初探

目的 研究姿势性微笑时面部软组织特征区域的三维变化,为正畸临床提供参考.方法 利用FaceScan三维面部成像系统采集44名志愿者[男性18人,女性26人,平均(26.7±2.6)岁]休息位和姿势性微笑位的面部信息,并在Rapidform软件中对两种表情状态下面部变化区域进行三维定量和定性分析.结果 姿势性微笑时面部发生变化的区域占全面部(29.65±8.40)％,面部左右侧变化差异率为6.69％(2.07％,13.11％);姿势性微笑时口角、颧部、下唇均发生位移改变;变化量由大到小依次为口角、下唇、颧部、鼻唇沟、颏唇沟、鼻翼、上唇、下睑、咬肌区、颏部、上睑、鼻背、颞部;女性鼻唇沟变化量[(4.49±1.51) mm]大于男性[(3.25±1.75) mm](P＜0.05).全面部整体变化方向以向后为主.结论 姿势性微笑时面部变化存在左右不对称性,不同部位变化量不同,男女之间变化比率不同.姿势性微笑时女性在鼻唇沟为主的口唇区域变化更大.     

成人正畸治疗对生活质量的影响

目的：研究正畸治疗对成人患者日常生活质量的影响。方法：随机抽取正畸治疗复诊患者400名进行问卷调查,年龄18～45岁,其中男90名,女310名。采用＂口腔健康状况对日常行为影响量表＂对患者进行测评。结果：正畸治疗对日常生活中进食、清洁、微笑的影响较大,疗程越长对患者工作学习的影响越大（P〈0.05）;正畸治疗对不同性别、不同年龄成人患者影响不同,女性患者认为对口腔卫生的护理更费时间,而男性则认为对社会交往的影响更明显（P〈0.05）;年轻患者（小于25岁）认为佩戴矫治器对日常生活中微笑的影响更显著（P〈0.05）。结论：正畸治疗影响成人患者的生活质量,在矫治初期、长疗程中表现更为明显;而不同性别,不同年龄的成人患者对正畸治疗影响日常生活各个方面的感受各不相同。     

Twin-block与Headgear-activator矫治骨性Ⅱ类错牙合临床疗效对比研究

目的:对比Twin-block与Headgear-activator两种功能矫治器的临床疗效.方法:选择自然生长和使用Twin-block、Headgear-activator功能矫治器矫治成功的60例骨性Ⅱ类错牙合患者为研究对象,将其分为对照组、Twin-block组和Headgear-activator组,每组均为20例患者.在正畸治疗前后拍摄X线头颅定位侧位片,对治疗前后X线头影测量值进行比较.结果:软组织指标:上唇审美平面距、下唇审美平面距、上唇突角、上唇倾角、下唇倾角、上下唇突角、颏沟倾角、上唇颏突角、软组织面角、鼻唇角、颏唇沟角、Z角、面突角、软组织面高、软组织下面高、上唇长的变化与对照组比较有统计学意义(P<0.05);硬组织指标:SNB、ANB、U1-SN、U1-NA的变化与对照组比较有统计学意义(P <0.05);两治疗组间,上唇倾角、上唇长、软组织面高、软组织下面高、IMPA、FMIA、FMA的变化有统计学意义(P<0.05).结论:Twin-block与Headgear-activator可明显改善上下颌骨矢状不调,一定程度上恢复了鼻、唇、颏之间的协调性,两者在下前牙唇倾度、下面高、唇部形态等方面的效果存在差异.     

正畸可控的笑容特征指标对微笑美的影响研究

目的 探讨各项正畸可控的笑容特征指标与微笑美的相关性。方法 选取男女微笑时面下1/3照片各1张,利用Photoshop依据各指标（切牙暴露量、露龈量、笑弧、颊廊、上颌牙合平面倾斜度及上切牙下唇间距）分别进行变动,选择200名大学生对其进行评价。数据输入Spss 19.0 统计软件包,将每项指标对应各图得分与该指标的变化进行等级资料Spearman相关分析。结果 男女笑容图的得分均与切牙暴露量、笑弧一致性成正相关（P<0.05）,与露龈量、颊廊面积、上颌牙合平面倾斜度、上切牙下唇间距成负相关（P<0.05）。结论 唇齿龈的相对位置对笑容的美观有显著影响,正畸过程中应注意调控。     

Incisor display during speech and smile: Age and gender correlations

Objectives:To evaluate age- and gender-related changes in the soft tissues, incisors, and gingival display during rest, speech, and posed smile.Materials and Methods:A total of 265 participants (122 men, 143 women) ranging in age from 19 years to 60 years were recruited for this study. Participants were divided into one of the following four age groups: 19 to 24 years, 25 to 34 years, 35 to 44 years, and 45 to 60 years. Image capture was performed using standardized videographic methods. Each video produced pictures where measurements were performed: rest, speech, and smile positions.Results:A statistically significant gender dimorphism was apparent in most of the variables. There was a significant increase in the upper lip length and lip commissures height with aging and more markedly in men. A greater exposure of mandibular incisor with increasing age was a feature in both genders. With increasing age there was a significant decrease in maxillary incisor display, especially for men.Conclusions:After 25 years of age there is significant difference in the aging process between men and women. Gingival and maxillary incisor display during speech and smile is a youthful and feminine characteristic.     

Dynamics of a smile in different age groups

Objective:To evaluate smile in different age groups and to detect gender differences in smile.Materials and Methods:Digital videographic records of 241 randomly selected subjects were obtained for smile analysis. The subjects were divided into four groups by age (15–20 years, 21–30 years, 31–40 years, and 41–50 years). Each group was further subdivided by gender. After 41 subjects were excluded, the smile dimensions of 200 subjects were analyzed by two-way multivariate analysis of variance (MANOVA) with Duncan''s multiple range post hoc test.Results:All dynamic measurements (change in upper lip length, upper lip thickness, commissure height, and intercommissural width from rest to smile) decreased with age in both males and females. Changes in upper lip length and commissure height on smiling were greater in males as compared with females of the same age groups. Changes in intercommissural width on smiling were greater in females as compared with males in all age groups.Conclusion:Smile changes with increase in age, and the changes differ between males and females. Females had a wider smile as compared with males of similar age groups.     

The effects of upper lip height on smile esthetics perception in normal occlusion and nonextraction, orthodontically treated females

Background: The esthetic of smile is influenced by such features as the amount of incisor show and gingival display. Aims: The purposes of this study were to compare smile esthetics among normal occlusion and non extraction patients, assess upper lip height in two groups and discuss how this feature relate to smile esthetics. Settings and Design: We therefore conducted a case control study to determine the mentioned aims. Materials and Methods: Thirty females with non extraction orthodontically treated occlusions and thirty three with normal occlusions were selected. Standardized black and white photographs of their posed smiles were evaluated by a panel of 5 men and 5 women of varied vocations by use of visual analogue scale. Then upper lip height of the two groups were measured from photographs. Statistical Analysis: Smile esthetics and differences among the two groups were subjected to ANOVA and Mann-whitney test was used to compare upper lip height in them. Results: This study showed that upper lip height did not differ among the 2 groups ( P = 0.98). Also there were no significant differences in the distribution of fair,good and very good smiles among the two groups. Conclusions: This study demonstrates that the non extraction orthodontic treatment does not influence smile esthetics.     

The smile buccal corridors: aesthetic value for dentists and laypersons

The purpose of this study is to assess the aesthetic value of "buccal corridors" on smile attractiveness as judged by dentists and laypersons. In order to evaluate the aesthetic impact of the "buccal corridors", a pleasant smile (frontal view) was scanned (Scanner HP 5490C, 1200 x 1200 dpi) and modified (Adobe Photoshop 5.0) by a professional computer technician. Three pictures have been produced, one with minimal corridors (no 1), another with evident corridors (no 2), and a third one with moderate corridors (no 3). During a survey 1275 laypersons (413 M, 862 F; 14 to 77 years) and 646 dentists (361 M, 285 F; from 25 to 80 years) were asked to indicate the most pleasant and the most unpleasant smile and to fill in a short questionnaire; the data have been statistically evaluated through an ANOVA test. Among the laypersons: 838 (65.72%) chose the first smile; 91 (7.13%) the second one; whereas 346 (27.13%) the third one. The differences are statistically significant (p .05); no statistical differences were found by analyzing the gender and the age of the groups. Among the dentists: 481 (74.46%) preferred the first smile; 44 (6.81%) the second one; whereas 121 (18.73%) the third one, the differences are statistically significant (p .05), no statistical differences were found by analyzing the gender and the age of the groups. Moreover no statistical differences were found by comparing the two different groups. Therefore, a full, broad smile with minimal "buccal corridors" seems to please dentists as well as laypersons and age and gender were not relevant.     

Cephalometric characteristics of postorthodontic female patients with attractive and unattractive frontal posed smiles

Objectives:To identify differences in skeletal, dental, and soft-tissue morphology between postorthodontic patients with attractive and unattractive frontal posed smiles.Materials and Methods:The attractiveness of close-up photographs of frontal posed smiles in 100 adult female patients after conventional orthodontic treatment was evaluated by 20 dental students (10 men, 10 women) using a visual analogue scale. Posttreatment cephalograms of the 20 patients with the most attractive smiles (attractive group; mean age 23.75 ± 3.35 years) and the 20 patients with least attractive smiles (unattractive group; mean age 23.11 ± 4.45 years) were selected, and 41 measurements were made and compared between groups using the Mann-Whitney U-test (P < .05).Results:When compared with the attractive group, the unattractive group exhibited greater values for sella-nasion plane to mandibular plane, palatal plane to mandibular plane, anterior facial height, lower facial height, and lower facial height/anterior facial height as skeletal measurements; for occlusal plane to sella-nasion plane, palatal plane to occlusal plane, and maxillary central incisor to palatal plane as dental measurements; and for lower face, upper lip length, and upper lip superior to palatal plane as soft-tissue measurements.Conclusions:Cephalometric analysis revealed that postorthodontic Japanese female patients with unattractive frontal posed smiles are characterized by a hyperdivergent skeletal pattern with extruded maxillary incisors and a steep occlusal plane, accompanied by a longer upper lip than patients achieving attractive posed frontal smiles.     

Morphological features of smile attractiveness and related factors influence perception and gingival aesthetic parameters

IntroductionIn addition to understanding the basic standards of a smile and patient's opinion, dentists should take into account smile aesthetics, an essential factor for optimal outcomes. This study aimed to evaluate the factors that affect the perception of an aesthetic smile and determine its morphological characteristics and measure the gingival aesthetic parameters.MethodsIn all, 200 Vietnamese aged 18-35 years were recruited to have their spontaneous smiles captured. These smile images were assessed by 50 laypersons and 50 dentists using a visual analogue scale measurement. The images were analysed to evaluate perceptions of evaluators, determine smile attractiveness, and measure gingival aesthetics.ResultsThe difference in the judgements of laypersons and dentists, males and females, and laypersons aged 18-25 and 26-35 years were nonsignificant. High or average anterior smile line, parallel smile arc, upward upper lip curvature, second premolars as the posterior-most teeth displayed, smile index of 5.23-5.63, and dynamic smile symmetry of 1 were scored highly on smile attractiveness. The following maxillary gingival aesthetic parameters were preferred: gingival zenith (GZ) of the canine 0.72-0.75 mm apical to the GZ of the central incisor; GZ of the lateral incisor 0.66 mm coronal to the gingival line; gingival line angle of ～87°; for the central incisor, lateral incisor, and canines, distance from the GZ to the long axis of 1, 0.4, and 0 mm, respectively; interdental papilla height of 4.25, 3.60, and 3.85 mm, respectively; ratio of the distance from the GZ and the interdental papilla tip to the incisal edge of ～1.74-1.77 mm.ConclusionsFactors including profession, gender, and age of evaluators had almost no impact on their perception of aesthetics. Smile attractiveness characteristics and gingival aesthetic parameters have clinical applicability for patient care.     

Perioral age-related changes in smile dynamics along the vertical plane: A videographic cross-sectional study

Objective: To evaluate the changes in characteristics of perioral musculature at rest and when smiling, with respect to age and gender, measured along the vertical plane in a randomly selected sample of a North Indian population.Materials and Methods:Perioral musculature of 195 subjects (divided into three age groups) was recorded using standardized videographic methods. Two frames of each subject—at rest and widest posed smile—were analyzed for a comprehensive list of parameters. Data was evaluated using SPSS version 16 software. Two-way analysis of variance and post hoc least significant difference tests were conducted.Results:Significant observations were increased resting upper lip length for females; decreased upper lip thickness, maxillary incisor exposure, and lip elevation for males; and increased smiling upper lip length for both sexes.Conclusions:With age, the smile gets narrower vertically, especially for the male population. The pattern of change observed in the present study must be considered and incorporated during treatment planning to deliver healthier and long-lasting results to patients of all age groups.