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Soft tissue cephalometric analysis for orthognathic surgery Harz L, Legan, DDS, Dallas; and Charles J. Burstoe, DDS, MS, Farmington, Conn A oft tes pao nas Aerie othe patios ‘ake qr ee ttc ew dae pee nt a pry ited dnl ante To make uly praca. sasha hve mat ‘aol ondsigftan mrtroints, Uied lng ih othr hagmte ws ts aft tae ection ell tle the dimuan te shine god foc whee Jor hr ot hr ats ‘Trestmeat planning for patente who require anhog atic suger shoud iaclde both a ard ise and {of tue ceptalomesrc analy" Although the hard hue scaly will sow the nature of the exiting Aelia crepancy, i ip incomplete ie providing Fnformation concering the fcal form and propor Sone af the pation, and, in many instances, nay ‘etal be mseading. “The sot tne covering the teeth and bone & ighly variable it thickest and this variation may ‘berate than the variation ound nthe postion and ir the tenth ad bones! Ae a el hard tse fmeamurerent cin deviate comiderably fom the {cial form the patient expe with heft ee Patiats may appear cher more or lew cases in (heir pros than indicated by their hard owes Docaute of difernces in thcknew of sft tne, paricalanly atthe junction of te nove sd upper Up fad inthe rio ofthe chin. Silat, lips may be tore protraive oe retrsve than inated by dent: ‘Seleial measurement bonte of pe that ae either ‘exeenively tick ort Tm planning surgery on pationts with verte, dacrepancie lip length san portant factor. Lipe Imay be relatively shor, allowing the patient to produce Up closure oaly with great ical Irupper lip length i shor, an exeesive amount of malay Incr will show during speaking and sing. These fore, diagnose of wera! dicrepance depend on ‘of ve an well as ard ave factors? ‘Sheetal analy tend to une arbitrary planes sch ae Franklor: horizontal and wile aaion to deter Irine if 2 mala or mandibie f abrormlly pos Mined, Reference planes can be misleading a they can vary jum a the Landmark in the salle acd mandible that are related tothe. Although = posta ‘al herzotal plane can comet for the arbitrary ature ofa reference plane i does asl the bse problem that « geod [ail eof reflets harmony erween many facial ares that ate dependent ot tooth pasion, bone portion, end sft tue mes ‘Thus so tie areas ouch ete eck, nomad ips rit be considered tm determining whether progr "hk o etrognathis of hej ex Burvone!previeuly developed a system of st Yinue analyser planing treatment for patents Iauing onbodontic eatment, With the deveap sent and current tee in ortboynatie sree Procedures thie analy ad teen reduced te mast Ielvant measurements and new eneasrement hase een added that ave parcularly significant to We see patent ‘The meant and standard deviations forthe nea: surements wed in hips ve analysis wee derived From = population of 40 white adults (20 men and 20 sromen) tetween the ages of 20 and 30. All the patents inthe simple were orthogonally ntreated trth Clan Tecelanons and had versal aia propor “ons that were determined to be within normal ie (ANS/ANSMe was betncen 79 and 85)? 1 Cipaomabic Lands “The sft ta Janda usd in thin cepha secre sna ae the flowing (Fg 1 “Glabals(G), the mort prominectpoim in the nail plane af ee forehead “Catamela Poin (Cin), the moot anterior point on the collin of the mee “Subnaale (Sn), the point at which che aul rum mere th te pe atari pte “Laale sopeius (La), point indenting the mucnastancou border ofthe upper ip Siomionsuperivs (St, the lowermost pi en the vermin of the upp ip “Stomion iteris (St), the uppermost point en the wermiion of the lower ip, “Libra inferiae (Lip point indicating the nacnatanenas Romer ofthe we ip Mentlabia! sulcus (Si, the point of geste oncrity inthe midline between the kwe ip (U3) Sid ein (P. Soft time pogonion (Pe), the mone ante point alt nue chin Sof ine nathion (Gn), the comtrcte mi point betwen sot taste pogenion and sof nee You 38, Oorowen 1380 J Ouse Soromay ; ; ‘Leons-Bunsrone: Sore Tasos Gematowernic Anata Fig aphasia ‘menton; can be leated at the intracton of the ‘olasile (ost thee pogonion line aad the line from C10 Me. "Softw menton (ME), lowest point on the ‘contour of the soft tue cin: found by dropping 2 perpendicule fom boraostal plane through men Cervical point (©), the innermost point 3 Derween the submentl area and the neck located at ‘he intersection ef ins dram tangent othe eck aad ‘wbotntl ares orisontalretererce plane (HP), consnacted by drawing a line shyough mason 7° op fom sla (8) — ation (lin. he St Tune Aras Fact ForsTo describe the overall orzontl ‘oft time pele of the patent, the angle of fai ‘onvenity facial contour ale, G— Sn — Pe ‘ranted (Pig 24) This anges formed by the ine ‘abla (C) © submasle (Sn) aed the line Sn to sat tive pogonion (Pg). The mean atacand devin tion fr this angular meaneent a well at eer Ireasorement that are dered ae fund in Table LAs the ange of foil convey Dvomen x ama sgl ia negative (~] As the positive angle neem fhe profile becomes nore conven suggesting Cla ‘seletal and dental elaonthip. However, the ange of facial convexity snot apie a 0 the locaton of he ‘Aline perpendicular tothe horiontl plane HP) 's cropped fom glaelin and the ralonship of the rmasila and mandible ae related tito deere it {he problem is maxillary or mandibalar (Fig 28) The dsance to subpaeae frm this vertical ine eure perl to she hrizntal plane describe the amount Sf ranilary exces or decency i the anteropotror ig 2-Manon ffi for 1p ei fa mere ome fel ald al ‘gta win Rove ‘le mcr tid Ir pop 6 JOnge Sunsany Vou 38, Octoses 1980 ‘ole 14S inne sates tran, dimension. A negative number suggests malary Teinsion, wheres lange pritve umber eoaetes Iasillay prcuenbensy (The nese snatemse int ‘etpeaured in relaorahip vo te superioe structure, vith potive (+) meaning sotenor and negative (~) ‘eing pone) This neaurement ad oder rated “sterposterge menceerants re hmprtant i pla ing Westen or anterior neilaryadvancerent or Fodetion and for total esl or Le or Lmanlary orion advancement or reduction. At in mont Situation po sige method works all the time. For the small percentage of patente nom the label isto far anterior ov pomerio to be within nora Tange, some ceplimetric judgment must be exer (ed. in tis ete the vertical ine from abla fpontioned citer ener or poneriiy ar abla ad been surgically poe im 2 more acm psc “The poston of pogo iv ali measured pare Je to HP fom the perpendicular line dropped tom abel, This meanrement giver an indiation of frandibular prognathim or retroeathem: hat 3 the miagaitade of mandibular defiiencr become more mere, the more negative the teearement Cbg MD) becomes However, hs measurement most be-evaiated ih conjunction wth others 10

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