FACIAL SOFT & HARD

TISSUE ANALYSIS
FOR ORTHOGNATHIC
SURGERY PLANNING

Presented by: Dr. Fouad Al-Omari

Maxillofacial and Orthodontic
Surgeon

1
CONTENTS:
 INTRODUCTION
 SOFT TISSUE LANDMARKS
 CLASSIFICATION
-LATERAL CEPHALOGRAPHIC ANALYSIS
- PHOTOGRAPHIC ANALYSIS
 LATERAL CEPHALOGRAPHIC:
- HOLDAWAY’S ANALYSIS
- ARNETT’S SOFT TISSUE ANALYSIS
- COGS ANALYSIS
- SCHEIDAMAN’S CEPHALOMETRIC NORMS FOR
SOFT-TISSUE ANALYSIS
- PROFILE ANALYSIS
2
 - LIPS ANALYSIS
-METRIC DETERMINATION
- STEINER’S S LINE
- RICKETT’S E LINE
-BURSTONE B LINE
-MERRIFIELD’S Z ANGLE
- AIRWAY ANALYSIS
 PHOTOGRAPHIC ANALYSIS
-ADVANTAGES
-SOFT TISSUES PHOTOGRAPHIC ANALYSIS STUDIES
- LINEAR
- ANGULAR
- COMBINED
- FRONTAL 3
 SOFT TISSUE DEVELOPMENT AND ITS INFLUENCE
ON FACIAL PROFILE
 CONCLUSION

4
INTRODUCTION
 One of the most important components of
orthodontic diagnosis and treatment planning is
the evaluation of the patient’s facial soft tissue.
 Since the shape of the human face depends on
both the structure of the hard tissue (bone) and
the soft tissue that covers it, soft tissue should be
analyzed for the correct evaluation of an
underlying skeletal discrepancy because of
individual differences in soft tissue thickness.

5
 The quantitative assessment of the size and shape of the
facial soft tissue is widely used in several medical fields
such as orthodontics, maxillofacial and plastic surgery,
and clinical genetics for diagnosis, treatment planning,
and postoperative assessment
 Soft tissue of the face requires an independent appraisal in
addition to the skeletal and dental analysis to deduce a
comprehensive diagnosis and treatment planning of the
face.

MUPPARAPU M. (2005). RADIATION PROTECTION GUIDELINES FOR THE

PRACTICING ORTHODONTIST. AMERICAN JOURNAL OF ORTHODONTICS
AND DENTOFACIAL ORTHOPEDICS, 128(2), 168-72.
6
SOFT TISSUE
LANDMARKS

Related to Related
forehead to nose

Related Related
to lips to chin

BASAVARAJ SUBHASH CHANDRA PHULARI . AN ATLAS ON CEPHALOMETRIC

LANDMARKS, JAYPEE PUBLISHERS 2013. CHAPTER 16 7
RELATED TO FOREHEAD

Trichion
 Soft tissue glabella

8
SOFT TISSUE GLABELLA
 Abbreviation: G–Soft tissue
glabella
 Definition: Soft tissue glabella is
the most prominent or anterior
point in the midsagittal plane of
the forehead at the level of the
superior orbital ridges.
 Type: unilateral soft tissue
cephalometric landmark.
 Significance: used as one of the
reference points in the
construction of facial angles
9
RELATED TO NOSE
Soft tissue nasion
Nasal crown
Pronasale
Point “T”
Alar crease junction.

10
SOFT TISSUE NASION
 Abbreviation: N–Soft tissue nasion
 Definition: it is the concave or
retruded point in the tissue overlying
the area of the frontonasal suture.
 Type: unilateral soft tissue
cephalometric landmark.
 Significance: is used for facial
plane(Na’- Pog’) which is used along
with the dorsum surface of nose to
determine the nasal prominence and
subsequently helps in evaluation of
malocclusion pattern.

11
 PRONASALE

 Abbreviation: Pn–Pronasale
 Definition: is the most prominent or
anterior point of the nose.
 Type: unilateral soft tissue
cephalometric landmark.
 Significance: helps in the assessment
of nasal tip projection.
Pronasale -reference points in –
Ricketts’ E-line used to assess the
relationship of upper and lower teeth
to the upper and lower lip.
12
 SUBNASALE

 Abbreviation: Sn–Subnasale
 Definition: is the point at which the
nasal septum between the nostril merges
with the upper cutaneous tip in the
midsagittal plane.
 Type: unilateral soft tissue
cephalometric landmark
 Significance: in the assessment of nasal
tip projection and nasal height.
Subnasale - reference point – Burstone’s
B line used to assess the relationship of
upper and lower teeth to the upper and
lower lip. –Height of upper lip (Sn–Ls)
can be assessed. 13
 RELATED TO LIPS

RELATED TO UPPER
RELATED TO UPPER
LIP
AND LOWER LIP
Soft tissue subspinale TOGETHER
Labrale superius  Stomion
Philtrum
 Stomion superius
 Stomion inferius
Cuspid bow
Vermillion border of
upper lip
RELATED TO LOWER
LIP
 Labrale inferius
 Soft tissue point B
14
SOFT TISSUE SUBSPINALE
 Abbreviation: Ss–Soft tissue subspinale
 Definition: is the point of greatest
concavity in the midline of the upper lip
between subnasale (Sn) and labrale
superius (Ls).
 Type: unilateral soft tissue cephalometric
landmark.
 Significance: reference point- Steiner’s S
line used to assess the relationship of
upper and lower teeth to the upper and
lower lip.

15
 LABRALE SUPERIUS
 Abbreviation: Ls–Labrale superius
 Definition: most anterior point on the
margin of the upper membranous lip
 Type: unilateral soft tissue cephalometric
landmark.
 Significance: reference points in the
construction of planes
•Holdaway “H” line.
•Merrifield's “Z” angle.
•Measure the length of upper lip (Ls-Sn)
•Assess the planed incisor position (PIP)

16
 STOMION
 Abbreviation :Sto–Stomion
 Definition: median point of the
oral embrassure when the lips
are closed.
 Type: Stomion is a unilateral
soft tissue cephalometric
landmark
 Significance: Stomion is
established only at rest when
teeth are in centric occlusion and
centric relation. Presence of
stomion indicates averagely
positioned upper and lower
teeth.
17
LABRALE INFERIUS
 Abbreviation: Li–Labrale
inferius
 Definition: most anterior point
on the lower margin of the
lower membrane lip.
 Type: unilateral soft tissue
cephalometric landmark
 Significance : reference point-
construction of planes
• used to measure the
length of lower lip (Li-Me)
• used to assess the planed
incisor position (PIP)
18
SOFT TISSUE SUBMENTALE
(SOFT TISSUE POINT B)

 Abbreviation: B–Soft tissue point B

 Definition: point of greatest concavity in
the midline of the lip between labrale
inferius (Li) and soft tissue pogonion
(Pog’ )
 Type: unilateral soft tissue cephalometric
landmark.
 Significance :
•Used in the assessment of deepness of
submental
• Measure the length of lower lip (Li-Me).
•To assess the planed incisor position
(PIP). 19
SOFT TISSUE CEPHALOMETRIC
LANDMARKS RELATED TO CHIN

 Soft tissue Pogonion

 Soft tissue Gnathion

20
 SOFT TISSUE POGONION
 Abbreviation: Pog’–Soft tissue
pogonion
 Definition: most prominent or
anterior point on the soft tissue
chin in the midsagittal plane.
 Type: unilateral soft tissue
cephalometric landmark.
 Significance: reference point in the
construction of planes
-Steiner’s “S” line
-Rickett’s E-line
-Burstone's B line
-Holdaway “H” line 21
 SOFT TISSUE GNATHION

 Abbreviation: Gns–Soft
tissue Gnathion

 Definition: midpoint
between the most anterior
and inferior points of the
soft tissue chin in the
midsagittal plane

 Type : unilateral
constructed point soft
tissue cephalometric
landmark.
22
 PLANE OF REFERENCES
 SN Plane and FH Plane
 SN- more suitable- assessment of
growth and/ or treatment with a
individual over a period of time.
 FH Plane- despite the difficulty in
locating porion reproducibility- more
accurately represent the clinical
impression of jaw position.
 Alternative – Legan and Burstone-
constructed horizontal- tends to be II to
true horizontal
 Natural head position – TH is drawn
perpendicular to a plumb line
 Vertical reference line- TV- traced 23
passing through Subnasale.
SOFT TISSUE EVALUATION

Frontal
view
Profile
view
ALEXANDER JACOBSON. RADIOGRAPHIC CEPHALOMETRY FROM BASICS TO
VIDEOIMAGING.QUINTESSENCE PUBLISHING CO.IN,1995. CHAPTER18 24
FRONTAL VIEW

VERTICAL
FACIAL
FACIAL
SYMMETRY
PROPORTIONS

MAXILLARY
INCISOR TO
LIP
RELATIONSHIP

25
VERTICAL FACIAL PROPORTIONS
 Roman architect VITRUVIUS-
divided the face into 3 equal parts
 Distance from the hairline to
glabella- from glabella to subnasale-
from subnasale to menton.
 Because of Variation of the hairline,
face divided to upper and lower half.
 Upper face- G to Sn
 Lower face- Sn to Me, 57% of overall
facial height when N’ is used instead
of G
 Lower lip divided to 3- drawing lines
through Sn, stms, stmi and Me’
 Upper lip – half length of the lower 26
WILLAM. R. PROFFIT. CONTEMPORARY ORTHODONTICS, 6TH EDITION, ELSEVIER ,Inc. 2019.
CHAPTER 6
27
 Facial proportions and symmetry

- Idealy divided to cental medial

and lateral equal fifths

WILLAM. R. PROFFIT. CONTEMPORARY ORTHODONTICS, 6TH EDITION, ELSEVIER ,Inc. 2019.

CHAPTER 6
28
FACIAL SYMMETRY

 Divided along midsagittal plane.

 Symmetry line passing through G,
nasal tip, midpoint of upper lip,
and midpoint of chin.
 The nasal tip and midsymphysis
point are more likely to deviate
from the symmetry axis

29
 Composite photographs are the best way to illustrate
normal facial asymmetry

WILLAM. R. PROFFIT. CONTEMPORARY ORTHODONTICS, 6TH EDITION, ELSEVIER ,Inc. 2019.

CHAPTER 6
30
MAXILLARY INCISOR TO LIP
RELATIONSHIP
 Distance between Stms and
maxillary incisor edge to be
measured.
 Normal range- 1 to 5mm
 Smiling – ideal exposure- three
quarters of crown height to 2mm of
gingiva
 Women tend to show more gingiva
than men.
 Peck and Peck – a gingival smile is
not necessarily esthetically
objectionable.
 Gingival smile diminish with age. 31
32
 PROFILE VIEW

LABIOME LIP CHIN LIP CHIN

NASIOLAB
NTAL THROAT THROAT
IAL ANGLE
SULCUS ANGLE LENGTH

CHIN CHIN MERRIFIE

NECK PROMINE LD’S Z
ANGLE NCE ANGLE

33
34
LIP-CHIN-THROAT ANGLE

 Angle between the lower lip, chin and R point (deepest

point along the chin-neck contour)
 Approximately 90 degrees
 Obtuse angle- chin deficiency
- lower lip procumbency
- excessive submental fat
- retropositioned mandible
- low hyoid bone position

35
LIP-CHIN-THROAT LENGTH
 No norms exist for this
measurement.
 The distance of Pog’ to R point is
important in the ideal profile.

36
CHIN-NECK ANGLE

 Called as Cervicomental angle.

 Approximately 90 degrees.
 Studies reported that it can
vary between 105 to 120
degree, with gender being a
major consideration.
 Factors affecting are:
- submental/ subplatysmal
fat deposition.
-vertical resting hyoid bone
position.
37
 PHOTOGR
APHIC
ANALYSIS

LATERA
L CEPH
ANALYSI
S
SOFT
TISSUE
ANALYSIS

38
LATERAL CEPHALOGRAPH
ANALYSIS

39
 HOLDAWAYS SOFT TISSUE ANALYSIS
 ARNETT SOFT TISSUE ANALYSIS
 COGS SOFT TISSUE ANALYSIS
 SCHEIDAMAN’S CEPHALOMETRIC
NORMS FOR SOFT-TISSUE ANALYSIS
 LIP ANALYSIS
METRIC DETERMINATION
STEINER’S S LINE
RICKETT’S E LINE
BURSTONE B LINE
MERRIFIELD’S Z ANGLE
40
HOLDAWAY’S SOFT TISSUE
ANALYSIS

REED HOLDAWAY IN 1983

REED A. HOLDAWAY. SOFT TISSUE CEPALOMETRIC ANALYSIS AND IT

USE IN ORTHODONTIC TREATMENT PLANNING. AJO 1983 JULY :VOL
84(1); 2-28 41
 Presented a soft-tissue analysis which demonstrates the
inadequacy of using a hard-tissue analysis alone for treatment
planning.

 Comprises 11 measurements:
-facial angle -upper lip strain
-upper lip curvature -lower lip to H-line
-skeletal convexity at point A -lower sulcus depth
-harmony line (H-line) angle -chin thickness
-Pn to H-line
-upper sulcus depth
-upper lip thickness
42
 FACIAL
H ANGLE
LINE ANGLE

N’
Po Or

H Line

Pog’

90°
7-14° 43
 Faces demonstrate a relationship between the skeletal
convexity at point A and the H-line angle
 If not, facial imbalance may be evident.
 The best range is from 7 to 15 degrees

44
LOWER SULCUS DEPTH

H Line

Pog’

Ideal- 5mm 45
UPPER SULCUS DEPTH

H Line

Pog’

5mm 46
LOWER LIP TO
SUBNASALE TOTO H LINE
H LINE

Sn

H Line

5±2mm
47
SOFT TISSUE CHIN THICKNESS

N N’

Po Pog’
g
10-12 mm
-2±2mm 48
UPPER LIP THICKNESS
AND STRAIN

A
14mm
12mm

Ideal upper lip thickness -15 mm. 49

 PN TO H-LINE

H Line

should not exceed 12 mm in individuals 14

years of age and older.
50
 UPPER LIP CURVATURE

N’
FH plane

 2.5 mm - average thick lip Pog’

 thin or thick lip- 1.5 and 4.0 mm
 Lack of upper lip curvature: lip strain
 Excessive depth: caused by lip 51
SOFT TISSUE CEPHALOMETRIC
ANALYSIS FOR ORTHOGNATHIC
SURGERY
HARRY LEGAN AND CHARLES BURSTONE
1980

LEGAN HL, BURSTONE CJ. SOFT TISSUE CEPHALOMETRIC ANALYSIS

FOR ORTHOGNATHIC SURGERYJ ORAL SURG. 1980 OCT;38(10):744-51.
52
 The soft tissue covering the teeth and bone is highly
variable in it’s thickness and this variation may be greater
than the variation found in hard tissues.
 So the treatment planning for the patient who require
orthognathic surgery should also include the soft tissue
analysis.
 given by Harry.L.Legan & Charles Burstone.

53
 HORIZONTAL
PLANE

COLUMELLA

GNATHION

CERVICAL POINT
54
FACIAL CONVEXITY
ANGLE:-

 Angle formed between the G-

Sn to Sn- Pog line.

 The mean value is 12 degrees.

 Positive if G-Sn line is anterior

to Sn-Pog line - indicates Class
II skeletal or dental
relationship

 Negative value indicates Class

III relationship 55
THE ANALYSIS OF THIS ANGLE DOES NOT TELL
WHETHER THE MAXILLA OR THE MANDIBLE IS
ACCOUNTABLE FOR THE POSSIBLE DISCREPANCY

56
SO TO DEFINE THE ANTERIOR POSTERIOR
POSITION OF THE JAWS TWO SOFT TISSUE
MEASURES ARE TAKEN.

57
 MAXILLARY &
MANDIBULAR
PROGNATHISM:-

A line perpendicular to the

horizontal plane is dropped
from Glabella & relations of
maxilla and mandible are
related to this line.

The distance from Sn to this

line gives the amount of
mandibular excess or
deficiency.

58
Sn point to G perp : 6 +/-
3 mm

Pog’ point to G perp :

0 +/- 4 mmm

-Negative value indicates

mandibular retrusion.

-Positive value indicates

mandibular procumbency.

59
UPPER & LOWER LIP
PROTRUSION:-

by drawing a line from Sn to

Pog’.
Ls to Sn-Pog’ line - amount of
upper lip protrusion.
Sn
-The mean value- 3 mm.
Ls
Li to Sn-Pog’ line - amount of
lower lip protrusion. Li

-mean value- 2mm.

Pog

60
LOWER
CERVICOFACIALANGLE
(LOWER FACE THROAT
ANGLE)

 Formed by the intersection of Sn –

Gn’ and Gn’ – C lines.

Mean Value is 100±7 degrees.

A Mandibular set back cannot be

carried out if the angle is more than
90 degree, suggesting instead, the
use of another procedure to preserve
the anteroposterior position of the
61
chin.
MENTO LABIAL
SULCUS:-
Measurement
Fold frombetween
of soft tissue Sm to Li-
the
Pog line.
lower lip and the chin – vary
greatly in form and depth.
Clinical variable
The average – lower
value is 4 mm.
incisor position- affect Li
labiomental sulcus.
 Upright lower incisor- shallow Sm
labiomental sulcus
 Excessive lower incisor Pog
proclination- deep labiomental
sulcus.
62
VERTICAL HEIGHT
RATIO

 The ratio of the distance sn to Gn

and C to Gn is normally 1:1.2.

If the ratio becomes much larger

than one, patient has relatively
short neck & the anterior
projection of chin probably should
not be reduced.

63
 Acute
NASOLABIALANGLE
-maxillary procumbency
Formed by the intersection of lines
-maxillary
Cl-Sn dental protrusion
and Sn-Ls.
-low nasal – tip
-thick
 Mean maxillary
Value is 102lip
+/-8 degrees.
 Obtuse
-maxillary
 divided retrusion -upper
into 2 components
and lower- by a dental
-maxillary true horizontal
retrusion
intersecting the Sn.
-elevated nasal tip
-thin maxillary vermilion
In the diagnosis of surgical cases
the upper nasolabial angle is
analysed separately from the lower,
in search of components involved
in the alteration and for an
64
appropriate surgical solution
VERTICAL LIP-CHIN
RATIO:- (C/D)

 The ratio of Sn-Sts and Sti-Me’.

 The length of the upper lip
equals half the length of the
lower lip.( Ideal Ratio – 1 : 2 )
 The average length of the lower
lip -38 to 44 cm.
 Anatomically short lower lip is
related to Class II -anatomically
long lower lip is related to Class
III.
 Anatomically Short lower lip is
corrected by advancement
genioplasties. 65
MAXILLARY INCISOR
EXPOSURE (STS-UI B)

Distance between the stms and the

border of the upper incisor.
The Mean Distance is 1 – 3 mm.
 At rest , 2 t0 2.5 mm of crown
exposure is desirable for a
harmonious smile.
In men , exposure of the upper
incisor is lesser than women.
 In patients with anterior maxillary
vertical over growth – excessive
exposure of the upper incisors at
rest – “Gummy Smile”
66
 DOWN’S FACIAL CONVEXITY ANGLE
 Downs described the facial convexity
angle in relationship to skeletal
landmarks.
 The equivalent for soft tissue is formed
by the line glabella (G) to subnasale (Sn)
and the line Sn to Soft-tissue pogonoion
(Pog’)

 The mean value is 12 degree +/-4

degrees.

 Clockwise angle is (+)suggestive of class

II
 Anticlock angle is (-) suggestive of class
III
67
 n

Sn

pog

Profile Class I Class II

Classprofile
Skeletal III 174 178 181
Soft tissue profile 159 163 168
Total profile 133 133 139
68
PROFILE ESTHETICS BY ‘V’
ANGLE.

VIAZIS AD. A NEW MEASUREMENT OF PROFILE ESTHETICS. J CLIN

ORTHOD 1991;25:15-20

69
 Introduced by Anthony Viazis
in 1991.

 Cephalometric X-ray is taken

in natural head position.

 ‘V’ angle is the angle between

Steiner’s “S” line, which is
drawn through the middle of
nose parallel to the true
vertical.
 Mean ‘V’ angle-
Adults= 12.5+/-4 ˚.
Adolescents= 13.0+/-4 ˚.

70
 The ‘V’ angle is similar to facial contour
angle but provides a better indication of
profile convexity because it concentrates
on the lower half of the face and takes
into account the size of the nose.

 It does not allow the size of the nose to

affect the evaluation of lip position much
as the ‘E’ line does, since it uses only half
of the nose length.

71
CONCLUSION

 An aesthetically pleasing and balanced face is one of the

objectives of orthodontic treatment.

 An understanding of the soft tissues and their normal ranges

enables a treatment plan to be formulated to normalize the
facial traits for a given individual

 It is very difficult to achieve harmony of the soft tissue

facial profile because of the soft tissue thickness variability
that covers teeth and bones.

72
 Those variations do not appear only because of the
discrepancies in dental and skeletal structures but as a result
of the individual variability in the thickness of the soft
tissue drape

 Thus soft tissue photographic analysis serves as an ideal

guide to orthodontists to plan , diagnose and execute the
treatment in an most ideal manner possible.

73
REFERENCES

TEXT BOOKS
 BASAVARAJ SUBHASH CHANDRA PHULARI . AN ATLAS ON
CEPHALOMETRIC LANDMARKS, JAYPEE PUBLISHERS 2013.
CHAPTER 16.
 WILLAM. R. PROFFIT. CONTEMPORARY ORTHODONTICS, 6TH
EDITION, ELSEVIER ,Inc. 2019. CHAPTER 6
 ALEXANDER JACOBSON. RADIOGRAPHIC CEPHALOMETRY
FROM BASICS TO VIDEOIMAGING.QUINTESSENCE
PUBLISHING CO.IN,1995. CHAPTER18
 DAVID.M. SARVAR. ESTHETIC ORTHODONTICS AND
ORTHOGNATHIC SURGERY. MOSBY INC.1998. CHAPTER 1

74
 THOMAS RAKOSI. AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY.WOLFE MEDICAL
PUBLICATIONS LTD 1983. CHAPTER 6
 ORTHODONTICS AND ORTHOGNATHIC SURGERY-
DIAGNOSIS AND PLANNING, EDITION 1, JORGE
GREGORET, ELISA TUBER, ESPAXS PUBLISHING CO.
1999. CHAPTER 4
 THOMAS RAKOSI. COLOR ATLAS OF DENTAL MEDICINE
ORTHODONTIC DIAGNOSIS ,2ND EDITION, THIEME
PUBLISHERS,1993.

75
ARTICLES:
 MUPPARAPU M. (2005). RADIATION PROTECTION
GUIDELINES FOR THE PRACTICING ORTHODONTIST.
AMERICAN JOURNAL OF ORTHODONTICS AND
DENTOFACIAL ORTHOPEDICS, 128(2), 168-72.
 REED A. HOLDAWAY. SOFT TISSUE CEPALOMETRIC
ANALYSIS AND IT USE IN ORTHODONTIC TREATMENT
PLANNING. AJO 1983 JULY :VOL 84(1); 2-28
 G.WILLAM ARNETT etal. SOFT TISSUE CEPHALOMETRIC
ANALYSIS: DIAGNOSIS AND TREATMENT PLANNING OF
DENTOFACIAL DEFORMITY. AJO DO 1999;116:239-53
 LEGAN HL, BURSTONE CJ. SOFT TISSUE
CEPHALOMETRIC ANALYSIS FOR ORTHOGNATHIC
SURGERYJ ORAL SURG. 1980 OCT;38(10):744-51.

76
 SCHEIDEMANN GB etal. CEPHALOMETRIC ANALYSIS OF
DENTOFACIAL NORMALS. AJO. 1980; 78:404-20
 DOWNS WB. VARIATION IN FACIAL RELATIONSHIPS:
THEIR SIGNIFICANCEI TREATMENT AND PROGNOSIS.
AJO1948;34:812-40
 WORMS FW, ISSACSON RJ, SPEIDEL TM.
SURGICALORTODONTIC TREATMENTPLANNING:
PROFILE ANALYSIS AND MANDIBULAR SURGERY.
ANGLE ORTHOD 1976; 46: 1- 25
 VIAZIS AD. A NEW MEASUREMENT OF PROFILE
ESTHETICS. J CLIN ORTHOD 1991;25:15-20
 GRANT.G.COLEMAN etal. INFLUENCE OF CHIN
PROMINENCE ON ESTHETIC LIP PROFILE .AJO-DO
2007;132:36-42

77
 FERNANDEZ-RIVEIRO et al. LINEAR PHOTOGRAMMETRIC
ANALYSIS OF THE SOFT TISSUE FACIAL PROILE. AM J
ORTHOD DENTOFACIAL ORTHOP 2002;122:59-66
 ABIDA IJAZ, LINEAR PHOTOGRAMMETRIC ANALYSIS OF
THE ADULT SOFT TISSUE FACIAL PROFILE PAKISTAN ORAL
& DENT. JR ORTHODONTICS 2006 DEC; 26 (2) : 58- 67
 CINDI SY LEUNG ET AL ANGULAR PHOTOGRAMMETRIC
ANALYSIS OF THE SOFT TISSUE PROFILE IN 12-YEAR-OLD
SOUTHERN CHINESE. HEAD & FACE MEDICINE (2014). 10:56
 DIMAGGIOFR, CIUSAV, SFORZAC, FERRARIOVF.
PHOTOGRAPHIC SOFT-TISSUE PROFILE ANALYSIS IN
CHILDREN AT 6 YEARS OF AGE. AM JORTHOD.
DENTOFACIALORTHOP.2007;132(4):475-80
 AREZOO JAHANBIN ET AL .EVALUATION OF
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 SUBTELNY JD . A LONGITUDINAL STUDY OF SOFT
TISSUE FACIAL STRUCTURES AND THEIR PROFILE
CHARACTERISTICS, DEFINED IN RELATION TO
UNDERLYING SKELETAL STRUCTURES .AM. J.
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79