Facial Aesthetics - Farhad B. Naini

Facial Aesthetics

Concepts and Clinical Diagnosis

(Autor)

Buch | Hardcover
464 Seiten
2011
Wiley-Blackwell (Verlag)
978-1-4051-8192-1 (ISBN)
128,95 inkl. MwSt
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A resource for facial aesthetic surgery and dentistry. It provides readers with an examination of facial aesthetics in the context of dentofacial and craniofacial diagnosis and treatment planning. It covers the historical evidence for facial aesthetic canons and concepts in depth.
Facial Aesthetics: Concepts and Clinical Diagnosis is a unique new illustrated resource for facial aesthetic surgery and dentistry, providing the comprehensive clinical textbook on the art and science of facial aesthetics for clinicians involved in the management of facial deformities, including orthodontists, oral and maxillofacial surgeons, plastic and reconstructive surgeons and aesthetic dentists. It aims to provide readers with a comprehensive examination of facial aesthetics in the context of dentofacial and craniofacial diagnosis and treatment planning. This aim is achieved through coupling meticulous research and practical clinical advice with beautifully drawn supporting illustrations and diagrams. Structured over 24 logically arranged and easy-to-follow chapters, Part I of Facial Aesthetics covers the historical evidence for facial aesthetic canons and concepts in depth. It incorporates all aspects relevant to the work of the clinician, including the philosophical and scientific theories of facial beauty, facial attractiveness research, facial expression and the psychosocial ramifications of facial deformities. Part II of the book then goes on to examine clinical evaluation and diagnosis in considerable detail under four sections, from the initial consultation interview and acquisition of diagnostic records (section 1), complete clinical examination and analysis of the craniofacial complex (section 2), in depth analysis of each individual facial region using a top-down approach (section 3) and finally focussing on smile and dentogingival aesthetic evaluation (section 4).

An in-depth, thoughtful, practical and absorbing reference, Facial Aesthetics will find an enthusiastic reception among facial aesthetic surgeons and aesthetic dentists with an interest in refining their understanding and appreciation of the human face and applying practical protocols to their clinical diagnosis and treatment planning.

Key features:



Examines facial aesthetics in a clinical context
Promotes an interdisciplinary approach to facial aesthetic analysis
Detailed description of the systematic clinical evaluation of the facial soft tissues and craniodentoskeletal complex
Detailed, step-by-step aesthetic analysis of each facial region
In-depth analysis of 2D and 3D clinical diagnostic records
Evidence-based approach, from antiquity to contemporary scientific evidence, to the guidelines employed in planning the correction of facial deformities
Treatment planning from first principles highlighted
Clinical notes are highlighted throughout
Clearly organized and practical format
Highly illustrated in full colour throughout

Dr Farhad B. Naini is Consultant Orthodontist at Kingston and St George's Hospitals and Honorary Senior Lecturer in craniofacial anatomy, biology and development at St George's Medical School, University of London, UK.

Preface xv

Dedication xvii

Acknowledgements xviii

Part I Concepts

Chapter 1 Facial Beauty 3

Definition of beauty and aesthetics 3

Is beauty ‘in the eye of the beholder’? 4

The enigma of facial beauty: Why is one face seen as beautiful and another as unattractive? What guides and validates our judgement? 5

‘Ideal’ proportions 6

Symmetry 6

Averageness 6

Facial neoteny 7

Sexual dimorphism (secondary sexual characteristics) 7

Heredity 7

Cultural influences on the perception of facial beauty 7

Facial beauty: historical and philosophical perspectives 9

Facial beauty: scientific perspectives 13

Importance of facial beauty 14

Self- image and negative self-perception 15

Outsiders’ perceptions 16

Severity of deformity 16

References 16

Chapter 2 Facial Proportions: Classical Canons to Modern Craniofacial Anthropometry 18

Introduction 18

Ancient Egypt 18

Ancient Greece 19

The Archaic Period 19

The Classical Period 21

The Roman conquest of Greece 25

Ancient Rome 26

The Renaissance 27

Leon Battista Alberti 28

Leonardo da Vinci 29

Albrecht Dürer 36

The Enlightenment and neoclassicism 38

Neoclassical canons of proportion 38

Craniometry 39

Twentieth century 41

Modern craniofacial anthropometry 41

Leslie Farkas – the father of modern craniofacial anthropometry 42

The golden proportion 43

The ongoing problem with research into the golden proportion 44

Conclusion 44

References 44

Chapter 3 Facial Expression: Influence and Significance 45

Introduction 45

Importance of facial expressions 45

History of research into facial expressions 46

The work of Duchenne 47

The work of Darwin 47

The work of Ekman 49

The debate: Are facial expressions of emotion universal or culture-specific? 50

References 52

Chapter 4 Psychological Ramifications of Facial Deformities 54

Introduction 54

Health and psychosocial well-being 54

Self-image 55

The effect of the response of others on those with facial deformities 56

Teasing and bullying 56

To treat or not to treat? The controversial debate 57

Body dysmorphic disorder: the delusion of deformity 57

Body dysmorphic disorder 58

Conclusion 60

References 61

Part II Clinical Diagnosis Section 1

Patient Interview and Clinical Diagnostic Records 65

Introduction to Section 1 65

Diagnosis 65

Terms of direction, position and movement 65

Chapter 5 Patient Interview and Consultation 67

Introduction 67

Presenting complaint 67

History of presenting complaint 68

Psychosocial history 68

Medical history 68

Danger signals and the ‘problem’ patient 69

References 69

Chapter 6 Clinical Diagnostic Records, Natural Head Position and Craniofacial Anthropometry 71

Introduction 71

Clinical diagnostic records 71

Radiographs 71

Clinical photographs 73

Study models 73

Serial height measurement 74

Three-dimensional hard and soft tissue imaging 74

Natural head position 74

The Frankfort Craniometric Agreement and the Frankfort Plane 74

The unreliability of anatomical reference planes 75

Natural head position: the key to diagnosis 76

Choice of horizontal and vertical reference planes 77

Orientation of the patient in natural head position 78

The self-balance position 78

The mirror position 78

The aesthetic position (or ‘photographic position’ of the head) 78

Clinical photography 79

Equipment for digital photography and data storage 79

Patient consent forms 79

Background and lighting 79

Facial views 80

Intraoral views 80

Craniofacial anthropometry 81

Anthropometric craniofacial surface landmarks 81

References 85

Chapter 7 Cephalometry and Cephalometric Analysis 86

Introduction 86

Cephalometric landmarks and planes of reference 87

Landmarks, lines, planes and volumes 87

Hard tissue lateral cephalometric (skeletal) landmarks 88

Hard tissue lateral cephalometric (dental) landmarks 90

Soft tissue lateral cephalometric landmarks 91

Cephalometric planes of reference 92

Hard tissue lateral cephalometric reference planes 93

Soft tissue lateral cephalometric reference planes 95

Posteroanterior cephalometric radiography 95

Hard tissue posteroanterior cephalometric landmarks 96

Hard tissue posteroanterior cephalometric reference planes 97

Cephalometric analysis and geometric principles 98

Description of dentofacial deformities 98

Sagittal skeletal relationships 100

Sagittal positional relationships 100

Size relationships of maxilla and mandible 108

Sagittal dentoalveolar relationships 110

Inclination of the maxillary incisors 110

Sagittal position of the maxillary incisors 112

Inclination of the mandibular incisors 113

Sagittal position of the mandibular incisors 114

Inclination of maxillary to mandibular incisors 115

Vertical skeletal relationships 115

Convergence of horizontal facial planes (Sassouni analysis) 116

Anterior and posterior face height 116

Linear cephalometric measurements and normative values 119

Angular cephalometric measurements and normative values 120

Vertical dentoalveolar relationships 121

Inclination of the occlusal plane 121

Anterior maxillary dental height 121

Posterior maxillary dental height 121

Anterior mandibular dental height 121

Posterior mandibular dental height 122

Transverse skeletal relationships 122

References 122

Section 2 Facial Aesthetic Analysis: Facial Type, Proportions and Symmetry 123

Introduction to Section 2 123

‘Rules’ versus ‘guidelines’ in facial aesthetic evaluation 123

Clinical inspection – the ‘process’ 123

Clinical inspection – the ‘education of the eye’ 124

The diagnostic process – clinical evaluation 124

Qualitative evaluation 124

Quantitative evaluation and analysis 124

Clinical evaluation – the sequence 126

References 126

Chapter 8 Facial Type 127

Introduction 127

The fictional conception of the ‘normal’ 127

Proportion indices 127

Head type 129

Cephalic index 129

Ethnic differences 130

Ethnic differences in white individuals 130

Head circumference 130

Ethnic differences 130

Facial type: frontal view (norma frontalis) 130

Facial shape 130

Facial height-to-width ratio/proportion 131

Facial index 131

Facial type: profile view (norma lateralis) 132

Facial divergence 132

Sagittal facial profile contour 134

Angle of facial profile convexity (clinical/soft tissue) 134

Angle of facial profile convexity (cephalometric/skeletal) 135

Facial angle (clinical/soft tissue) 135

Facial angle (cephalometric/skeletal) 136

Cranial base angle 136

Anterior cranial base length 137

Parasagittal facial profile contour 137

Vertical facial profile form 137

Vertical facial growth pattern and hyperdivergent facial type 137

Horizontal facial growth pattern and hypodivergent facial type 138

Mandibular plane angle (clinical) 138

Mandibular plane angle (cephalometric) 139

Gonial angle (Ar-Go-Me) 139

Convergence of horizontal facial planes (Sassouni analysis) 140

Facial height to horizontal facial depth ratio (cephalometric) 140

Facial growth axes (cephalometric) 141

Facial curves and curvilinear relationships 141

Curvilinear relationships – frontal and profile views 142

Angularity of facial contour lines 142

Facial profile curves and ‘S-shaped’ curvilinear considerations 142

Contour defects 143

Sexual variation: the main differences between male and female faces 144

‘Ethnic’ variation: considerations in facial aesthetic evaluation 145

Historical background 145

Considerations in facial aesthetic evaluation 145

Facial ageing 146

Skin 146

Fat 147

Muscle 147

Dentoalveolus 147

Recognizing the visible effects of ageing 147

References 149

Chapter 9 Facial Proportions 150

Introduction 150

Craniofacial height to standing height proportion 151

Classical, Renaissance and neoclassical proportional canons 151

Anthropometric data 155

Attractiveness research 155

Clinical implications 156

Vertical facial proportions 156

Vertical craniofacial bisection 156

Vertical facial trisection (Vitruvian trisection) 156

Vertical craniofacial tetrasection 157

Artist’s facial ‘grid’ 157

Validity of proportional canons 157

Cephalometric evaluation – anterior face height ratio 158

Lower anterior facial proportions 158

Anthropometric vertical facial measurements 159

Comparison of proportional canons with modern measured proportional ratios 159

Attractiveness studies 159

Clinical implications 160

Transverse facial proportions 160

The central fifth of the face 160

The medial fifths of the face 163

The lateral fifths of the face 164

References 164

Oblique lateral (three-quarter) view 171

Transverse occlusal plane view 171

Dynamic clinical evaluation 172

Mandibular lateral displacement 172

Asymmetrical facial animation 174

Dental midlines 174

Maxillary dental midline 174

Mandibular dental midline 175

Distinguishing between mandibular and isolated chin asymmetry 175

Radiographic-cephalometric evaluation 176

Posteroanterior cephalometric radiograph 176

Lateral cephalometric radiograph 179

Panoramic rotational tomography (OPT – orthopantomograph) 179

Three-dimensional imaging evaluation 180

Dental study casts 180

Three-dimensional facial soft tissue scans 180

Computed tomography 181

Magnetic resonance imaging 184

Craniofacial growth and treatment timing 184

Treatment timing 184

Superimposition of serial cephalometric images and other imaging modalities 185

Growth prediction 185

Nuclear medicine (scintigraphy) 186

References 188

Section 3 Facial Aesthetic Analysis: Regional Analysis 189

Introduction to Section 3 189

The modified subunit principle 189

Relativity and the five facial prominences 190

The five facial profile prominences 191

References 191

Upper Facial Analysis 192

Chapter 10 Facial Symmetry and Asymmetry 165

Introduction 165

Relationship between symmetry and proportion 165

Balance and harmony: a note on terminology 166

Aetiology and classification of facial asymmetry 166

Aetiology 166

Classification 166

Clinical evaluation 167

Purpose of the clinical evaluation 167

Frontal facial examination 167

Superior view 171

Submental view 171

Lateral view 171

Chapter 11 The Forehead 193

Introduction and terminology 193

Anatomy 193

Clinical evaluation 194

Frontal view 194

Profile view 195

Superior view 197

Curvilinear relationships 197

References 198

Chapter 12 The Orbital Region 199

Introduction 199

The eyes 199

Eyebrows 200

Terminology 200

Anatomy 200

Clinical evaluation 202

Eyebrow position and contour 202

Orientation of palpebral fissure 202

Eyelids (palpebrae) 203

Eye width and interocular dimensions 205

Proportional relationships of the orbital region 205

Relationship of bony orbit and globe 206

Symmetry 206

References 206

Midfacial Analysis 207

Chapter 13 The Ears 208

Introduction 208

Terminology 208

Anatomy 208

Clinical evaluation 209

Ear position 210

Ear size and proportions 210

Ear axis 211

Ear protrusion (lateral projection) 211

Ear symmetry 213

References 213

Chapter 14 The Nose 214

Introduction 214

Terminology 216

Anatomy 217

Soft tissue features of the external nose 217

Skin of the external nose 217

Bony skeleton of the external nose 217

Cartilaginous skeleton of the external nose 218

Nasal type, topography and the subunit principle 219

Classification of nasal type 219

Topographic nasal landmarks and nomenclature 220

Nasal aesthetic subunits 222

Clinical evaluation 222

Frontal evaluation 222

Profile evaluation 224

Basal evaluation 233

Relative nasal relationships – evaluation 234

Normative values for nasal dimensions 235

Nasal function 235

References 236

Chapter 15 The Malar Region 238

Introduction 238

Terminology 238

Anatomy 239

Clinical evaluation 239

Bizygomatic width 239

Malar position 241

Height of malar contour 242

Malar projection and sagittal contour 242

Area of maximal malar projection 242

Principles in planning the correction of malar deficiency 244

References 244

Chapter 16 The Maxilla and Midface 245

Introduction 245

Terminology 245

Terms of jaw position in the sagittal plane 246

Terms of maxillary position in the vertical plane 246

Terms of jaw size 246

Terms of maxillary bodily movement in the three planes of space 246

Terms of maxillary rotation around the three axes of rotation 246

Anatomy 247

Clinical evaluation 248

Sagittal midfacial-maxillary evaluation 248

Vertical maxillary evaluation 254

Transverse maxillary evaluation 255

Maxillary deficiency 258

Sagittal maxillary deficiency 258

Vertical maxillary deficiency 259

Transverse maxillary deficiency 260

Principles in planning the correction of maxillary deficiency 261

Maxillary excess 262

Sagittal maxillary excess 262

Vertical maxillary excess 263

Transverse maxillary excess 265

Principles in planning the correction of maxillary excess 265

Maxillary asymmetry 266

References 267

Lower Facial Analysis 268

Introduction 268

Chapter 17 The Lips 269

Introduction 269

Anatomy 269

Embryology 269

Anatomy 269

Ageing 270

Terminology 271

Clinical evaluation 271

Lip lines 271

Lip activity (function) 272

Lip morphology (form) 273

Lip posture 280

Lip prominence 281

References 286

Chapter 18 Mentolabial (Labiomental) Fold 288

Introduction 288

Mentolabial fold (sulcus) depth 288

Mentolabial angle 288

Vertical position of the mentolabial fold 291

Mentolabial fold morphology 291

Advantages of mandibular advancement surgery over isolated genioplasty 291

Influence of mentolabial fold morphology on management of chin deformities 292

Influence of vector of bony chin movement on mentolabial fold morphology 292

Influence of lower anterior face height on mentolabial fold morphology 292

References 294

Chapter 19 The Mandible 295

Terminology 295

Anatomy, morphology and size 295

Normal anatomy and subunits 295

Morphology 295

Size and position 298

Sagittal and vertical relationships 300

Mandibular deficiency 300

True sagittal mandibular deficiency 300

Relative mandibular deficiency 300

Diagnostic features 300

Mandibular excess 302

True mandibular excess 302

Relative mandibular excess 302

Diagnostic features 303

Transverse relationships 306

Proportional relationships 306

Bicondylar width and bigonial width 307

Mandibular asymmetries 307

Hemimandibular hyperplasia 308

Hemimandibular elongation 309

Hybrid (mixed) forms of hemimandibular hyperplasia and elongation 311

Unilateral condylar hyperplasia 311

References 311

Chapter 20 The Chin 312

Introduction 312

Anatomy 312

Terminology 313

Chin excess and chin deficiency 313

Classification of chin deformities 318

Clinical evaluation 321

Sagittal evaluation and chin projection 321

Sagittal position of soft tissue chin 322

Sagittal position of hard tissue (skeletal) pogonion 326

Indirect morphological influences on sagittal chin projection 328

Soft tissue chin pad 328

Mentolabial fold and chin pad morphology 329

Dynamic chin pad evaluation 329

Mentalis muscle – anatomy, activity and significance 330

Vertical chin height 332

Proportional relationships 332

Mandibular anterior dental height 332

Transverse chin width 333

References 333

Chapter 21 Submental-Cervical Region 335

Introduction 335

Anatomy 335

Terminology 335

Aetiology 336

Aetiology of poor submental-cervical contour 336

Clinical evaluation 337

Skeletal pattern (jaw relationship) 337

Morphology of the submental soft tissues 338

Submental-facial angle 341

Submental length 341

Submental-neck (submental-cervical) angle 341

Submental-sternomastoid (SM-SM) angle 344

Submental soft tissue thickness 344

Hyoid bone position and submental-cervical aesthetics 344

Relative submental projection and aesthetics 347

References 348

Section 4 Smile and Dentogingival Aesthetic Analysis 351

Introduction to Section 4 351

Chapter 22 Dental-Occlusal Relationships: Terminology, Description and Classification 353

Introduction 353

Terminology 353

Terms of description of tooth form 353

Terms of direction in dental nomenclature 353

Terms of tooth position in the three planes of space 354

Terms of bodily tooth movement in the three planes of space 354

Terms of tooth rotation around the three axes of rotation 354

Dental occlusion 355

The concept of ‘ideal’ occlusion 355

Curves of the occlusion 356

Aims of treatment and the ‘six keys’ to ‘ideal’ occlusion 356

Classification of dental-occlusal relationships 358

Incisor relationships 358

Buccal segment relationships (canine and molar relationships) 360

The term ‘Class’ and classification 362

The aetiology of malocclusion 364

Skeletal factors 364

Soft tissue factors 365

Local factors 367

Habits 367

Oral health 367

Dental condition 367

Oral hygiene and gingival/periodontal condition 368

Oral mucosa 368

Occlusal function 368

Dynamic occlusal function 368

Temporomandibular joint function 368

References 368

Chapter 23 Smile Aesthetics
with Daljit S. Gill 370

Introduction 370

Importance of the smile in facial aesthetics 370

Types of smile 370

The generation of a smile 371

Clinical evaluation 371

Lip aesthetics 371

Lip lines 371

Upper lip–maxillary incisor relationship 372

Incisor exposure and phonetic analysis 375

Incisor exposure and anterior occlusal guidance 377

Smile symmetry 377

Dynamic upper lip curvature 377

Orientation of the transverse occlusal plane 377

Orientation of the sagittal occlusal plane 378

Smile curvature (smile arc) 378

Dental midlines 380

Buccal corridors (negative space) 382

Smile aesthetics in profile view 383

References 386

Chapter 24 Dentogingival Aesthetics
with Daljit S. Gill 387

Introduction 387

Anatomy 387

The concept of ‘biological width’ 388

Clinical evaluation 389

Tooth shape 389

Theories of ‘ideal’ tooth shape 389

Tooth size 391

Width-to-height ratio of maxillary central incisor crown 391

Seventh key and dental occlusion 392

Tooth size analysis 392

Tooth proportions 392

Tooth symmetry 394

The unilaterally peg-shaped or congenitally absent maxillary lateral incisor 394

Arch form 395

Maxillary incisor axial angulations 395

Gradation (front-to-back progression) 396

Gingival aesthetics 398

Gingival colour, texture and biotype 398

Gingival level 398

Gingival contour 399

Contacts, connectors and embrasures 400

Tooth colour 402

Description of tooth colour 402

Arch shade progression 402

Tooth shade value contrast with skin colour 402

Age changes 402

Clinical shade selection 402

References 403

Index 405

Erscheint lt. Verlag 4.3.2011
Verlagsort Hoboken
Sprache englisch
Maße 221 x 277 mm
Gewicht 1438 g
Themenwelt Medizin / Pharmazie Allgemeines / Lexika
Medizinische Fachgebiete Chirurgie Ästhetische und Plastische Chirurgie
Medizin / Pharmazie Zahnmedizin Chirurgie
ISBN-10 1-4051-8192-3 / 1405181923
ISBN-13 978-1-4051-8192-1 / 9781405181921
Zustand Neuware
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