Farhad B. Naini

Facial Aesthetics

Concepts & Clinical Diagnosis

• Gebundenes Buch

Produktbeschreibung

Facial Aesthetics: Concepts and Clinical Diagnosis is aunique new illustrated resource for facial aesthetic surgery anddentistry, providing the comprehensive clinical textbook on the artand science of facial aesthetics for clinicians involved in themanagement of facial deformities, including orthodontists, oral andmaxillofacial surgeons, plastic and reconstructive surgeons andaesthetic dentists. It aims to provide readers with a comprehensiveexamination of facial aesthetics in the context of dentofacial andcraniofacial diagnosis and treatment planning. This aim is achievedthrough coupling meticulous research and practical clinical advicewith beautifully drawn supporting illustrations and diagrams.
Structured over 24 logically arranged and easy-to-followchapters, Part I of Facial Aesthetics covers the historicalevidence for facial aesthetic canons and concepts in depth. Itincorporates all aspects relevant to the work of the clinician,including the philosophical and scientific theories of facialbeauty, facial attractiveness research, facial expression and thepsychosocial ramifications of facial deformities. Part II of thebook then goes on to examine clinical evaluation and diagnosis inconsiderable detail under four sections, from the initialconsultation interview and acquisition of diagnostic records(section 1), complete clinical examination and analysis of thecraniofacial complex (section 2), in depth analysis of eachindividual facial region using a top-down approach (section 3) andfinally focussing on smile and dentogingival aesthetic evaluation(section 4).

An in-depth, thoughtful, practical and absorbing reference, Facial Aesthetics will find an enthusiastic reception amongfacial aesthetic surgeons and aesthetic dentists with an interestin refining their understanding and appreciation of the human faceand applying practical protocols to their clinical diagnosis andtreatment planning.

Key features:

Examines facial aesthetics in a clinical context
Promotes an interdisciplinary approach to facial aestheticanalysis
Detailed description of the systematic clinical evaluation ofthe facial soft tissues and craniodentoskeletal complex
Detailed, step-by-step aesthetic analysis of each facialregion
In-depth analysis of 2D and 3D clinical diagnostic records
Evidence-based approach, from antiquity to contemporaryscientific evidence, to the guidelines employed in planning thecorrection of facial deformities
Treatment planning from first principles highlighted
Clinical notes are highlighted throughout
Clearly organized and practical format
Highly illustrated in full colour throughout

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Produktdetails

• Verlag: Wiley & Sons / Wiley-Blackwell
• Artikelnr. des Verlages: 1A405181920
• 1. Auflage
• Seitenzahl: 464
• Erscheinungstermin: 21. März 2011
• Englisch
• Abmessung: 278mm x 222mm x 32mm
• Gewicht: 1575g
• ISBN-13: 9781405181921
• ISBN-10: 1405181923
• Artikelnr.: 30685694

Autorenporträt

Dr Farhad B. Naini is Consultant Orthodontist at Kingston and St George's Hospitals and Honorary Senior Lecturer in craniofacial anatomy, biology and development at St George's Medical School, University of London, UK.

Inhaltsangabe

Preface xv
Dedication xvii
Acknowledgements xviii
Part I Concepts
Chapter 1 Facial Beauty 3
Definition of beauty and aesthetics 3
Is beauty 'in the eye of the beholder'? 4
The enigma of facial beauty: Why is one face seen as beautiful and another
as unattractive? What guides and validates our judgement? 5
'Ideal' proportions 6
Symmetry 6
Averageness 6
Facial neoteny 7
Sexual dimorphism (secondary sexual characteristics) 7
Heredity 7
Cultural influences on the perception of facial beauty 7
Facial beauty: historical and philosophical perspectives 9
Facial beauty: scientific perspectives 13
Importance of facial beauty 14
Self- image and negative self-perception 15
Outsiders' perceptions 16
Severity of deformity 16
References 16
Chapter 2 Facial Proportions: Classical Canons to Modern Craniofacial
Anthropometry 18
Introduction 18
Ancient Egypt 18
Ancient Greece 19
The Archaic Period 19
The Classical Period 21
The Roman conquest of Greece 25
Ancient Rome 26
The Renaissance 27
Leon Battista Alberti 28
Leonardo da Vinci 29
Albrecht Dürer 36
The Enlightenment and neoclassicism 38
Neoclassical canons of proportion 38
Craniometry 39
Twentieth century 41
Modern craniofacial anthropometry 41
Leslie Farkas - the father of modern craniofacial anthropometry 42
The golden proportion 43
The ongoing problem with research into the golden proportion 44
Conclusion 44
References 44
Chapter 3 Facial Expression: Influence and Significance 45
Introduction 45
Importance of facial expressions 45
History of research into facial expressions 46
The work of Duchenne 47
The work of Darwin 47
The work of Ekman 49
The debate: Are facial expressions of emotion universal or
culture-specific? 50
References 52
Chapter 4 Psychological Ramifications of Facial Deformities 54
Introduction 54
Health and psychosocial well-being 54
Self-image 55
The effect of the response of others on those with facial deformities 56
Teasing and bullying 56
To treat or not to treat? The controversial debate 57
Body dysmorphic disorder: the delusion of deformity 57
Body dysmorphic disorder 58
Conclusion 60
References 61
Part II Clinical Diagnosis Section 1
Patient Interview and Clinical Diagnostic Records 65
Introduction to Section 1 65
Diagnosis 65
Terms of direction, position and movement 65
Chapter 5 Patient Interview and Consultation 67
Introduction 67
Presenting complaint 67
History of presenting complaint 68
Psychosocial history 68
Medical history 68
Danger signals and the 'problem' patient 69
References 69
Chapter 6 Clinical Diagnostic Records, Natural Head Position and
Craniofacial Anthropometry 71
Introduction 71
Clinical diagnostic records 71
Radiographs 71
Clinical photographs 73
Study models 73
Serial height measurement 74
Three-dimensional hard and soft tissue imaging 74
Natural head position 74
The Frankfort Craniometric Agreement and the Frankfort Plane 74
The unreliability of anatomical reference planes 75
Natural head position: the key to diagnosis 76
Choice of horizontal and vertical reference planes 77
Orientation of the patient in natural head position 78
The self-balance position 78
The mirror position 78
The aesthetic position (or 'photographic position' of the head) 78
Clinical photography 79
Equipment for digital photography and data storage 79
Patient consent forms 79
Background and lighting 79
Facial views 80
Intraoral views 80
Craniofacial anthropometry 81
Anthropometric craniofacial surface landmarks 81
References 85
Chapter 7 Cephalometry and Cephalometric Analysis 86
Introduction 86
Cephalometric landmarks and planes of reference 87
Landmarks, lines, planes and volumes 87
Hard tissue lateral cephalometric (skeletal) landmarks 88
Hard tissue lateral cephalometric (dental) landmarks 90
Soft tissue lateral cephalometric landmarks 91
Cephalometric planes of reference 92
Hard tissue lateral cephalometric reference planes 93
Soft tissue lateral cephalometric reference planes 95
Posteroanterior cephalometric radiography 95
Hard tissue posteroanterior cephalometric landmarks 96
Hard tissue posteroanterior cephalometric reference planes 97
Cephalometric analysis and geometric principles 98
Description of dentofacial deformities 98
Sagittal skeletal relationships 100
Sagittal positional relationships 100
Size relationships of maxilla and mandible 108
Sagittal dentoalveolar relationships 110
Inclination of the maxillary incisors 110
Sagittal position of the maxillary incisors 112
Inclination of the mandibular incisors 113
Sagittal position of the mandibular incisors 114
Inclination of maxillary to mandibular incisors 115
Vertical skeletal relationships 115
Convergence of horizontal facial planes (Sassouni analysis) 116
Anterior and posterior face height 116
Linear cephalometric measurements and normative values 119
Angular cephalometric measurements and normative values 120
Vertical dentoalveolar relationships 121
Inclination of the occlusal plane 121
Anterior maxillary dental height 121
Posterior maxillary dental height 121
Anterior mandibular dental height 121
Posterior mandibular dental height 122
Transverse skeletal relationships 122
References 122
Section 2 Facial Aesthetic Analysis: Facial Type, Proportions and Symmetry
123
Introduction to Section 2 123
'Rules' versus 'guidelines' in facial aesthetic evaluation 123
Clinical inspection - the 'process' 123
Clinical inspection - the 'education of the eye' 124
The diagnostic process - clinical evaluation 124
Qualitative evaluation 124
Quantitative evaluation and analysis 124
Clinical evaluation - the sequence 126
References 126
Chapter 8 Facial Type 127
Introduction 127
The fictional conception of the 'normal' 127
Proportion indices 127
Head type 129
Cephalic index 129
Ethnic differences 130
Ethnic differences in white individuals 130
Head circumference 130
Ethnic differences 130
Facial type: frontal view (norma frontalis) 130
Facial shape 130
Facial height-to-width ratio/proportion 131
Facial index 131
Facial type: profile view (norma lateralis) 132
Facial divergence 132
Sagittal facial profile contour 134
Angle of facial profile convexity (clinical/soft tissue) 134
Angle of facial profile convexity (cephalometric/skeletal) 135
Facial angle (clinical/soft tissue) 135
Facial angle (cephalometric/skeletal) 136
Cranial base angle 136
Anterior cranial base length 137
Parasagittal facial profile contour 137
Vertical facial profile form 137
Vertical facial growth pattern and hyperdivergent facial type 137
Horizontal facial growth pattern and hypodivergent facial type 138
Mandibular plane angle (clinical) 138
Mandibular plane angle (cephalometric) 139
Gonial angle (Ar-Go-Me) 139
Convergence of horizontal facial planes (Sassouni analysis) 140
Facial height to horizontal facial depth ratio (cephalometric) 140
Facial growth axes (cephalometric) 141
Facial curves and curvilinear relationships 141
Curvilinear relationships - frontal and profile views 142
Angularity of facial contour lines 142
Facial profile curves and 'S-shaped' curvilinear considerations 142
Contour defects 143
Sexual variation: the main differences between male and female faces 144
'Ethnic' variation: considerations in facial aesthetic evaluation 145
Historical background 145
Considerations in facial aesthetic evaluation 145
Facial ageing 146
Skin 146
Fat 147
Muscle 147
Dentoalveolus 147
Recognizing the visible effects of ageing 147
References 149
Chapter 9 Facial Proportions 150
Introduction 150
Craniofacial height to standing height proportion 151
Classical, Renaissance and neoclassical proportional canons 151
Anthropometric data 155
Attractiveness research 155
Clinical implications 156
Vertical facial proportions 156
Vertical craniofacial bisection 156
Vertical facial trisection (Vitruvian trisection) 156
Vertical craniofacial tetrasection 157
Artist's facial 'grid' 157
Validity of proportional canons 157
Cephalometric evaluation - anterior face height ratio 158
Lower anterior facial proportions 158
Anthropometric vertical facial measurements 159
Comparison of proportional canons with modern measured proportional ratios
159
Attractiveness studies 159
Clinical implications 160
Transverse facial proportions 160
The central fifth of the face 160
The medial fifths of the face 163
The lateral fifths of the face 164
References 164
Oblique lateral (three-quarter) view 171
Transverse occlusal plane view 171
Dynamic clinical evaluation 172
Mandibular lateral displacement 172
Asymmetrical facial animation 174
Dental midlines 174
Maxillary dental midline 174
Mandibular dental midline 175
Distinguishing between mandibular and isolated chin asymmetry 175
Radiographic-cephalometric evaluation 176
Posteroanterior cephalometric radiograph 176
Lateral cephalometric radiograph 179
Panoramic rotational tomography (OPT - orthopantomograph) 179
Three-dimensional imaging evaluation 180
Dental study casts 180
Three-dimensional facial soft tissue scans 180
Computed tomography 181
Magnetic resonance imaging 184
Craniofacial growth and treatment timing 184
Treatment timing 184
Superimposition of serial cephalometric images and other imaging modalities
185
Growth prediction 185
Nuclear medicine (scintigraphy) 186
References 188
Section 3 Facial Aesthetic Analysis: Regional Analysis 189
Introduction to Section 3 189
The modified subunit principle 189
Relativity and the five facial prominences 190
The five facial profile prominences 191
References 191
Upper Facial Analysis 192
Chapter 10 Facial Symmetry and Asymmetry 165
Introduction 165
Relationship between symmetry and proportion 165
Balance and harmony: a note on terminology 166
Aetiology and classification of facial asymmetry 166
Aetiology 166
Classification 166
Clinical evaluation 167
Purpose of the clinical evaluation 167
Frontal facial examination 167
Superior view 171
Submental view 171
Lateral view 171
Chapter 11 The Forehead 193
Introduction and terminology 193
Anatomy 193
Clinical evaluation 194
Frontal view 194
Profile view 195
Superior view 197
Curvilinear relationships 197
References 198
Chapter 12 The Orbital Region 199
Introduction 199
The eyes 199
Eyebrows 200
Terminology 200
Anatomy 200
Clinical evaluation 202
Eyebrow position and contour 202
Orientation of palpebral fissure 202
Eyelids (palpebrae) 203
Eye width and interocular dimensions 205
Proportional relationships of the orbital region 205
Relationship of bony orbit and globe 206
Symmetry 206
References 206
Midfacial Analysis 207
Chapter 13 The Ears 208
Introduction 208
Terminology 208
Anatomy 208
Clinical evaluation 209
Ear position 210
Ear size and proportions 210
Ear axis 211
Ear protrusion (lateral projection) 211
Ear symmetry 213
References 213
Chapter 14 The Nose 214
Introduction 214
Terminology 216
Anatomy 217
Soft tissue features of the external nose 217
Skin of the external nose 217
Bony skeleton of the external nose 217
Cartilaginous skeleton of the external nose 218
Nasal type, topography and the subunit principle 219
Classification of nasal type 219
Topographic nasal landmarks and nomenclature 220
Nasal aesthetic subunits 222
Clinical evaluation 222
Frontal evaluation 222
Profile evaluation 224
Basal evaluation 233
Relative nasal relationships - evaluation 234
Normative values for nasal dimensions 235
Nasal function 235
References 236
Chapter 15 The Malar Region 238
Introduction 238
Terminology 238
Anatomy 239
Clinical evaluation 239
Bizygomatic width 239
Malar position 241
Height of malar contour 242
Malar projection and sagittal contour 242
Area of maximal malar projection 242
Principles in planning the correction of malar deficiency 244
References 244
Chapter 16 The Maxilla and Midface 245
Introduction 245
Terminology 245
Terms of jaw position in the sagittal plane 246
Terms of maxillary position in the vertical plane 246
Terms of jaw size 246
Terms of maxillary bodily movement in the three planes of space 246
Terms of maxillary rotation around the three axes of rotation 246
Anatomy 247
Clinical evaluation 248
Sagittal midfacial-maxillary evaluation 248
Vertical maxillary evaluation 254
Transverse maxillary evaluation 255
Maxillary deficiency 258
Sagittal maxillary deficiency 258
Vertical maxillary deficiency 259
Transverse maxillary deficiency 260
Principles in planning the correction of maxillary deficiency 261
Maxillary excess 262
Sagittal maxillary excess 262
Vertical maxillary excess 263
Transverse maxillary excess 265
Principles in planning the correction of maxillary excess 265
Maxillary asymmetry 266
References 267
Lower Facial Analysis 268
Introduction 268
Chapter 17 The Lips 269
Introduction 269
Anatomy 269
Embryology 269
Anatomy 269
Ageing 270
Terminology 271
Clinical evaluation 271
Lip lines 271
Lip activity (function) 272
Lip morphology (form) 273
Lip posture 280
Lip prominence 281
References 286
Chapter 18 Mentolabial (Labiomental) Fold 288
Introduction 288
Mentolabial fold (sulcus) depth 288
Mentolabial angle 288
Vertical position of the mentolabial fold 291
Mentolabial fold morphology 291
Advantages of mandibular advancement surgery over isolated genioplasty 291
Influence of mentolabial fold morphology on management of chin deformities
292
Influence of vector of bony chin movement on mentolabial fold morphology
292
Influence of lower anterior face height on mentolabial fold morphology 292
References 294
Chapter 19 The Mandible 295
Terminology 295
Anatomy, morphology and size 295
Normal anatomy and subunits 295
Morphology 295
Size and position 298
Sagittal and vertical relationships 300
Mandibular deficiency 300
True sagittal mandibular deficiency 300
Relative mandibular deficiency 300
Diagnostic features 300
Mandibular excess 302
True mandibular excess 302
Relative mandibular excess 302
Diagnostic features 303
Transverse relationships 306
Proportional relationships 306
Bicondylar width and bigonial width 307
Mandibular asymmetries 307
Hemimandibular hyperplasia 308
Hemimandibular elongation 309
Hybrid (mixed) forms of hemimandibular hyperplasia and elongation 311
Unilateral condylar hyperplasia 311
References 311
Chapter 20 The Chin 312
Introduction 312
Anatomy 312
Terminology 313
Chin excess and chin deficiency 313
Classification of chin deformities 318
Clinical evaluation 321
Sagittal evaluation and chin projection 321
Sagittal position of soft tissue chin 322
Sagittal position of hard tissue (skeletal) pogonion 326
Indirect morphological influences on sagittal chin projection 328
Soft tissue chin pad 328
Mentolabial fold and chin pad morphology 329
Dynamic chin pad evaluation 329
Mentalis muscle - anatomy, activity and significance 330
Vertical chin height 332
Proportional relationships 332
Mandibular anterior dental height 332
Transverse chin width 333
References 333
Chapter 21 Submental-Cervical Region 335
Introduction 335
Anatomy 335
Terminology 335
Aetiology 336
Aetiology of poor submental-cervical contour 336
Clinical evaluation 337
Skeletal pattern (jaw relationship) 337
Morphology of the submental soft tissues 338
Submental-facial angle 341
Submental length 341
Submental-neck (submental-cervical) angle 341
Submental-sternomastoid (SM-SM) angle 344
Submental soft tissue thickness 344
Hyoid bone position and submental-cervical aesthetics 344
Relative submental projection and aesthetics 347
References 348
Section 4 Smile and Dentogingival Aesthetic Analysis 351
Introduction to Section 4 351
Chapter 22 Dental-Occlusal Relationships: Terminology, Description and
Classification 353
Introduction 353
Terminology 353
Terms of description of tooth form 353
Terms of direction in dental nomenclature 353
Terms of tooth position in the three planes of space 354
Terms of bodily tooth movement in the three planes of space 354
Terms of tooth rotation around the three axes of rotation 354
Dental occlusion 355
The concept of 'ideal' occlusion 355
Curves of the occlusion 356
Aims of treatment and the 'six keys' to 'ideal' occlusion 356
Classification of dental-occlusal relationships 358
Incisor relationships 358
Buccal segment relationships (canine and molar relationships) 360
The term 'Class' and classification 362
The aetiology of malocclusion 364
Skeletal factors 364
Soft tissue factors 365
Local factors 367
Habits 367
Oral health 367
Dental condition 367
Oral hygiene and gingival/periodontal condition 368
Oral mucosa 368
Occlusal function 368
Dynamic occlusal function 368
Temporomandibular joint function 368
References 368
Chapter 23 Smile Aesthetics
with Daljit S. Gill 370
Introduction 370
Importance of the smile in facial aesthetics 370
Types of smile 370
The generation of a smile 371
Clinical evaluation 371
Lip aesthetics 371
Lip lines 371
Upper lip-maxillary incisor relationship 372
Incisor exposure and phonetic analysis 375
Incisor exposure and anterior occlusal guidance 377
Smile symmetry 377
Dynamic upper lip curvature 377
Orientation of the transverse occlusal plane 377
Orientation of the sagittal occlusal plane 378
Smile curvature (smile arc) 378
Dental midlines 380
Buccal corridors (negative space) 382
Smile aesthetics in profile view 383
References 386
Chapter 24 Dentogingival Aesthetics
with Daljit S. Gill 387
Introduction 387
Anatomy 387
The concept of 'biological width' 388
Clinical evaluation 389
Tooth shape 389
Theories of 'ideal' tooth shape 389
Tooth size 391
Width-to-height ratio of maxillary central incisor crown 391
Seventh key and dental occlusion 392
Tooth size analysis 392
Tooth proportions 392
Tooth symmetry 394
The unilaterally peg-shaped or congenitally absent maxillary lateral
incisor 394
Arch form 395
Maxillary incisor axial angulations 395
Gradation (front-to-back progression) 396
Gingival aesthetics 398
Gingival colour, texture and biotype 398
Gingival level 398
Gingival contour 399
Contacts, connectors and embrasures 400
Tooth colour 402
Description of tooth colour 402
Arch shade progression 402
Tooth shade value contrast with skin colour 402
Age changes 402
Clinical shade selection 402
References 403
Index 405

Rezensionen

"The text comprehensively examines facial aesthetics in the context of dentofacial and craniofacial diagnosis and treatment planning." -- Booknews, 1 June 2011

"[An] opus...inimitable in its field...an outstanding composition...an in-depth, thoroughly comprehensive arrangement of information to inform, guide, and teach us in the analysis and diagnosis of facial deformity...incredibly interesting and painstakingly researched pages...highly illustrated on every page...This is a book that will be of interest to anyone who has an interest in facial aesthetics. From a clinical point of view, this book will interest anyone who looks after patients with dentofacial deformity from maxillofacial and plastic surgeons, orthodontists, to general dentists and any other dental and medical specialists who desire an understanding of the importance of facial aesthetics in the treatment of 'real people' rather than 'patients with a disease entity'." (European Journal of Orthodontics, 1 May 2013)

"I think this a remarkable effort from a single author: it is clearly a labor of love . . . Most residents in plastic surgery, facial plastic surgery, or maxillofacial surgery should be exposed to this material in their training, and this is a good place to get that exposure in one place." (Plastic and Reconstructive Surgery,1 November 2012)

"Thoughtfully integrates historical, clinical, and surgical perspectives in the medical fields ranging from maxillofacial to plastic and reconstructive surgery. The author elegantly provides the science and art of facial aesthetics with emphasis given to analysis of the craniofacial complex, facial aesthetic units, and clinical evaluation, in addition to smile and dental-occlusal relationships...has undertaken a detailed approach in presenting dental aesthetics, which makes this publication rather unique...allows a broad appeal to both dental and medical specialists." (Archives of Facial Plastic Surgery, 1 September 2012)

"The best analysis I have ever seen of the comprehensive factors involved in establishing exactly what makes a person facially attractive, unattractive, or simply average. The book's 24 logically arranged, easy-to-follow chapters--beautifully illustrated in full colour--systematically and thoroughly explore all the dentofacial and craniofacial details that determine how we look. I believe Facial Aesthetics will find an enthusiastic reception among orthodontists who would like to refine their understanding and appreciation of the human face and to apply the author's practical protocols to their clinical diagnosis and treatment planning." (Journal of Clinical Orthodontics, 2012)

"This is an excellent reference text for those interested in facial aesthetics and surgery. Section II looks at facial type, propor­tions and symmetry, providing an out­standing and essential reference...Section III is astounding and presents each facial region using annotated illus­trations and methodically explains each facial subunit. The research at the core of this text is comprehensive and it is complemented by the generous use of illustrations. I highly recommend this book to anyone with an interest in facial aesthetics." (British Dental Journal, 24 September 2011) "In summary, this book is written in a clear and accessible format, with colour illustration throughout, an important guide for all the practitioners in the field of facial aesthetic surgery and aesthetic dentistry with an interest in refining their understanding and appreciation of the human face and applying practical protocols to their clinical diagnosis and treatment planning." (Journal of Oral Health and Dental Management, 1 December 2011)

"The text comprehensively examines facial aesthetics in the context of dentofacial and craniofacial diagnosis and treatment planning." (Booknews, 1 June 2011)