How to identify soft tissue profile for orthodontic diagnosis

Abstract

In the present day, esthetics is the main motivation that brings the patient seeking orthodontic treatment. Soft tissue analysis is a tool in planning orthodontic treatment to obtain not only good function but also improve facial attractiveness, psychosocial status and quality of life. Objectives: To create a clinical diagnostic tool for soft tissue analysis and determine norms for Thai adult males and females together with comparing this tool with the currently used soft tissue analyses and the expert opinion. Materials and Methods: Part 1 The TVL through alar was chosen as a reference line in this study. 39 females and 31 males (mean age 24.5 and 25.4 years) with a good facial profile and were accepted by at least 4 of 5 orthodontists were selected. The profile photos of all subjects were taken in natural head position. The soft tissue measurements using TVL through alar were done to determined norms for Thai adult males and females. Part2 To test the effectiveness of the new diagnostic tool by comparing with the expert opinion (which was regarded as gold standard) and the currently used soft tissue analyses. The profile photos of 18 females and 18 males with any profile type were taken. The soft tissue profiles of these subjects were diagnose with the TVL through alar, TVL through Sn, E line and the expert opinion. Kappa analysis was used to determine the agreements among these methods. Results: The agreements of our tool with TVL through Sn were higher than the agreements of our tool with E line. When compare these 3 analyses with the expert opinion, the agreements of expert opinion with our tool was the highest, following by the agreements of expert opinion with TVL through Sn. And the last was the agreements of expert opinion with E line. The experts agreed with our tool more than the TVL through Sn for upper lip in both sexes and chin in males. They also agreed with our tool more than E line for upper and lower lips in both sexes. Conclusions: The TVL through alar is an alternative diagnostic tool for clinical soft tissue evaluation in orthodontic treatment.