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American Journal of ORTHODONTICS

Volume 55, Number 2, February,



A classificationof skeletal facial types

Viken Sassouni, D.F.M.P., D.D.S., M.S.,


Pittsburgh, Pa.

he endless variations in size, position, form, and proportions of the

structures composing the dentofacial complex make it difficult, if not impossible to
discriminate between the important and the secondary factors (muscular and
skeletal) influencing dental occlusion. The particular problem is seldom related to a
disease at cellular level. Most often, disproportions or malpositions are leading to
malocclusions or facial deformities. The origin of these dis-proportions may be
traced to some genetic or environmental factors. These are difficult to identify, as
they may not be present or they may be obscured at the time of the examination of
the patient. However, in order better to define an etiologic classification of
dentofacial disturbance, the identification of the char-acteristic symptoms becomes
Definition of facial


Historic review. Prior to the interest of dentists and orthodontic specialists in

facial balance, artists had often accurately described the variations of human
physiognomy. A. Diirer, by modifying only some coordinates, had shown the
contrast resulting between a convex and a concave profile or between a broad
and a narrow face. Santayana, writing on the sense of beauty, played a game
of mismatching facial components of the same size and producing
disproportionate profiles. Anthropologists put these initial attempts on a more
scientific basis by measuring either the skulls or the soft tissues of the face and
deriving types associated with racial variations. Following these earlier
classifications, the development of medical knowledge suggested that perhaps
Presented at the annual meeting of the Middle Atlantic Society of Orthodontists,
Williamsburg, Va., January, 1968.
*Professor and Chairman, Department of Orthodontics, University of Pittsburgh School
of Dentistry.



Am. J. Orthodontics

some correlation exists between the facial pattern and certain predominant
functions. It was along this line of thought that Sheldonle established somatotypes or constitutional types on the basis of the predominant traits of endomorphy, mesomorphy, and ectomorphy. With the advent of roentgenographic
cephalometry, the interest in the variability of facial patterns was renewed with a
shift of emphasis toward their association with malocclusions. Bjijrk,l Downq2
Graber, Lindegard,3 Sassouni,12sI3 Ricketts,l and Muller have described
specific findings of skeletal imbalances associated predominantly with defined
classes of malocclusion. Most of the descriptions, however, have been
incomplete in the sense that they were centered on the profile or were based on
only one dimension of space. Furthermore, the nomenclature, far from being
standard-ized, added to the confusion.
Definition and nomenclature. In the present context, types and classes are
synonymous. In order to avoid confusion, however, class will be used for grouping dental malocclusions, while types will bc restricted to descriptions of skeletal
disproportion grouping. A classification is the identification of a num-ber of
characteristics which, seen together, present enough similarities to be included in
the same group. This process, however, disregards minor details. Typology leads
to a similar simplification.
One of the objcctivcs in orthodontic diagnosis is to detect the association
between malocclusions and skeletal disproportions. Therefore, the nomenclature
selected for facial t,ypes is parallel to the nomenclature describing classes of
malocclusion. The different types are termed skeletal deep-bite, open-bite, Class
II, and Class III.
A given facial type is characterized by a number of symptoms; in this sense,
a type is a syndrome. Each of the four basic facial types will be described here,
and then their combinations will be considered.
Skeletal classification

of basic facial


There are two basic types with vertical disproportions (the skeletal deep-bite
and open-bite) and two types with anteroposterior disproportions (the skeletal
Class II and Class III).
The constitution of each skeletal type may be due to a dimensional or a
positional imbalance. When it is dimensional, it will be described as large or
small. When it is positional, the direction of the displacement will be described
as anterior or posterior, downward or upward, and lateral.
Skeletal deep-bite (Fig.


Positional deviations. The four planes of the face as seen from the lateral
roentgenograms (the supraorbital, palatal, occlusal, and mandibular planes) are
horizontal and nearly parallel to each other. According to the archial analysis,l*,
I3 this carries the center (0) of convergence of the four planes far away from the
profile. The anterior arc traced from center 0 and nasion is nearly a straight line.
The midface (palatal complex) is usually retrusive, creating a concave profile.

The posterior vertical chain of muscles (masseter, internal pterygoid, temporal)

is attached anteriorly on the mandible and stretches in

Skeletal facial



Fig. 1. Deep-bite skeletal type. Top row shows skull to which masseter and temporal mus-cles have
been added. Notice extreme extensive development of these muscles charac-teristic of deep-bite
skeletal type. Molars are under impact of these muscles.

nearly a straight line vertically. The molars are directly under the impact of the
masticatory forces of the posterior vertical chain of muscles. Two local positional
characteristics are influential. The cranial base angle (supraorbital to clivus
angle) is small. The effect of this is to position the glenoid fossa (and, therefore,
the condyles) more anteriorly, often directly below sella turcica. Compensating
this anterior positioning of the condyles, the gonial angle (ramus to corpus) is
small and the posterior border of the ramus is nearly vertical. At the dentition
level the upper and lower incisors have their long axes nearly parallel and are
vertically extruded, while the molars are intruded.
Dimensional deviations. The total posterior height (sella to gonion) is nearly
equal to the total anterior facial height (supra-orbitale to menton). The lower
face height (ANS-Me) is smaller than the upper face height (SOr-ANS). The
facial breadths (minimum frontal and bigonial diameters) tend to be equal to
total facial height, giving a square appearance from the frontal view. The gonial
processes are flared laterally, indicating strong masseter action. The




J. Orthodontics


ramus is long, tending to equal the length of the corpus. The ramus is broad
anteroposteriorly with a large coronoid process, indicating a strong temporalis
muscle. This is further suggested by a large infratemporal fossa and an extensive temporal fossa, the medial line of which in extreme cases tends to meet
that of the opposite side and to form a sagittal crest.
Some additional characteristics are often present but are more difficult to
measure. A lack of antegonial notch in the mandible leads to what is some-times
called a rocking lower border of the mandible. The mandibular sym-physis is
short vertically and broad anteroposteriorly. Often the distance be-tween
supramentale (B) and pogonion is large, creating a chin button. At the cranial
area the skull is usually round or brachycephalic. The forehead is bulging.
Nasion is deep seated posterior to both frontal and nasal bones. The nasal
apertures are broad. In Sheldons classification, these individuals will rate high in
endomorphic characteristics. In Lindegards approach, they will have a high
periosteal activity that will be expressed by a high factor in stur-diness.
The dentition exhibits a tendency toward small teeth prone to abrasion.
There is a high percentage of congenitally missing teeth. The palatal vault is flat,
and the maxillary dental arch is broad. There is often a maxillary buccal crossbite. There is a tendency toward spacing of teeth, but there may be a crowding
of lower incisors as a result of the deep-bite. The dental arches are in bidental
retrusion relative to their bony bases. There is a tendency toward distal drift of
the anterior teeth. Some reports indicate an early dental formation and eruption,
as well as an advance in skeletal or biologic matura-tion.
At the soft-tissue level, the lips are thin with an excess of lip height rela-tive
to face height. This gives a curled appearance to the lips. There is usually a
deep furrow or sulcus between the prominent chin and the lower lip.
Factors in the development of a deep-bite type. Besides the anatomic details described, the vertical relationship of the maxilla and the mandible may be
conducive to the creation of the deep-bite skeletal type. The unfavorable
association of a lack of vertical growth between the cranial base and the maxillary posterior teeth and an excess of growth of the ramus and posterior cranial
base permits the mandible to rotate in a closing direction. When the teeth are
reduced in size and number, the dental arches oppose less resistance to
mandib-ular closure. When the posterior vertical chain of muscle is strong and
ante-riorly positioned, a greater depressive action is transmitted to the dentition.
Probably because of the long ramus, the pharyngeal space is large and the
tongue, set posteriorly, does not interfere with breathing. A tongue-thrusting habit
is seldom present. As for the other types or syndromes, it is possible that only a
few of the characteristics described are present in a given patient. In addition,
opposite characteristics may cancel each other.
Skeletal opesbite type (Fig. 2)

Most of the characteristics of the open-bite type are directly opposite those of
the deep-bite.

Volums 55
Number 2

Skeletal facial types 113

Fig. 2. Open-bite skeletal type. Top row shows underdevelopment of masseter and tem-poral muscles.
Notice narrow, long face and small posterior. height, especially due to an infantile mandible where the
gonial processes are nearly absent. Note also extremely large lower facial height relative to upper facial
height. Teeth are anterior to posterior vertical chain of muscles confined between palate and mandible.
They are subjected to mesial com-ponent of forces leading to bidental protrusion. In physioprint of patient,
notice that forc-ible lip closure brings mentalis muscl-e upward, accentuating chinless appearance.

Yositional deviations. The four bony planes of the face are steep to each
other, bringing the center 0 close to the profile. The anterior arc, therefore,
follows the convexity of the profile in these patients. The posterior vertical chain
of muscles is arcuate, and the masse& muscle is posterior to the buccal teeth,
thus creating a mesial component of forces responsible for the dental protrusion.
The cranial base angle and the gonial angle are obtuse. The long axis of the
incisors forms a small interincisal angle. Although the incisors are usually more
extruded in the open-bite type, this extrusion is not sufficient to establish their
vertical contact.14
Dimensiona, deviations. The total posterior facial height (S-Go)
tends to be half the size of the anterior total facial height (SOr-Me).

The lower a,ntc-rior facial height exceeds the upper anterior facial
height, while the reverse

114 Xassou7li

Am. J. Orthodolztics

is true in the posterior face. The facial breadths tend to be narrow, giving a long,
ovoid appearance in the frontal view. The nasal apertures are narrow. The ramus
is short with an antegonial notch at its lower border. The mandible seems to have
retained its infantile characteristics, with all its processes under-developed. The
temporal fossa is small, suggestive of weak musculature. The mandibular
symphysis is narrow anteroposteriorly and long vertically. There is a lack of chin
(mental protuberance) development. The cranium is sometimes dolichocephalic.
According to the Sheldonian somatotyping, the open-bite type rates high in
ectomorphy. Lindegards a.nalysis indicates important endochon-dral activity
translated by a high linearity factor.
Proportionally large teeth characterize the dcntition. Crowding and bi-dental
protrusion are often present. Impaction or ectopic eruption of third molars is
frequent. The palatal vault is high and narrow.
The mouthis wide. The broad lips, short vertically relative to their skeletal
support, are kept apart at rest, leading to mouth breathing. W hen the lips are
forcibly closed, the mentalis muscle is displaced ~~pward. This further increases
the chinless appearance of these persons.
Factors i7L the development
of ~11~opera-bite type. The posterior half of the
palate is tipped downward, carrying the molars further downward. This gives rise
to a large palatomanclibular plane angle. The combination of an excessive
development of the upper midfacial heights (cranial base to molars) and a lack of
dcvclopment of posterior facial heights (S-Go) results in the downward and
backward rotation of the mandible. It is to be noticed that these two opposite
factors confront each other at the level of the molars. Without the presence of
these intermediary structures (as in an edentulous person), an open-bite facies is
difficult to conccivc, as nothing prcvcnts the mandible from rotating in a closing
dircct,ion. Because of the short ramus and the lower palate, the pharyn-geal
space is constricted. In order to breathe, these persons keep their tongues
forward. l?urt,hcr enham
by7 the dental open-bite, there is a tongue-t,hrusting
tendency. W hcn enlarged tonsils arc present, the tongue is further confined
anteriorly. As the narrow palatal vault rtdnccs the necessary space, t,here is
a tendency toward tongncr protrusion. This, in turn. may be a factor in the creation of bidental protrusion.
Skeletal CIlass I1 type (Fig. 3)

Positional tleviatiows. The basic skeletal Class II can be viewed as a mismatching of charactrristics of the open-bite and deep-bite types. All the factors
that arc leading to a maxillary protrusion and a mandibular rctrusion arc in-fluential
From the deep-bite, the skeletal Class II borrows the long auterior
cranial base, but the large cranial base angle comes from the openbite. The short ramus is from the open-bite, but the small gonial angle
is from the deep-bite. The palate is tipped downward and backward,
much as in the open-bite. The result of these combinations is a
protrusive maxilla, a rctrusive mandible, or both. As these deviations
are positional, the regularity of the dental arches is not disturbed, but
an Angle Class II malocclusion is often present.

Skeletal facial types 115

Volume 55
Number 2

Fig. 3. Class II skeletal


Dimensional deviations. Two major disproportions are the large maxilla and
the small mandible:
i!4acromaz%ZZa. It is possible, in an individual face, to find that all structures are
normal in position, but a discrepancy in size may create a Class II type. The macromaxilla
is characterized by a palate in which the posterior nasal spine is normal in position but too
long for the rest of the face. Usually the malar bone is also positioned anteriorly. These
persons usually do not have a maxillary dental crowding. The mandible is normal in size
and position.
Microwrandible. This is the most frequent cause of dimensional Class II skeletal type.
The corpus is short in absolute and relative dimension. Usually gonion is in normal
position but, because of the short corpus, the chin is retrusive. As a rule, dental crowding,
ectopic eruption, and impaction are seen in these cases. The man-dibular incisors, held
posteriorly, do not meet antagonist teeth during eruption and overextrude, impinging on
the soft palate. This accentuates the curve of Spee. The discrepancy between the
maxilla and the mandible keeps the lips apart; the lower incisors are found behind the
maxillary incisors.

Combination of positional and dimensional Class II. Positional and

dimen-sional deviations are not mutually exclusive. It is possible for a




J. OrthodoMcs


to be normal in position at the chin; in this instance, the corpus is short at gonion,
which will not affect the profile but probably will be a factor for molar impaction.
Similarly, a macromaxilla is not necessarily protrusive, as the excess in size may
be expressed at the posterior nasal spine.
Skeletal Class III type (Pig.


Positional deviations. Like the skeletal Class II, the Class III type can be
defined as the unfavorable presence of characteristics of the open-bite and
deep-bite types. In common with the deep-bite type, the skeletal Class III has a
small cranial base angle which brings the glenoid fossa (and, therefore, the
condyles) more anteriorly relative to sella turcica. The mandible is more typical of
the open-bite type with a large gonial angle. The palate is characteristically
tipped upward at PNS and downward at ANS. This usually brings the maxillary
molar to a higher level. The result of this set of deviations, when present together, even in the absence of dimensional disproportions, is conducive to a
maxillary retrusion, a mandibular protrusion, or both.
Dimensimd deviations. A skeletal Class III may bc the result of a small maxilla
and/or a long mandible.

Fig. 4. Class III skeletal


Skeletal faciaZ types


Micromaxilla. The palate is short and often constricted transversally, with a high vault.
Crowding of the maxillary dental arch leads to impaction. Congenital absence of incisors,
premolars, and molars has been associated with micromaxilla. A number of diseases may
be at the origin of the deficiency. When the premaxilla is constricted and underdeveloped,
there is crowding of the incisors and canines. When the palatine bone is deficient,
impaction or ectopic eruption of molars is more frequent. The constriction of the maxilla is
associated with narrow nasal apertures.
Macromandible. The excessive length of the mandible may be located at the
condyles, the ramus, or the corpus. Seldom is the mandible excessive in antero-posterior
length without the breadth (bicondylar, bigonial) also being large. From clinical
observation, there seems to be a dichotomy between the size of the mandible and the size
of the perioral musculature. The lower lip is tight against the mandib-ular incisors, tipping
them lingually. The symphysis supporting these teeth is high and narrow. Radiographically,
there seems to be a very thin layer of alveolar bone surrounding them. The chin is pointed
rather than round as in the deep-bite type. Often long styloid processes arc present. As a
rule, the mandibular dental arch is not crowded and impaction of the third molars is rare.
Gingival recession and periodontal disease are often present, probably due to the crossbite and disuse atrophy of the teeth.

Combination of dimensional and positional Class III type. To a degree, these are
associated. When an anterior cross-bite is present, the further growth of the
mandible does not transfer its force to the maxilla through the intermediary of the
dental interdigitation, and the palatal growth lags behind ; this difference
increases with age. Sometimes a positional deviation in one direction compen-


close to prpfile

4 -optic


Fig. 5. Diagram

of four


(Class II and




Class III).





and deep-bite]

and two



Am. J. Orthodontics

sates for a dimensional excess. For example, a long ramus and corpus may be
neutralized (as far as mandibular protrusion is concerned) by a small gonial
angle, or a large cranial base angle (posterior positioning of glenoid fossa) may
compensate for a long ramus. These variations in size and position create an
infinite number of composite Class III types.

of vertical

and anteroposterior

skeletal types

The four types studied were basically undimensional, the open-bite and
deep-bite being primarily vertical dysplasia and Class II and Class III being
anteropost,erior in nature (Fig. 5). For more accurate identification of facial
types, it is important to define the multidimensional combinations. This will lead
to a more precise differential diagnosis from which more specific treat-ment
could be planned.
Skeletal Class II opewbite (Pigs. 6, 7, and 8)
This combination is primarily an open-bite type, positionally and dimensionally. The major variant here is in the anteroposterior dimensions of the

Fig. 6. Combination





and combination

of vertical


of eight

and anteroposterior




to their





jaws. The palate may be longer, and the mandible shorter. The different,ial
evaluation of these two possibilities is important, as the prognosis and the
treatment approach may be different. In this respect, it points out that a given
dental Class II malocclusion may be present in opposite facial types. In this
type, in some instances, the retrusion of the mandible may be purely positional.
Often this is due to a downward and backward rotation of the mandible. As
previously described, this rotation is associated with excessive extrusion of the
molars. If these interferences were removed, the mandible could be permitted to
rotate in a closing direction, improving the Class II and the open-bitt pat-terns
Skeletal Class II deep-bite (Figs. 6, 7, a& 8)
This combination is primarily a deep-bite type with dimensional deviations of
the jaws anteroposteriorly; the maxilla may be too long or the mandible too
short. As opposed to the Class II open-bite, a downward rotation of the mandible






Fig. 7. Tracings and analyses of four basic and four combination facial
types. The three in-dividuals on the top row all have deep-bite. All

three individuals in the left vertical row are Class II. All three
individuals in the right vertical row are Class III.



Am. J. Orthodmtics


worsens the Class II pattern, although this might improve the deep-bite. During
growth, some improvement of this type can be expected as the mandible will
grow more vertically and anteroposteriorly than the maxilla. In the adult, little can
be done to improve this facial type by orthodontic means; surgical or
prosthodontic measures should be considered.
Skeletal C~LSSIII open-bite type


6, 7,

and 8)

This combination consists primarily of an open-bite with a palatal deficiency

or a large mandible. Among the facial deformities, these have probably the worst
prognosis in terms of dentofacial orthopedics. If correction of this open-bite is
attempted by rotating the mandible in a closing direction, the pro-trusion of the
chin is increased. If, on the other hand, the reduction of the mandibular
protrusion is attempted by rotating the mandible downward and backward, the
open-bite is increased. Xven surgical correction of the mandible is of limited
benefit here, as the teeth interfere in the closing of the lower

Fig. 8. Physioprints

soft outlines

This raises

of persons

the question



in Figs.


of the esthetic values

6 and

not only
of these

7, with
at dental



but at skeletal



as well.

face height. Probably a combined prosthetic and surgical approach will be

Skeletal Class III


type (Figs.

6,~, and 8)

This is primarily a deep-bite skeletal type associated with a deficiency or a

large mandible. If the palate is deficient in young persons, the splitting of the
median suture provides a means to enlarge the midface. If the mandible is too
large, its downward and backward rotation may correct the deep-bite and Class
III simultaneously. The prognosis for this type is favorable.
Applications of the classification

of facial


This classification of facial types has a number of advantages for diagnosis,

prognosis, and treatment-planning objectives.
It permits one to distinguish skeletal from dental malocclusions. This dis-tinction is a
real one because it identifies the degree of severity of the total problem. By
definition, a skeletal malocclusion is a dental malocclusion with additional
skeletal imbalance. This means that facial esthetics problems are present with
skeletal malocclusion. Frequently the degree of severity of the malocclusion is
greater when associated with skeletal imbalance. Furthermore,

Fig. 9. Electromyographic records of extreme open-bite and deep-bite facial types, Left: In-sufficient
lips. More than average activity in the temporal (1) and average activity in the masseter (2) muscles.
Weak activity in the lips (3, 4) simultaneously with the elevator mus-cles. Early onset of strong
activity in the mylohyoid muscles (5). Subject 14; 24 years old. Right: Lips closed. Average activity in
the temporal (1) and more than average activity in the masseter (2) muscles. Marked activity in the
upper lip (3), strong activity in the lower lip (a), and a prolonged initial phase with low activity in the
mylohyoid muscles (5). Subject 2; 231/z years old. The vertical lines indicate the onset of activity in
the right anterior temporal muscle (ref. m.). RAT right anterior temporal; MA, masseter; UL, upper lip;
11, lower lip; MY, mylohyoid; surface electrodes: 1-4; needle electrode: 5. (From Moller: Acta Physiologica Scandinavica, 69: Supp. 280, Copenhagen, 1966.)

ilwc. J. Orthodontics
Feblunq 1969

Fig. 10. Gnathodynamometer utilized for measuring biting forces in open-bite and deep-bite skeletal
types. [Courtesy of David A. Paolini.)

malocclusions associated with skeletal imbalances are more stable than those
confined to the dental arches only. Finally, their prognoses with and without
treatment are different.
The classification of facial types permits the evaluation of physiologic differences. So far, the first studies on this subject have consisted of the evaluation
of muscular activity typically associated with extreme facial types. This indi-cates
differences of forces in the different masticatory muscles (Fig. 9). A rela-tively
simple apparatus-a gnathodynamometer-was built for the purpose of determining
whether open-bite and deep-bite skeletal types show a different degree or a
different level of masticatory force7 (Fig. 10). A first test did show that persons
with open-bite facial types have a biting force clustering between 50 and 80
pounds at the molar level, whereas persons with deep-bite skeletal types cluster
around 150 to 200 pounds.
Facial esthetics. Very few studies have been directly devoted to facial
esthetics in a scientific manner that would permit one to distinguish which
dimensions of the face and teeth are primarily responsible for a pleasing or
unpleasing face. Poulton9 made an initial attempt which would indicate that large
lower face heights associated more with unpleasing faces than antero-posterior
variations or a small lower face height. In other words, it seems that (although it
is dangerous to generalize) our society frowns upon open-bite facial types, either
Class II or Class III, and accepts more easily the deep-bite skeletal
Racial frequencies. Comparison between major racial groups would show
that the Mongoloid and Negroid races have a greater tendency toward open-bite
skeletal types. In other words, a greater frequency of open-bite skeletal type is
present in these racial groups. This may be an indication that classifica-tions of
facial type, although applicable to many racial groups, should be modified for
each race if they have to be defined in precise terms. It may also indicate that
facial types are genetically established.

Heredity. Family-lint studieP~ I5 did show that when both parents had openbite skeletal facial types there was a very strong tendency for the offspring to
have an open-bite skeletal facial type.
Growth. Sassouni and Nanda* have shown that in the open-bite skeletal type
mandibular growth is predominantly vertical, whereas in deep-bite it is primarily
horizontal. These findings were studied again on a longitudinal basis bp Sahni,ll who
confirmed t,hat t,he pattern of growth differs relative to facial types.


Four basic facial types have been defined-two in the xnteroposterior and two
in the vertical dimensions. They are syndromes of characteristics which, added
together, may create a facial deformity. Facial types of a multidimen-sional
nature derive from the combination of anteropostcrior and vertical di-mensions.
Teeth, muscles, and bones interact intimately during growth, in-creasing or
masking initial deformities.
This classification of facial types may be used (1) to distinguish skeletal
from dental malocclusion, (2) to evaluate physiologic differences, (3) to explain
variation in facial esthetics, (4) to describe racial differences in facial proportions, (5) to study hereditary transmission, and (6) to predict facial growth.
1. Bjiirk, A.: The face in profile, Svensk Tad.Tidskr. 40: Supp. 56,1947.
2. Downs, W.: Variation in facial relationships: Their significance in treatment and prog-nosis, AnI.

J. ORTHODOPTICS34: 812.840, 1948.




Lindegard, B.: Variations in human body-build, Acta psychint. et ncurol., Supp. 86, 1953.

Mollcr, E.: The chewing apparatus, Acta physiol. scandinav. 69: Supp. 280, 1953.
Muller, G.: Growth and development of the middle fat?, J. D. R,es. 42: 385399, 1963.
Muzj, E., Xtaj, G., and Luzj, C.: A constitutional classification of the crnniofacial skeletal types,
Tr. European Ortho. Sot., 1955.
Paolini, David, A.: Estimation of masticatory forces in open-bite and deep-bite skeletal type with
a new gnathodynamometc~r. (Work in progress, Cniversity of Pittsburgh, Orthodontic
Porado, Michael E.: The dimensional components of facial types (n roentgenogrnphic
cephalometric three-dimensional study), Master of Science thesis, Universit,y of Pittsburgh,
Poulton, Donald R.: Facial esthetics and angles, Angle Orthodontist27: 133.137, 1957.
Rick&s,R. M.: A foundationfor cephalometric communication,AX. J. ORTHODOXTICS
46: 330-357, 1960.
Sahni, Prndeep P.: Differential growth of vertical facial types, Master of Science thesis,
University of Pittsburgh, 1966.
Snssouni, Viken: A roentgenographic cephalometric analysis of cephalo-facie-dentnl rel:ttionships, ASI. J. ORTHODONTICS41: 735-764, 1955.
Sassouni, Viken: The Face in Five Dimensions, Pl~iladelphi~, 1959, University of Penn-sylvania
Growth Center Publication.
Sassouni, Viken, and Nanda, Surrender K.: Analysis of dento-facial vertical proportions, AM. J.
ORTIIOIHNTICS 50: 801-823, 1964.
Scitz, Lawrence J.: Heredity of facial types: A cephalometric family-line study, Mastcl of
Science thesis, University of Pittsburgh, 1965.
Sheldon, W. H.: The Varieties of Human Physique, New York, 1940, Harper & Brothers.