Nasal Morphology / Orthodontic Courses by Indian Dental Academy

NASAL INTEGUMENT - AN
INDICATOR OF MAXILLARY
SKELETAL PATTERN

INDIAN DENTAL ACADEMY

Leader in continuing dental education
www.indiandentalacademy.com

WWW.INDIANDENTALACADEMY.COM
INTRODUCTION
FACIAL INTEGUMENT FACIAL SKELETON
Importance of integument

Will integument follow underlying
skeleton pattern?

ANATOMY OF MAXILLA
RIGHT AND LEFT MAXILLA

NASAL ANATOMY
EXTERNAL MORPHOLOGY
COLUMELLA
ALAE
INTERNAL
MORPHOLOGY[SKELETAL]
NASAL PARAMETERS
NASAL LENGTH NASAL PROJECTION
NASOLABIAL ANGLE
GROWTH & DEVELOPMENT

NASAL INTEGUMENT AS AN
INDICATOR OF MAXILLARY
SKELETAL PATTERN
AIMS AND OBJECTIVES
Evaluate nasal morphology in sagittal and
vertical maxillary excess.

Evaluate nasal morphology in sagittal and
vertical maxillary deficiency.

To correlate the nasal morphology to class II
skeletal and class III skeletal patterns.

MATERIALS AND METHODS
DATA PRESENTATION
Pretreatment lateral cephalometric radiographs
of 40 patients / 4 sub groups
10 Patients Sagittal Maxillary Deficiency
10 Patients Sagittal Maxillary Excess
10 Patients Vertical Maxillary Deficiency
10 Patients Vertical Maxillary Excess
5Male and 5Female in each subgroup

SOURCE OF SAMPLE

Pretreatment lateral cephalometric radiographs of
Sample selected from the patients who are
visiting department of orthodontics at Narayana
dental college.

INCLUSION CRITERIA
1. AGE > 18 Years for both Male and Female samples

EXCLUSION CRITERIA
1. Prior history of Orthodontic treatment
2. History of Trauma or Surgery to Facial region
Vertical facial skeletal parameters assessed on lateral cephalogram WWW.INDIANDENTALACADEMY.COM
Soft tissue reference planes and variables used to assess nose on
lateral cephalogram
NORMATIVE VALUES FOR ADULT NASAL PARAMETERS

RESULTS
SIGNIFICANT CORRELATION WERE SEEN BETWEEN THE
FOLLOWING SKELETAL AND SOFT TISSUE NASAL
VARIABLES
1.ANTERIOR FACIAL HEIGHT AND NASAL LENGTH
AFH NASAL LENGTH

2.ANGLE OF INCLINATION AND NASAL LENGTH
- AOI NLTH
3.UPPER ANTERIOR FACIAL HEIGHT AND NASAL
DEPTH
- AFH ND

4.AOI AND NASAL DEPTH
AOI ND
5.NASOLABIAL ANGLE AND ANTERIOR FACIAL LENGTH
AFH NASOLABIAL ANGLE

CONVEX NASAL PROFILE IS SEEN IN CLASS II CASES

CONCAVE NASAL PROFILE IS SEEN IN CLASS III CASES

NASAL DEPTH IS INCREASED INCREASED MAXILLARY
SAGITTAL DIMENSIONS

NASAL LENGTH INCREASED IN CLASS III SKELETAL
PATTERNS


DISCUSSION
Subtelny [AJO 1959;45:481-507],
- first demonstrated downward and forward growth of
mandible during maturity.
-nose grows more vertically when compared to its
growth in sagittal dimension.

Meng etal [AJO1988 ],
-Supported the subtelny conclusions

Scott [Br.Dent J 1953;95:37-43],
- Nasal septum is determinant of midfacial growth

Lathum [J Anat 1970;107:47-78],
-nasal septum acted as a starter mechanism ,pulling
the premaxillae and maxillae forward via the so
called septo-premaxillary ligaments

Grymer et al [Rhinology 1997;35: Abstract],
- Decient nasal septum growth along with decreased
anteroposterior growth of the maxilla leads to an
upward displacement of the anterior part of the
maxilla indicating a strong relationship between nasal
growth and inclination of the maxillary plane.
Robinson et al [AJO 1986;89:499-506],
-Their cephalometric study on the
relationship between skeletal facial pattern and soft
tissue nasal form concluded that nasal shape followed
the underlying skeletal pattern very closely in the
sagittal dimension.
Peter H. Buschang [JCO 1992;26:111-118],
-Horizontal growth at pr and sn is closely associated
with horizontal growth at ANS and A POINT

CONCLUSION
-Nasal length was seen to be significantly correlated to
upper anterior facial height and inclination of palatal
plane.

-An upturned nose in an adult individual was
significantly correlated with anti-clockwise rotation
of maxilla.
-SIgnificant correlation is present between nasal
projection and nasal length with sagittal
maxillary dimensions.
Growth and development of any structure will
occur in three dimensions of space simultaneously
and the overlying integument adapts in three
dimensions.so,its wise to understand the concept
in three dimensions of space than analyzing in one
or two dimensions.


Thank you

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www.indiandentalacademy.com


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NASAL INTEGUMENT - AN

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