Page 22 - MDJ Volume 47 Number 2 ( Jul-Dec 2024)

Khan, et al.: Soft tissue analysis of the chin, length and thickness of the upper lip
independently of their skeletal structure. [3,4] Development Sindh Medical University from January 2021 to March
disorders are also followed by various mandibular growth 2021 after approval from the Institutional Review Board.
patterns, commonly categorised as hypodivergent, Male and female subjects with an age range of 13–30
normodivergent and hyperdivergent. [5,6] years and presenting with malalignment of teeth with
normal, high and low angle case were recruited. Patients
Outlook or facial aesthetics is one of the major issues with a history of orthodontic treatment, orthognathic
[7]
faced by maxillofacial surgeons and orthodontists. surgery, craniofacial anomalies and endocrine disorders
The nose, lip and chin are major components of the soft affecting facial growth and facial trauma were excluded.
tissue. A number of soft tissue-related analyses have been Participants provided written consent for participation
introduced to aid the clinicians to evaluate and quantify in the study, which was sought after explaining them the
the facial morphology. [8]
benefits of the study and its main purpose. Sample size
Soft tissue-related analysis in patients opting orthodontic was calculated on the WHO sample size calculator using
therapy plays a vital role and simplifies diagnosis and mean hyperdivergent facial angle 84.7° ± 3.6° with a
[7]
treatment planning. Normal values of both soft and hard confidence interval of 95% and 1% margin of error. The
tissues should be considered in maintaining a balanced calculated sample size was 150. The non-probability
facial proportion and ideal aesthetic appearance. [9] consecutive sampling technique was used to recruit study
subjects.
In various vertical growth patterns, studies have
evaluated and compared the thickness of the soft tissue The current study was conducted on the patients’ pre-
chin. Previous studies in different vertical and sagittal treatment records, that is, lateral cephalograms, which
discrepancies provided an interpretation of soft tissue were taken with written informed consent before
chin thickness. Burstone noted that the upper lip and its commencing orthodontic treatment. Three groups of
absolute length can not only be measured and contrasted the patients were formed based on the GoGn-Sn angle.
with the maxillary incisor position, but the lengths of the Patients with hypodivergent patterns were having SN-MP
lower lip and chin may also be related to that. [8] < 28°, FH-MP < 21° and MMA < 21°, and those with

Khalid Ashraf et al. measured the facial-angle normodivergent patterns were having SN-MP 28°–37°,
[10]
(FH-NʹPogʹ) in hyper, hypo and normodivergent FH-MP 21°–29° and MMA 21°–29° Patients having
individuals and found it was 78°–99°. In hypodivergent SN-MP > 37°, FH-MP > 29° and MMA > 29° were
subjects, the facial angle was estimated to be maximum labeled as hyperdivergent using lateral cephalograms.
(89.00° ± 4.00°), normodivergent (88.70° ± 4.70°) and Data were collected by filling the Performa’s for each
minimum in hyperdivergent (84.70° ± 3.60°). The soft patient and recording the measurements in millimeters
tissue chin Pog–Pogʹ value was between 6 and 16 mm, the using the scale of upper lip and chin length and thickness
soft tissue chin Gn-Gnʹ value was between 4 and 15 mm from the lateral cephalogram for each patient.
and soft tissue chin Me-Meʹ ranged from 3 to 13 m in
patients exhibiting hypodivergent, hyperdivergent and SPSS version 20 was used for data entry and analysis.
normodivergent patterns. Frequency and percentages were computed to summarise
categorical variables. Quantitative variables were presented
The upper lip length (Sn-ULI) value among the through mean ± standard deviation or median with
subjects exhibiting hyperdivergent, hypodivergent and interquartile range (IQR) depending on the assumption
normodivergent patterns was in a range of 15–25 mm. of normality, which was tested by the Shapiro–Wilk test.
Soft tissue upper lip thickness (ULIn-ULA) in the ANOVA (one-way) for normally distributed variables or
subjects was in between 6 and 18 mm in patients exhibiting Kruskal–Wallis test for non-normal variables was applied
hypodivergent, hyperdivergent and normodivergent to compare soft tissue chin, upper lip length and thickness
patterns. among three study groups, followed by post hoc analysis
The current planned study was to determine the thickness when a significant difference was observed. A two-tailed
of soft tissues including chin and upper lip and also record test with P-value less than 0.05 indicated statistical
their length in patients visiting the orthodontic department significance.
in a tertiary care hospital and compare the thickness
and length of the above-mentioned entities in patients results
exhibiting different divergent patterns in the mandibular The overall median age of study participants was 18
arch to implement better treatment plans accordingly. (IQR = 15–21) years. More than half of the study
participants were females (n = 100, 66.7%). Patients
in hypodivergent, normodivergent and hyperdivergent
MaterIals and Methods pattern group were in 1:1 ratio, that is, 50 (33.3%) in each
This design of the current study was cross-sectional, and group. Three groups did not show differences on the basis
it was conducted at the Orthodontic Department, Jinnah of participants’ age (P = 0.062). Increase in the specific

48 Malaysian Dental Journal ¦ Volume 47 ¦ Issue 2 ¦ July-December 2024
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