Research Article

Evaluation of Horizontal Lip Position in Adults with Different Skeletal Patterns: A Cephalometric Study

Rohit Kulshrestha*, Vinay V Umale, Kamlesh Singh, Aftab Azam and Madhvi Bhardwaj

Published: 10 March, 2017 | Volume 2 - Issue 1 | Pages: 009-016

Aim: To evaluate sexual dimorphism in horizontal lip position in adults with different skeletal patterns.

Material and Methods: The sample comprised of 120 patients (Females 18 years and above, Males 21 years and above) with no history of previous orthodontic treatment or functional jaw orthopaedic treatment. They were divided into different groups based on the ANB angle and gender. Group I and II included 30 males and 30 females with skeletal class I malocclusion (ANB 0-4 degree). Group III and IV included 30 males and 30 females with skeletal class II malocclusion respectively (ANB above 4 degree).

Results: When comparison between males and females (Class I+Class II) was done S-line (p<0.001), B-line (p<0.001), E-line (p<0.001), Holdaways angle (p<0.001) and Merrifield angle (p<0.001) were found to be statistically significant. S-line (p<0.001), E-line (p<0.001) and Holdaways angle (p<0.001) were found to be statistically significant when comparison was done between males and females (Class I). When comparison was done between males and females (Class II) only Holdaways angle (p<0.001) showed a significant statistical difference.

Conclusion: Sexual dimorphism was found in various lip parameters. Significant amount of differences were found between Class I and Class II (male and female) subjects.

Read Full Article HTML DOI: 10.29328/journal.johcs.1001005 Cite this Article Read Full Article PDF


Lip analysis; Soft tissue evaluation; Holdaways angle


  1. Hwang HS, Kim WS, McNamara JA Jr. A Comparative Study of Two Methods of Quantifying the Soft Tissue Profile. Angle Orthod. 2000; 70: 200-207. Ref.: https://goo.gl/y88lk3
  2. Subtelny JD. A longitudinal study of soft tissue facial structures and their profile characteristics, defined in relation to underlying skeletal structures. Am J Orthod. 1959; 45: 481-507. Ref.: https://goo.gl/FFsLJA
  3. Steiner CC. The use of cephalometrics as an aid to planning and assessing orthodontic treatment. Am J Orthod. 1960; 46: 721-735. Ref.: https://goo.gl/RRYxXM
  4. Ricketts RM. Esthetics, environment, and the law of lip relation. Am J Orthod. 1968; 54: 272-289. Ref.: https://goo.gl/8CalpE
  5. Burstone CJ. Integumental contour and extension patterns. Angle Orthod. 1959; 29: 93-104. Ref.: https://goo.gl/wGBb2X
  6. Holdaway RA. A soft tissue cephalometric analysis and its use in orthodontic treatment planning. Part I. Am J Orthod. 1983; 84: 1-28. Ref.: https://goo.gl/BuO2uF
  7. Sushner NI. A photographic study of the soft-tissue profile of the Negro population. Am J Orthod. 1977; 72: 373-385. Ref.: https://goo.gl/pSOzou
  8. Bowker WD, Meredith HV. A metric analysis of the facial profile. Angle Orthod. 1959; 29: 149-160. Ref.: https://goo.gl/wQoXYn
  9. Gulsen A, Okay C, Aslan BI, Uner O, Yavuzer R. The relationship between craniofacial structures and the nose in Anatolian Turkish adults: A cephalometric evaluation. Am J Orthod Dentofacial Orthop. 2006; 130: e15-e25. Ref.: https://goo.gl/F2T0NL
  10. Hwang HS, Kim WS, McNamara JA Jr. Ethnic Differences in the Soft Tissue Profile of Korean and European-American Adults with Normal Occlusions and Well-Balanced Faces. Angle Orthod. 2002; 72: 72-80. Ref.: https://goo.gl/8vlRPy
  11. Miyajima K, McNamara JA Jr, Kimura T, Murata S, Iizuka T. Craniofacial structure of Japanese and European-American adults with normal occlusions and well-balanced faces. Am J Orthod Dentofacial Orthop. 1996; 110: 431-438. Ref.: https://goo.gl/41WZWU
  12. Altemus LA. Comparative integumental relationships. Angle Orthod. 1963; 33: 217-221. Ref.: https://goo.gl/4yKqT4
  13. Mcnamara JA, Brust EW, Riolo ML. Soft tissue evaluation of individuals with an ideal occlusion and well balanced face. In Mcnamara JA Jr, editor. Esthetics and the treatment of facial form. Craniofacial growth series. Ann Arbor, Mich: center for human growth and development, The University of Michigan; 1992; 115-146.
  14. Erbay EF, Caniklioğlu CM, Erbay SK. Soft tissue profile in Anatolian Turkish adults: Part I. Evaluation of horizontal lip position using different soft tissue analyses. Am J Orthod Dentofacial Orthop. 2002; 121: 57-64. Ref.: https://goo.gl/p5mBeo
  15. Basciftci FA, Uysal T, Buyukerkmen A. Craniofacial structure of Anatolian Turkish adults with normal occlusions and well-balanced faces. Am J Orthod Dentofacial Orthop. 2004; 125: 366-372. Ref.: https://goo.gl/fgm2wF
  16. Merrifield LL. The profile line as an aid in critically evaluating facial esthetics. Am J Orthod. 1966; 52: 804-822. Ref.: https://goo.gl/rQFUpk
  17. Naidoo LC, Miles LP. An evaluation of the mean cephalometric values for orthognathic surgery for black South African adults. Part II: soft tissue. J Dent Assoc S Afr. 1997; 52: 545-550. Ref.: https://goo.gl/Lt24t4
  18. Lew KK, Ho KK, Keng SB, Ho KH. Soft-tissue cephalometric norms in Chinese adults with esthetic facial profiles. J Oral Maxillofac Surg. 1992; 50: 1184-1189. Ref.: https://goo.gl/O73723
  19. Alcalde RE, Jinno T, Orsini MG, Sasaki A, Sugiyama RM. Matsumura T. Soft tissue cephalometric norms in Japanese adults. Am J Orthod Dentofacial Orthop. 2000; 118: 84-89. Ref.: https://goo.gl/DSrcRT
  20. Scheideman GB, Bell WH, Legan HL, Finn RA, Reisch JS. Ceph- alometric analysis of dentofacial normals. Am J Orthod. 1980; 78: 404-420. Ref.: https://goo.gl/OXja61
  21. Yuen SWH, Hiranaka DK. A photographic study of the facial profile of southern Chinese adolescents. Quintessence International. 1989; 20: 665-676. Ref.: https://goo.gl/X6otoq
  22. Fernández-Riveiro P, Smyth-Chamosa E, Suárez-Quintanilla D, Suárez-Cunqueiro M. Angular Photogrammetric analysis of the soft tissue facial profile. Eur J Orthod. 2003; 25: 393-399. Ref.: https://goo.gl/zy5tU3


Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More