Accepted Manuscript

Title: Facial Soft Tissue Thicknesses in the Present Czech

Population

Author: Anna Drgáčová Ján Dupej Jana Velemı́nská

PII: S0379-0738(16)00019-0
DOI: http://dx.doi.org/doi:10.1016/j.forsciint.2016.01.011
Reference: FSI 8279

To appear in: FSI

Received date: 28-8-2015

Revised date: 11-12-2015
Accepted date: 7-1-2016

Please cite this article as: A. Drgáčová, J. Dupej, J. Velemínská, Facial Soft Tissue
Thicknesses in the Present Czech Population, Forensic Science International (2016),
http://dx.doi.org/10.1016/j.forsciint.2016.01.011

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Technical note:

Facial Soft Tissue Thicknesses in the Present Czech Population

Anna Drgáčová, M.S. 1; Ján Dupej, M.S.1, 2; Jana Velemínská Ph.D.1

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Department of Anthropology and Human Genetics, Faculty of Science, Charles University in

Prague, Czech Republic

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Department of Software and Computer Science Education, Faculty of Mathematics and Physics,

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Charles University in Prague, Czech Republic

Corresponding author:
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Anna Drgacova, M.S.
Permanent address: Lublaňská 34, 120 00 Prague 2, Czech Republic
Tel: +420 221 951 618; fax: +420 221 951 619
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E-mail: drgan@seznam.cz
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Forensic Anthropology Population Data

Facial Soft Tissue Thicknesses in the Present Czech Population

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ABSTRACT
The aim of this study was to find any relation between soft facial tissue thickness (FSTT)
and sex, age and asymmetry in the contemporary Czech population. The studied sample
consisted of head CT scans of 102 adult Czech individuals between the ages of 21 and 83. Forty
FSTTs were evaluated and analysed using PCA, Hotelling’s T2 test, LDA, the Kolmogorov-
Smirnov test, MANOVA, the Kruskal-Wallis test and Wilcoxon´s paired test. The greatest sexual
dimorphism was detected in the lower part of the face, which had discriminant power almost the

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same as the entire faces (approximately 80%). On the other hand, a significant influence of
aging was shown, mostly in the area of the upper face (In females, twice as many landmarks

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displayed a significant influence, compared with males). The influence of asymmetry was
confirmed in seven bilateral landmarks, five of them favouring the right side.

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KEYWORDS: forensic science, forensic anthropology, craniofacial reconstruction, soft tissue
thickness, computer tomography, sexual dimorphism

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Knowledge of facial soft tissue thicknesses (FSTT) provides the basis for any craniofacial
reconstruction (CFR). The aim of CFR is to produce a face that matches the underlying skull.

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This reconstructed face can help in the recognition of an individual. Craniofacial reconstruction
cannot itself lead to positive identification of human remains; however, it plays an important
role in cases in which the remains cannot be identified by DNA analysis, fingerprint comparison
or dental record examination [1]. Knowledge of FSTT plays an important role in other fields as
well, for example, embryology or aesthetic surgery [2]. The appearance of the face is modelled
from the skeletal remains on the basis of a known average FSTT in specific anthropometric

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points [3]. FSTT in reality fluctuates within a specific interval. The final value is dependent on

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the sex, age, population group and constitution of the subject [4, 5], among other aspects. The
different values are measured in living people and cadavers. Some methods tend to generate

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higher values of FSTT; for example, the radiography method generates higher values of FSTT in
the medial plane, and ultrasounds generate higher values on supra-M2, infra-M2 or gonion

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landmarks [6]. The position of scanned subjects can be important as well. Therefore, the
comparison of different studies is often extremely difficult.

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The studies monitoring FSTT are inspired by the assumption of the large variability in
faces. The reliability of CFR may be negatively influenced by a lack of records about the
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thickness of soft tissues in a specific population. For that reason, many new studies have been
performed aiming at data collection. Building a database of specimens from various populations
to establish the reference values for FSTT is advantageous; however, it is equally important to
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perform studies on a specific population and analyse the intra- and inter- population variability.
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Foreign studies focus primarily on sex and age dimorphism in FSTT. Males typically have
higher values than females on almost all landmarks [2, 5, 7, 8]. However, De Greef et al. [9] and
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Stephan and Simpson [6] noticed that females reach higher levels of dimorphism on the cheeks
and males near the eyes and mouth [9]. Significant differences were found in many studies [e.g.,
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2, 5, 10, 11, 12], but greater variation has been detected within one sex than between sexes [9,
13]. The differences between males and females are less than 2 mm on average; therefore, they
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are not crucial for predicting the appearance of a face. Sexual dimorphism in FSTT does not
contribute to facial recognition; however, it plays an important role in the improvement of CFR
[13].

Age-related changes in the face are caused mostly by external factors [14, 15]. Significant
determinants of aging include body mass index, smoking, sun exposure, use of antidepressants,
alcohol and drugs consumption and marital status [16, 17, 18]. The appearance of the face is
also affected by changes in skeletal structure and loss of volume in soft tissues [19]. Aging
demonstrates common traits in both sexes, but male faces exhibit more intense aging changes
(Sexually dimorphic traits tended to diminish in the elderly age category) [20]. The least

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pronounced changes were registered between the ages of 20 and 30, and the most pronounced
between the ages of 40 and 50. Soft tissues reveal decreases in facial skin elasticity, the
formation of skin folds and wrinkles due to the loss of subcutaneous fat, and gravitation effects
[19]. Unfortunately, these age-related changes are extremely variable and difficult to predict
[21].

The asymmetry of FSTT has been the focus of relatively few studies [e.g., 7, 22]. De

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Greef et al. [23] noted probably the greatest influence of asymmetry (50 % from select

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landmarks). However, asymmetry of the face is a commonly accepted fact, which forensic

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papers should therefore consider.

Our research was based on the measurement of soft tissue depth using CT scans of 102

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Czech adult individuals between the ages of 21 and 83. The aim of this study was to determine
the mean and variability of FSTT in Czech adults and to expand the Central European

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population FSTT sample. Our analyses were evaluated with respect to sex, age and bilateral
asymmetry of the face.
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Material and methods

Our study was performed using CT scans from 102 adults, including 56 males and 46
females. None of the patients had any facial malformations [24], and the data were anonymous,
tagged only with the age and sex of the patients. All individuals were treated at the Department
of Radiology in Na Homolce Hospital, Prague. Surface models of the heads were created using
reconstruction methods that employed virtual 3-D modelling from the Digital Imaging and
Communications in Medicine (DICOM) image sequence of the CT outputs. The initial raw data

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were acquired by scanning the heads of patients using a Somatom Sensation 16 tomograph
(Siemens, Erlangen, Germany). The slice distance was 0.75 mm (0.4 mm kernel, H60). Patients
gave informed consent for the use of their CT images and data in this study. The sample ranged
in age from 21 to 83 years and was divided into three age groups: 20 to 39 years, 40 to 59 years,
and above 60 years.
Soft tissue depth was measured at 40 standard anthropological landmarks on the head

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(see Table 1). The position of every landmark was controlled in relation to three planes. The

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points in the medial plane were defined on the hard and soft profiles separately. Bilateral points
were defined initially on the skull, and the corresponding soft tissue landmarks were found in

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locations proximate to the craniometric landmarks. The only exception was the point alare,
which was always placed on soft and hard tissues separately. Landmark placement was

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performed by the first author using the in-house software Morphome3cs
(https://www.natur.cuni.cz/biology/anthropology/veda-a-vyzkum/morphome3cs-ii-

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en?set_language=en). Morphome3cs uses a ray casting approach to place landmarks on an
isosurface with a defined density (http://www.cs.utah.edu/~shirley/papers/iso/iso.pdf).
Thresholds for soft and hard tissues were set to -700 HU and 226 HU, respectively
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(http://mspace.lib.umanitoba.ca/xmlui/bitstream/handle/1993/22023/Maltais%20Lapointe_Gene
vieve.pdf?sequence=1). The measurements were taken perpendicular to the craniometric points,
following Vanezis [25] and Panenková et al. [8]; the FSTT equals the length of the line
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projecting from the skeletal to the facial point.

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A complete set of landmarks was defined in only 54 specimens. In some scans, landmark
placement was impossible due to beam-hardening artefacts caused by dental fillings. Therefore,
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the data were split into 3 sets: data using all landmarks (31 males and 23 females), data with the
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upper part of the face only (55 males and 45 females) and data with the lower part of the face
(32 males and 23 females). The division of face is illustrated in Fig. 1.
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Measurement error was determined according to [26], using 5 repeated measurements of

5 specimens. The mean measurement error was 0,778 mm.

General descriptive statistics were calculated first. Variability of sex was tested using a
non-parametric Kolmogorov-Smirnov test. Principal component analysis (PCA) was performed
on all three sets. The first principal components were selected and tested using Shapiro Wilk´s
normality W test, Hotteling´s T2 test and linear discriminant analysis (LDA). Scores on the first
three principal components were used for LDA, and this number was tested using the broken-
stick rule. The effect of age on tissue thickness was evaluated using the Kruskal Wallis test
performed separately on each linear measurement and using multivariate analysis of variance

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(MANOVA) applied to the first three principal components. The significance of soft tissue
depth asymmetry at bilateral points was tested using Wilcoxon´s paired test. Statistical
significance was set at α=0.05.

All data were analysed using Microsoft Excel (Microsoft Corporation), PAST 1.99
(Natural History Museum, Oslo) and Morphome3cs (Faculty of Mathematics and Physics of
Charles University, Prague). The results were compared with Panenkova et al. [8] because of the

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geographical relationship between the samples.

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Results
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Sexual dimorphism

The results with regard to sexual dimorphism in FSTT are shown in Table 2 and Fig. 2.
Landmarks with significant sexually dimorphic FSTT were situated primarily on the A lower
part of the face (all lower face landmarks with the exception of the mid-mandibular border,
gonion and infra M2 on the right side). Significant FSTTs were detected also at almost all
landmarks on or near the midline, with the exception of glabella, and at nine bilateral landmarks
(mentale, supra canine, infra canine, supra M2, infra M2 on the left side, alare, orbitale, orbitale
superius and mid-ramus). All significant soft tissue thicknesses are higher in males.

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 On the basis of these results, sex classification using FSTT was evaluated (see Table 3).
The accuracy of sex classification was tested three times (for the face as a whole, the upper part
of face and the lower part of face) using Hotelling´s T2 test and LDA with cross-validation.
Significant sexual dimorphism in FSTT was detected for all groups (for the entire face p <0.001,
for the upper part of face p = 0.004, and for the lower part of face p<0.001). The most accurate
classification was obtained using all FSTT landmarks (81.48 %), but the discriminant power of

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only the lower face FSTT landmarks was almost the same (80 %). Using landmarks in the upper

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part of face, the classification success rate dropped to 62 %.

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Age

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The results with regard to the influence of age on FSTT variability are shown in Fig. 3.
Twice as many landmarks with significant age influence were detected in females (glabella,

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subspinale, gonion, orbitale, zygion, jugale, inferior malar on the right side only, mid-ramus on
the left side only and mid-mandibular border). In males, age had a significant effect on 4
landmarks (supramentale, orbitale, ectoconchion on the left side only and mid-ramus on the left
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side only). The FSTT values for males always increased with age. The FSTT values for females
increased with age especially at landmarks in the midline plane. The values in the buccal area
(orbitale, jugale and inferior malar) increased from the ages of 21 to 59 and then decreased. The
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significant values were often detected in the upper part of face for both sexes. This result was
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confirmed using MANOVA (p <0.001).

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Asymmetry
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A significant influence of asymmetry was detected in 18% of the landmarks (see Table 4).
The values for supra M2, infra M2, and infra canine are higher on the right side. The values for
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inferior malar and mid-mandibular border are higher on the left side.

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Discussion and conclusion

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Craniofacial reconstruction is one of the methods in forensic anthropology which models

the appearance of the face from the skeletal remains. A reliable CFR requires knowledge of
average FSTTs in relation to sex, age and population affinity [27]. The purpose of this study was
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to define these FSTT values in the adult Czech population with respect to sexual dimorphism,
age and facial asymmetry. The results were compared with those obtained in selected European
populations [8, 28, 29] and in North American [5], South American [7, 12, 22], Australian [30]
and Asian populations [31, 32]. These comparisons revealed a great variability in the FSTT
values, and the thicknesses obtained in this study tend to be greater than the average values in
other works (with the exception of Guyomarc´h et al. [28]). This result could be the result of our
sample size and of the frequent occurrence of obesity in the Czech population. Nevertheless, it
cannot be said that the differences between populations are so great as to affect the
reconstruction of the face. As noted by Stephan and Simpson [6], the intra-population variability

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of FSTTs is larger than the variability between populations. This result can be caused by
different sample sizes and compositions or by the differing methods of procuring the data (e.g.,
ultrasound [5, 35] or contact scanning [2]). Also relevant are the influence of the body
constitution of the studied specimens and the considerable variability of soft tissues at the
studied landmarks [33]. Tables 5 and 6 show comparisons in FSTT with the studies by
Panenkova et al. [8] and Guyomarc´h et al. [28]. The similarities in results can be explained by

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the use of the same methods for scanning subjects and for measurements of FSTT. The

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differences could be caused by dissimilar datasets or the number of scanned subjects.
Sexual dimorphism was studied on the whole face and on the upper and lower parts

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separately and was found to be statistically significant in all of these sections. The greatest levels
of sexual dimorphism were detected in glabella, nose, mandible and maxilla. Similar results

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were obtained by Shrimpton et al. [10], who found the most pronounced dimorphism near
glabella, nose and mandible. Almost all landmarks on the medial plane displayed a significant

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influence of sex on FSTT. Codinho [11] came to the same conclusion with a Portuguese
population.
In spite of the significant sexual dimorphism in FSTT, greater variability is found within
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the sexes than between them [13]. Males typically exhibit greater FSTT values than females at
almost all landmarks [2, 5, 7, 8]. In our sample, females had greater soft tissue thicknesses only
at zygion and jugale. The FSTTs at ectoconchion and mid-mandibular border were similar in
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both sexes. Despite the confirmed sexual variability, the differences are often as small as 1 or 2
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mm, which has no practical bearing on the reconstructed facial appearance [9, 12]
The influence of age was confirmed in all facial regions, more so in males than in females.
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The values of FSTT either rise with age (e.g., glabella, jugale) or rise until the second age group
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and then diminish (e.g., mid-ramus, zygion). In contrast to other studies, we have detected a
significant influence of age on the cheeks and in the nasal area (Only [8] mentions a significant
influence on nasion in males). Additionally, contrary to other sources [8, 29, 34], our study
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demonstrated a trend in which FSTT near the teeth increases with age.
The influence of asymmetry was more pronounced in our study than in others [7, 22, 30,
32, 34]. A significant relation between asymmetry and FSTT was shown by De Greef [35] in 12
of the 24 landmarks studied. Both [35] and our study agree on the significant influence of
asymmetry at inferior malar, supra canine and infra M2. Additionally, both studies show a
greater FSTT on the right side of the face. Other works [7, 22, 34], on the other hand, have
found greater soft tissue thickness on the left side.

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 In this work, we have established standards for the average values and variability of
FSTT at 40 landmarks in the adult Czech population. Sexual dimorphism of FSTT has been
confirmed and shown to be more pronounced in the lower half of the face. A significant
influence of age has also been shown in the upper face. The influence of asymmetry has been
confirmed in seven bilateral landmarks, five of which favour the right side of the face.

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 Table 1. Definitions of soft and hard tissue landmarks.

Skeletal Definition Soft Tissue Definition

Landmark Landmark
Median Points Median Points
Glabella (g) The most anterior midline point on the frontal Glabella´ (g´) The most anterior midline soft tissue point
bone overlying the glabella
Nasion (n) Midline point on the naso-frontal suture Nasion´ (n´) The most posterior soft tissue point
overlying the nasion
Rhinion (rhi) Midline point at the inferior free end of the Rhinion´ (rhi´) Midline soft tissue point directly above the
internasal suture hard tissue rhinion

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Spinale (sp) The most anterior midpoint of the anterior Subnasale (sn) Midline point of the angle at the comulella

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nasal spine of the maxilla base where the septum and upper lip join
Subspinale (ss) The most posterior midline point on the Subspinale´ (ss´) The most posterior point between soft tissue
premaxilla between the anterior nasal spine subnasale and the vermilion border of the

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and prosthion upper lip in the groove of the philtrum
Prosthion (pr) The most anterior point on the maxillary Labrale superius Midline soft tissue point at the vermilion
alveolar process, between the central incisor (ls) border of upper lip
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Infradentale (id) The most anterior point of the alveolar process Labrale inferius Midline soft tissue point at the vermilion
of the mandible (li) border of lower lip
Supramentale Deepest midline point in the groove superior Supramentale´ Deepest soft tissue point at the midline of
(sm) to the mental eminence (sm´) the groove just superior to the chin

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Pogonion (pg) The most anterior midline point on the mental Pogonion´ (pg´) The most anterior midline point on the
eminence of the mandible eminence of the soft tissue chin
Gnathion (gn) The most inferior midline point at the mental Gnathion´ (gn´) Midline soft tissue point directly overlying
symphysis of the mandible the gnathion
Bilateral Points Bilateral Points
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Orbitale The most superior point at the supraorbital Orbitale Soft tissue point directly overlying the hard
superius (ors) margin superius´ (ors´) tissue orbitale superius
Ectoconchion The most lateral point at the lateral margin of Ectoconchion´ Soft tissue point directly overlying the hard
(ec) orbit (ec´) tissue ectoconchion
Orbitale (or) The most inferior point at the infraorbital Orbitale´ (or´) Soft tissue point directly overlying the hard
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margin tissue orbitale

Zygion (zy) The most lateral extent of the lateral surface of Zygion´ (zy´) Soft tissue point directly overlying the hard
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the zygomatic arch tissue zygion

Jugale (ju) A craniometric point at the union of the Jugale´ (ju´) Soft tissue point directly overlying the hard
temporal and frontal processes of the tissue jugale
zygomatic bone
p

Inferior malar The deepest point at fossa canina Inferior malar´ Soft tissue point directly overlying the hard
(im) (im´) tissue inferior malar
ce

Alare (al) Most lateral point at the border of the nasal Alare´ (al´) The most lateral point at alae nasi
aperture
Supra canine Point on superior alveolar ridge superior to the Supra canine´ Soft tissue point directly overlying the hard
(sC) crown of the maxillary canine(s) (sC´) tissue supra canine
Infra canine Point on inferior alveolar ridge inferior to the Infra canine´ Soft tissue point directly overlying the hard
Ac

(iC) crown of the mandibular canine(s) (iC´) tissue infra canine

Supra M2 Point on superior alveolar ridge superior to the Supra M2´ Soft tissue point directly overlying the hard
(sM2) crown of the maxillary second molar(s) (sM2´) tissue supra M2
Infra M2 (iM2) Point on inferior alveolar ridge inferior to the Infra M2´ (iM2´) Soft tissue point directly overlying the hard
crown of the mandibular second molar(s) tissue infra M2
Gonion (go) Point on the lateral aspect of the border of Gonion´ (go´) Soft tissue point directly overlying the hard
mandibular angle where a tangent bisects the tissue gonion
angle formed by the posterior ramus border
and the inferior corpus border
Mentale (m) The most inferior point at border of foramen Mentale´ (m´) Soft tissue point directly overlying the hard
mentale tissue mentale
Mid-ramus (mr) Point at the center of the mandibular ramus Mid-ramus´ Soft tissue point directly overlying the hard
(mr´) tissue mid-ramus
Mid-mandibular Point on the inferior border of the corpus of Mid-mandibular Soft tissue point directly overlying the hard
border (mmb) the mandible midway between pogonion and border´ (mmb´) tissue mid-mandibular border
gonion

Page 16 of 24
 t
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Table 2. The results of sex dimorphism (Kolmogorov-Smirnov test).

us
Landmark Females Males K-S test
n Min Max Mean SD S-W test n Min Max Mean SD S-W test (p-value)
(mm) (mm) (mm) (mm) (p-value) (mm) (mm) (mm) (mm) (p-value)
Glabella 46 3.662 9.505 6.019 1.315 0.506 56 3.991 9.659 6.298 1.165 0.022 0.155
Nasion 46 5.173 14.595 8.255 1.868 0.082 56 3.831 12.900 9.416 1.905 0.125 0.003*

an
Rhinion 46 1.587 4.766 2.618 0.627 0.009 56 2.168 4.690 3.115 0.633 0.001 0.004*
Spinale-Subnasale 46 6.723 14.458 9.848 1.947 0.022 56 7.206 19.019 11.518 2.255 0.013 0.001*
Subspinale 46 9.867 16.838 12.765 1.773 0.325 56 11.792 19.825 15.655 1.803 0.311 < 0.001*
Prosthion-Labrale 43 7.462 17.335 11.128 1.966 0.230 47 4.312 20.638 13.707 2.689 0.216 < 0.001*

M
superius
Infradentale- 43 9.716 18.215 14.151 1.962 0.773 49 12.24 23.871 16.351 2.104 0.096 < 0.001*
Labrale inferius
Supramentale 46 8.513 14.642 10.939 1.420 0.049 56 10.061 16.602 12.514 1.559 0.004 < 0.001*
Pogonion 46 7.309 17.384 11.767 2.197 0.671 56 7.510 22.995 13.542 2.641 0.004 0.002*

ed
Gnathion 41 4.942 13.526 7.978 2.155 0.106 52 4.921 13.512 9.148 1.876 0.132 0.014*
Mentale (R) 46 6.063 18.029 12.053 2.430 0.925 56 9.988 19.193 14.170 2.081 0.177 < 0.001*
Mentale (L) 46 6.057 16.885 11.560 2.386 0.668 56 8.891 17.737 13.342 2.229 0.060 0.003*
Gonion (R) 46 5.401 28.492 15.948 6.224 0.123 56 6.861 33.597 17.941 6.206 0.064 0.060
Gonion (L) 46 4.804 31.534 16.152 6.808 0.344 56 7.476 34.858 17.998 6.170 0.019 0.181
pt
Supra canine (R) 40 5.318 12.725 8.438 1.762 0.323 47 7.417 15.657 11.035 1.679 0.641 < 0.001*
Supra canine (L) 41 5.943 13.278 8.640 1.632 0.150 47 7.530 15.595 10.844 1.841 0.301 < 0.001*
Infra canine (R) 43 5.898 13.672 9.316 1.724 0.022 50 6.701 14.846 10.476 1.913 0.142 0.002*
ce

Infra canine (L) 43 6.215 13.394 8.943 1.713 0.003 50 6.845 15.208 9.947 1.825 0.018 0.013*
Supra M2 (R) 34 21.535 45.605 29.626 5.965 0.016 39 25.815 42.700 33.530 4.988 0.009 0.001*
Supra M2 (L) 34 19.707 40.365 29.414 4.823 0.657 39 24.638 46.431 32.162 4.765 0.071 0.041*
Infra M2 (R) 31 21.535 36.852 25.519 6.096 0.071 37 19.111 36.551 27.107 4.979 0.088 0.060
Infra M2 (L) 30 14.859 37.853 24.838 6.346 0.030 37 18.784 37.776 26.793 4.478 0.111 0.006*
Ac

Alare (R) 46 8.498 14.724 10.623 1.282 0.075 56 8.776 19.821 12.02 1.668 0.000 < 0.001*
Alare (L) 46 7.681 14.778 10.690 1.401 0.812 56 8.667 21.929 12.357 1.985 0.000 < 0.001*
Orbitale (R) 46 3.022 12.953 7.229 2.301 0.237 56 3.677 15.007 8.350 3.005 0.001 0.230
Orbitale (L) 46 2.897 12.648 7.479 2.547 0.133 56 3.596 16.169 8.370 3.204 0.000 0.593
Zygion (R) 46 4.556 14.586 9.174 2.882 0.016 56 4.315 17.680 8.491 2.440 0.002 0.357
Zygion (L) 46 4.718 16.839 9.197 3.164 0.024 56 4.934 16.300 8.770 2.874 0.000 0.322
Jugale (R) 46 6.555 16.489 10.565 2.458 0.026 56 6.048 15.095 10.367 2.372 0.001 0.458
Jugale (L) 46 6.007 16.630 10.270 2.554 0.061 56 5.128 16.134 9.721 2.532 0.005 0.607
Ectoconchion (R) 46 2.558 10.134 5.879 1.752 0.704 56 3.109 9.740 5.847 1.684 0.003 0.919
Ectoconchion (L) 46 3.244 9.858 5.857 1.560 0.026 56 3.262 9.946 5.856 1.767 0.000 0.540
Orbitale superius 46 5.444 12.588 8.935 1.587 0.975 56 5.924 13.974 10.221 1.693 0.078 0.001*
(R)

Page 17 of 24
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Orbitale superius 46 4.878 12.032 8.911 1.776 0.338 56 5.224 13.433 9.996 1.716 0.106 0.008*
(L)
Inferior malar (R) 46 11.826 35.187 17.460 3.826 0.000 56 10.794 26.948 18.060 3.123 0.023 0.136

us
Inferior malar (L) 46 13.577 25.723 17.913 2.651 0.090 56 11.898 25.769 18.200 2.864 0.068 0.872
Mid-ramus (R) 46 14.448 40.158 23.040 4.809 0.013 56 17.468 36.164 25.892 4.230 0.722 0.017*
Mid-ramus (L) 46 14.706 37.477 22.824 4.689 0.045 56 18.432 33.714 25.441 3.877 0.168 0.006*
Mid-mandibular 46 7.253 23.101 13.149 3.804 0.319 56 6.164 23.029 13.220 3.740 0.073 0.992

an
border (R)
Mid-mandibular 46 7.166 26.409 14.215 4.091 0.128 56 6.763 22.444 13.566 3.738 0.336 0.573
border (L)
(S-W test = Shapiro-Wilk´s test normality, K-S test = Kolmogorov-Smirnov test, * p < 0,05)

M
Table 3. The results of LDA.

ed
Part of face Success rate Number of successful Number of unsuccessful Success rate Number of successful Number of unsuccessful
classifications classifications of classifications classifications
(F/M) (F/M) clasification (F/M) (F/M)
with cross-
validation
pt
% n % n % % n % n %
ce

All face 85.19 19/27 82.61/87.10 4/4 17.39/12.90 81.48 18/25 78.26/80.65 5/6 21.74/19.35
Upper part of
65.00 26/39 57.78/70.91 19/16 42.22/29.09 62.00 26/36 57.78/65.45 19/19 42.22/34.55
face
Lower part of
87.27 18/30 78.26/93.75 5/2 21.74/6.25 80.00 17/27 73.91/84.38 6/5 26.09/15.62
Ac

face

Page 18 of 24
Table 4. The results of asymmetry (Wilcoxon´s paired test).

Landmark n Mean Mean Wilcoxon paired test

(mm) (mm) (p-value)
Mentale 102 13.215 12.556 < 0.001*
Gonion 102 17.042 17.176 0.673
Supra canine 87 9.863 9.797 0.498

t
Infra canine 93 9.947 9.502 < 0.001*

ip
Supra M2 71 31.773 30.682 0.009*
Infra M2 66 26.432 26.050 0.042*
Alare 102 11.390 11.598 0.088

cr
Orbitale 102 7.844 7.968 0.420
Zygion 102 8.799 8.960 0.702
Jugale 102 10.456 9.969 < 0.001*
Ectoconchion 102 5.861 5.856 0.680

us
Orbitale superius 102 9.635 9.502 0.090
Inferior malar 101 17.808 18.059 0.042*
Mid-ramus 102 24.621 24.275 0.077
Mid-mandibular 102 13.188 13.862 0.003*

an
border
* p < 0,05

Table 5. Comparison of results with study Panenkova et al. [8].

M
Landmark Sex N Mean (SD) P-value
Glabella M 80 5.9 (1.3) 0.071
F 80 5.5 (1.0) 0.017*
Nasion M 80 8.0 (1.5) <0.001*
F 80 6.9 (1.2)
d
<0.001*
Rhinion M 80 2.5 (0.7) <0.001*
F 80 2.1 (0.6) <0.001*
te

Subspinale M 69 15.2 (2.6) 0.225

F 72 12.4 (2.0) 0.273
Prosthion/labrale superius M 21 12.9 (1.9) 0.224
F 12 11.4 (1.9) 0.628
p

Orbitale superius M 80 8.2 (1.6) <0.001*

F 80 7.2 (1.3) <0.001*
ce

Orbitale M 80 7.0 (2.1) 0.002*

F 80 6.8 (2.5) 0.375
Ektokonchion M 79 9.0 (2.0) <0.001*
F 80 10.0 (2.0) <0.001*
Ac

Zygion M 75 9.5 (2.4) 0.019*

F 66 9.1 (2.5) 0.846
Inferior malar M 75 16.4 (2.5) <0.001*
F 74 15.2 (2.5) <0.001*
Supra M2 M 60 30.6 (5.2) 0.007*
F 57 28.1 (4.8) 0.189
* p < 0,05

Page 19 of 24
Table 6. Comparison of results with study Guyomarc´h et al. [28].

Landmark N Mean (SD) P-value

Glabella 366 6.5 (1.2) 0.026*
Nasion 469 8.2 (1.6) <0.001*
Rhinion 321 3.0 (1.3) 0.458
Subspinale 459 12.9 (0.9) <0.001*

t
Prosthion/labrale superius 294 14.1 (2.5) <0.001*

ip
Infradentale/labrale inferius 266 16.8 (3.1) <0.001*
Pogonion 254 11.8 (2.1) <0.001*
Gnathion 211 9.5 (3.3) <0.001*

cr
Orbitale 371 8.6 (2.3) 0.003*
Ectokonchion 372 7.8 (2.6) <0.001*
Zygion 364 10.0 (2.8) <0.001*

us
Jugale 245 10.9 (2.2) 0.134
Gonion 238 18.5 (6.9) 0.060
Supra canine 307 13.4 (2.6) <0.001*
Infra canine 262 12.8 (2.1) <0.001*

an
Mentale 255 12.8 (2.1) 0.125
Mid-ramus 327 22.7 (4.8) <0.001*
Mid-mandibular border 242 14.6 (4.3) 0.005*
* p < 0,05
M
d
p te
ce
Ac

Page 20 of 24
List of figures

Figure 1: The complete set of landmarks. The line separates the face to upper and lower part.

Figure 2: The results of sexual dimorphism of FSTT. The significant FSTT are displayed by
full points.

t
ip
Figure 3: The results of age influence on FSTT variability (females on the left side, males on

cr
the right sides). The significant FSTT are displayed by full points.

us
an
M
d
p te
ce
Ac

Page 21 of 24
Figure

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an
M
d
te
p
ce
Ac

Page 22 of 24
Figure

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an
M
d
te
p
ce
Ac

Page 23 of 24
Figure

i
cr
us
an
M
ed
pt
ce
Ac

Page 24 of 24