• Nofil Ahmad Frontier college of Dentistry, Abbottabad
  • Khalid Saeed Mirza HOD, Department of periodontology,Akhtar Saeed Medical and Dental College,Bahria town, Lahore
  • Faiza Ijaz Abbottabad International Dental College Abbottabad
  • Rabia Mushtaq Akhtar Saeed Medical and Dental College, Bahria town, Lahore
  • Zuhaa Mushtaq Department of Oral biology, Abbottabad International Dental College, Abbottabad
  • Amna Khalid Akhtar Saeed Medical and Dental College, Bahria town, Lahore
  • Husnain Abbas Dugoni School of Dentistry, University of Pacific, USA


Background: Although the results derived from orthodontic treatment are focused at attaining an aesthetically pleasing soft tissue profile as directed by Angle’s paradigm, however hard tissue including bone and tooth dimensions also play a pivotal role in attaining the set goal. This study was focused on evaluating the comparison of photographs and cephalometric radiographic images to dictate the differences that might occur when the same aesthetic evaluation technique is applied. A cross sectional comparative study was carried out at Frontier college of dentistry, Abbottabad and Sharif Medical and Dental College, Lahore from June to November 2020. Methods: In this cross-sectional study, 60 subjects were incorporated as part of the study amongst which lateral cephalometric radiographic images and photographs, other diagnostic records such as dental casts were procured. The same analysis was applied to assess the lower third of the face in both the photographs and the radiographs with focus on the Labiomental and nasolabial angles for comparison. Results: The normal value of Nasolabial angle 102.10°±3.126° (NLA2) indicates the relationship of nose and upper lip which is within the normal range for the age group selected. No significant difference was found between the nasolabial angles measured by two separate methods (p-value is 0.67). Mean labiomental angle was found to be 120.70°±6.46°(LNA1) and 121.60°±5.386 degrees °(LMA2) respectively, which was within the normal range for the age group selected. Conclusion: There is no significant difference in the assessment of lower facial height and aesthetics between lateral cephalometric radiographic images and photographs taken from the camera.


Ferrario VF, Sforza C, Miani A, Tartaglia G. Craniofacial morphometry by photographic evaluations. Am J Orthod Dentofacial Orthop 2013;103(4):327–37.

Halazonetis DJ. Morphometric correlation between facial soft tissue profile shape and skeletal pattern in children and adolescents. Am J Orthod Dentofacial Orthop 2007;132(4):450–7.

Dimaggio FR, Ciusa V, Sforza C, Ferrario VF. Photographic soft tissue profile analysis in children at 6 years of age. Am J Orthod Dentofacial Orthop 2007;132(4):475–80.

Han K, Kwon HJ, Choi TH, Kim JH, Son D. Comparison of anthropometry with photogrammetry based on a standardized clinical photographic technique using a cephalostat and chair. J Craniomaxillofac Surg 2010;38(2):96–107.

Ozdemir ST, Sigirli D, Ercan I, Cankur NS. Photographic facial soft tissue analysis of healthy Turkish young adults: anthropometric measurements. Aesthetic Plast Surg 2009;33(2):175–84.

Rose AD, Woods MG, Clement JG, Thomas CD. Lateral facial soft tissue prediction model: analysis using Fourier shape descriptors and traditional cephalometric methods. Am J Phys Anthropol 2003;121(2):172–80.

Zhang X, Hans MG, Graham G, Kirchner HL, Redline S. Correlations between cephalometric and facial photographic of craniofacial form. Am J Orthod Dentofacial Orthop 2007;131(1):67–71.

Staudt CB, Kiliaridis S. A nonradiographic approach to detect Class III skeletal discrepancies. Am J Orthod Dentofacial Orthop 2009;136(1):52–8.

Solow B, Tallgren A. Natural head position in stand ingsubjects. Acta Odontol Scand 1997;29(5):591–607.

Cummins DM, Bishara SE, Jakobsen JR. A computer assisted photogrammetric analysis of soft tissue changes after orthodontic treatment. Part II: results. Am J Orthod Dentofacial Orthop 2015;108(1):38–47.

Broadbent BH. A new X-ray technique and its application to orthodontia. Angle Orthod 1981;51:93–114.

Graber TM. Orthodontics-principles and practice. 3rd ed. Philadelphia: W. B. Saunders, 2002; p.397–431.

Arnett GW, Gunson MJ. Facial planning for orthodontists and oral surgeons. Am J Orthod Dentofacial Orthop 2004;126(3):290–5.

Arnett GW. Facial keys to orthodontic diagnosis and treatment planning--Part II. Am J Orthod Dentofacial Orthop 1993;103(5):395-411.

Brezniak N, Turgeman R, Redlich M. Incisor inclination determined by the light reflection zone on the tooth’s surface. Quintessence Int 2010;41(1):27–34.

Saxby PJ, Freer TJ. Dentoskeletal determinants of soft tissue morphology. Angle Orthod 2005;55(2):147–54.

Kasai K. Soft tissue adaptability to hard tissues in facial profiles. Am J Orthod Dentofacial Orthop 2008;113(6):674–84.

Rashid A, ElSharaby F, Nassef E, Mehanni S, Mostafa Y. Effect of platelet‐rich plasma on orthodontic tooth movement in dogs. Orthod Craniofac Res. 2017;20(2):102–10

Bishara SE, Jorgensen GJ, Jakobsen JR. Changes in facial dimensions assessed from lateral and frontal photographs. Part I--methodology. Am J Orthod Dentofacial Orthop 2005;108(4):389–93.

Kale-Varlk S. Angular photogrammetric analysis of the soft tissue facial profile of Anatolian Turkish adults. J Craniofac Surg 2008;19(6):1481–6.

Aksu M, Kaya D, Kocadereli I. Reliability of reference distances used in photogrammetry. Angle Orthod 2010;80(4):482–9.

Shaikh AJ, Alvi AR. Comparison of cephalometric norms of esthetically pleasing faces. J Coll Physicians Surg Pak 2009;19(12):754–8.

Bergman RT. Cephalometric soft tissue facial analysis. Am J Orthod Dentofacial Orthop 1999;116(4):373–89.

Farkas LG, Katic MJ, Hreczko TA, Deutsch C, Munro IR. Anthropometric proportions in the upper lip-lower lower-chin area of the lower face in young white adults. Am J Orthod 1998;86(1):52–60.

Langolis JH, Roggman LA. Attractive faces are only average. Psycho Sci 1990;1(2):115–21.

Langolis JH, Roggman LA, Musselman L. What is average and what is not average about attractive faces? Psychol Sci 1994;5(4):214–20.

Perret DI, May KA, Yoshikawa S. facial shape and judgment of female attractiveness. Nature 1994;368(6468):239–42.

Arnett GW, Bergman RT. Facial keys to orthodontic diagnosis and treatment planning. Part I. Am J Orthod Dentofac Orthop 1993;103(4):299–312.

Yuen SW, Hiranaka DK. A photographic study of the facial profiles of southern Chinese adolescents. Quintessence Int 2006;20(9):665–76.

McNamara JA, Brust EW, Riolo ML. Soft tissue evaluation of individuals with an ideal occlusion and well balanced face. In: McNamara JA, Carlson DS, Ferrara A, Editors. Aesthetics and the treatment of facial form. Monograph No 28, Craniofacial Growth series, Center for human growth and development, University of Michigan. Ann Arbor, 1992; p.115–46.

Hashim HA, AlBarakati SF. Cephalometric soft tissue profile analysis between two different ethnic groups: A comparative study. J Contemp Dent Pract 2009;4(2):60–73.

Lines PA, Lines RR, Lines CA. Profilometrics and facial esthetics. Am J Orthod 1998;73(6):648–57.