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Anthropology and orthodontics

Anthropology and orthodontics

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Anthropology and orthodontics

  1. 1. ANTHROPOLOGY
  2. 2. ANTHROPOLOGY Anthropos + logos - Anthropology Anthropo- Human logos - Science “ANTHROPOLOGIST” - ARISTOTLE
  3. 3. DEFINITIONS KROEBER – Anthropology is the science of groups of men and their behavior and production. JACOBS & STERN – Anthropology is the scientific study of the physical, social, and cultural development and behavior of human beings since their appearance on the earth.
  4. 4. Classification of anthropology  PHYSICAL ANTHROPOLOGY  CULTURAL ANTHROPOLOGY
  5. 5. PHYSICAL ANTHROPOLOGY 1. HUMAN GENETICS 2. HUMAN PALEONTOLOGY 3. ETHNOLOGY 4. ANTHROPOMETRY 5. BIOMETRY
  6. 6. CULTURAL ANTHROPOLOGY 1. PREHISTORIC ANTHROPOLOGY 2. SOCIAL ANTHROPOLOGY
  7. 7. PHYSICAL ANTHROPOLOGY Physical anthropology is concerned with man as a physical organism in ‘time’ & ‘space’  Study of the man through evolutionary processes  study of human populations BEALS & HOIJER – The study of processes where by man developed from his non human ancestors and the continuing process of change still slowly altering his bodily form.
  8. 8. PHYSICAL ANTHROPOLOGY HUMAN GENETICS E.C.COLIN – Genetics is the branch of biology which deals with the laws and principles of heredity and variation as observed in plants, in animals and in human. HUMAN PALEONTOLOGY Webster’s New International Dictionary – Human paleontology is the science that deals with life of the past geographical periods.
  9. 9. PHYSICAL ANTHROPOLOGY ETHNOLOGY S.S DUBE – Ethnology is a comparative study of the races and culture of mankind in their different aspects. ANTHROPOMETRY HERSKOVITS – The measurements of man BIOMETRY CHARLES WINIK – Biometry is the statistical analysis of biological studies specially as applied to such areas as disease, birth, growth, and death.
  10. 10. Cultural anthropology E.A . HOEBEL – Culture is the sum total of learned behavioral patterns . 1. PREHISTORIC ARCHEOLOGY BEALS & HOIJER – It deals with ancient cultures and with past phases of modern civilization. .
  11. 11. Cultural anthropology 2. SOCIAL ANTHROPOLOGY CHARLES WINIK – Social anthropology is the study of social behavior especially from the point of view of the systematic comparative study of social forms and institutions.
  12. 12. Human evolution PRIMATOLOGY PRIMATE PALEONTOLOGY Mammal Protheria Theria Metatheria Eutheria Primate
  13. 13. Characteristics of primates 1. Limbs - prehensile 2. Thumb / great toe 3. Nails - grasping function 4. Teeth - adopted for mixed food 5. Mammary gland - lactation 6. Brain - well developed 7. Clavicle
  14. 14. Classification of primates  Prosimian  anthropoidea
  15. 15. Classification of primates 1. Prosimian primates ( 60 mil years ) a. lemuroidea - lemur, loris b. torsoidea - torsier  Earliest true primates  Well developed cerebellar cortices  Limbs had highly mobile joints  Unspecialised tooth cusps  Dental formula – I 2/2 C1/1 PM 3/3 M3/3
  16. 16. ANTHROPOIDEA 1. Ceboidea ( Platyrrhine of New World Monkeys) 2. Cercopithecoidea ( Catarrine Of Old World Monkeys ) 3. Hominoidea
  17. 17. ANTHROPOIDEA CEBOIDEA – ( spider monkey )  The higher primates Dental formula – I 2/2, C1/1, PM2/2, M3/3  4 blunt cusps on molars
  18. 18. ANTHROPOIDEA Cercopithecidae –( Macaque monkey ) 1. Arboreal in their habits 2. Non prehensile tails 3. Dental formula – I2/2, C1/1, PM2/2, M3/3
  19. 19. HOMINOIDEA Hominoidea is further sub divided into  Pongids  Australopithecines
  20. 20. ANTHROPOIDEA Pongids ( Great apes ) Ex : Gibbons, Gorillas, Orang-utans, Chimpanzees  Large brains  Pelvic girdle & legs became more robust  Orangutans remained arboreal  Chimpanzees, gorillas are quadripedal
  21. 21. HOMINOIDS AUSTRALOPITHECINES First bipedal fossil anthropoids found in rocks of Eastern & South Africa ( 1-3.6 mil years ago ) HOMO ERUCTUS ( Upright man ) HOMOSAPIENS HOMOSAPIENS SAPIENS NIANDERTHALENSIS ( Cro-magnon man ) ( Neanderthal man )
  22. 22. Neanderthal man skull-Very large -Dolico cephalic -Face is highly developed with maxillay prognathism -Lower jaw is strong & large -chin is less prominent -human dentition -canine is of ordinary size
  23. 23. Cro-magnon man Skull–large & massive -face is short, and flat -maxillary region shows less marked prognathism -lower jaw is strong & not massive -a well marked chin
  24. 24. MODERN MAN Final steps to modern man ( 20 mil years ) 1. Remarkable increase in brain size gave the forehead a more domed appearance 2. Folding of cerebral cortex 3. Bipedal walking 4. Use of hands for manipulation 5. Occipital ridges became small
  25. 25. MODERN MAN 7. Simplification of nasal region 8. Reduced prognathism 9. Chin increased in prominence 10. Angle between base of the skull and cervical vertebrae is 900
  26. 26. Evolution of human face Face is the seat of principle sense organs In lower vertebrates No fully ossified skeleton Jaw muscles are merely modified gill arch muscles Teeth are specialisations of tough shagreen or skin with minute calcified papillae or denticles In the amphibians The bony plates behind the jaws have disappeared, leaving an exposed area –orbit notch
  27. 27. In the fossil, mammal like reptiles The bony mask of the temporal region is perforated Complex dentary – lower jaw Dentary becomes enlarged & presses external pterygoid muscle, forming the cushion – meniscus ( glenoid fossa ) Heat regulating devices Forward migration of neck muscles Bony mask was replaced by skin
  28. 28. FACIAL FORM Each person’s face is a custom made original Anthropologists can reconstructs the face from a dry skull The biologic rationale underlying common variations : 1. Different facial types 2. Male & female developmental facial differences 3. Child & adult facial differences
  29. 29. Head form Two general extremes  Dolicocephalic ( long, narrow ) leptoprosopic  Brachycephalic ( Wide, short, globular ) euryprosopic
  30. 30. DOLICOCEPHALIC  Nose is longer & Protrusive with Aquiline type of Nasal contour  Convex profile  Cheek bones are less prominent  Longer, narrower, & deeper maxillary arch & palate  Downward & backward rotation of the mandible  Receding chin
  31. 31. BRACHYCEPHALIC  Nose is protrusively shorter (rounded tip )  Prominent cheek bones  Concave / straight profile  Wider, shorter and more shallow palate and maxillary arch  Mandible is more protrusive  More prominent chin
  32. 32. DINARIC HEAD FORM Dinaric Alps, Yugoslavia “Brachycephalised dolicocephalic” Flattened occipital regions Bossing of parietal regions Skull has triangular configuration Fore head is sloping & the profile tending towards orthognathic Mandible tends to be less retrusive
  33. 33. Male versus female features  Size & configuration of the nose  Fore head  Cheek bones  upper jaw look more prominent in females
  34. 34. Child versus adult features  Nasal part is small  Dentition ( primary & permanent )  Jaw bones (masticatory musles & airway) Head form Sexual dimorphism
  35. 35. Child versus adult features Child’s face is not a miniature of the adult face 1. Forehead 2. Face appears diminutive in child 3. Nasal region 4. Eyes appears wide set 5. Mandible is small 6. chin is incompletely formed
  36. 36. Evolution of teeth Lobe finned fishes - upper & lower jaws had bone bearing plates ( labyrinthodont ) - peg formed teeth Reptiles & mammals  teeth are set in separate sockets  cone shaped canines  milk teeth & permanent teeth
  37. 37. RACE “A group that differs from other classes or human group by virtue of some specific physiological characteristics that are found uniformly within that group” - Maclver & page
  38. 38. RACIAL CLASSIFICATION Important characters used for racial determination :  skin colour  hair  head form  face  nose  eye  stature  blood groups
  39. 39. CLASSIFICATION CATEGORIES OF CRITERIA  COMMON VARIABLE CHARACTERS  COMMON PHYSIOLOGICAL CHARACTERS  RARE GENETIC CHARACTERS
  40. 40. RACIAL CLASSIFICATION 1. NEGROID 2. CAUCASOID 3. MANGOLOID AUSTRALOIDS
  41. 41. NEGROIDS African negroes & oceanic negros  woolly or frizzly hair on the head  Black coloured skin  Nose is broad and flat  Lips are thick and everted  Facial prognathism  Brow ridges are small
  42. 42. MANGOLOID PHYSICAL CHARACTERISTICS  Black, straight, coarse hair  Yellowish brown colour skin  Broad flat face with prominent cheek bones  Mangoloid fold
  43. 43. MANGOLOIDS 1. CLASSIC / CENTRAL MANGOLOID -Northern Chaina, Tibet& Mangolia 2. ARCTIC / ESKIMOID -Northern Asia, arctic coast of north America 3. INDONESIAN - MALAY MANGOLOID -Japan, Thailand, Southern China 4. AMERICAN INDIAN -North, Middle, and South America
  44. 44. CAUCASOID Skin – fair, olive & all shades of brown Hair – flat, wavy to various degrees of curliness Head form –dolicocephalic to brachycephalic Nose – leptorrhine to mesorrhine Jaws –no prognathism Chin - pronounced
  45. 45. CAUCASOIDS 1. MEDITERRANEAN- all sea shores ( India, Spain, Portugal, France etc. ) 2. NORDIC – Scandinavians, Northern Germany, Northern France 3. ALPINE – Central Europe 4. EAST BALTIC – North eastern Germany, Poland, Baltic states 5. DINARIC –Dinaric alps region in Yugoslavia
  46. 46. CAUCASOIDS 6. ARMENOIDS – turkey, Syria,Palestine Iraq, Iran 7. CELTIC – Iceland, Scotland and western Europe 8. LAPP – Norway, Sweden 9. INDO-DRAVIDIAN –south & central India 10. POLYNESIAN – Polynesian islands of the pacific e.g. New Zealand 11. AINU – ancient stock of Japan
  47. 47. Australoids They closely resemble the Caucasoids in many characters 1. Australian aborigins -Australia 2. Pre-Dravidian ( veddoid )- South and central India including Typical Indian tribes
  48. 48. Races in india Sir Herbert Risley ( > 75 yrs ) Based on Indo-Aryans ( west ) mangoloids ( east)  Dravidian  Indo Aryan  Mangoloid
  49. 49. RACES IN INDIA Based on the measurements on the samples of indian population – Risley 1. Turko- iranian – they inhabitat the Baluchistan ( now in Pakistan ). Tall in nature& brachycephalic 2. Indo- aryan – eastern part of Punjab Rajastan & Kashmir. Tall & fair complexioned 3. Scytho-dravidian- hilly traces of Madhya pradesh, & Coorg. Medium statured & Brachycephalic
  50. 50.  Aryo- dravidian – U.P. Rajastan & Bihar. Short statured & mesocephalic  Mangolo- dravidian- Bengal & Orissa Stature is medium & sometimes short, round headed with medium nose  Mangoloid – Himalayan regions ( Nepal, Bhutan, Assam, & North eastern states
  51. 51. Dental anthropology Beginning - Eighties of 18th century Recognised - 20th century Founder of american journal of physical anthropology – Ales Hrdlicka The term dental anthropology was used in early 1900s
  52. 52. Different aspects of anthropology ( applied anthropology )  Dental development  Dental pathology  Dental morphology  Forensic odontology  odontometry
  53. 53. DENTAL DEVELOPMENT Tooth eruption standards which are relatively independent of general body growth and skeletal maturation are of great significance in the diagnosis & treatment planning of children with growth disturbances protein-calorie malnutrition ( PCM )
  54. 54. PATHOLOGY Dental caries – it is a pathologic condition of the teeth resulting in the decalcification of the dentin, enamel and the disintegration of the remaining organic material often leading to the loss of teeth. Caries susceptibility expresses the inherent or acquired proneness to caries Low incidence of caries in the prehistoric as also in the living tribal communities – coarse & fibrous food products
  55. 55. DENTAL MORPHOLOGY Teeth are best preserved & most easily accessible anatomical system of the body. pioneering studies – Hrdlicka, Dahlberg, Campbell, Hellmen, Krogman, Moorrees etc.
  56. 56. 1.Supernumerary teeth or hyperdontia - causes dental disturbances by interfering with normal eruption - either peg shaped or have large crown - Higher frequency in the maxilla -Campbell conducted a study on the skulls and living Australian aborigines.(1.8% )
  57. 57. 2.Carabelli’s cusp or anomaly Von Carabelli in 1842 Its occurrence – back to paleolithic man An elevation or tubercle on the lingual surface of the mesio-lingual cusp of the maxillary molars particularly the first one A marker for differentiation between different ethnic groups.
  58. 58. 3.Shovel-shaped incisors “SHOVELLING” – Muhlreiter ( 1870 ) A condition resulting from a combination of a concave lingual surface and elevated mesial and distal marginal ridges enclosing a central fossa in the upper and lower incisor teeth Hrdlicka ( 1911 ) had done pioneering work in dental anthropology and reported pronounced shovelling in the incisors of american indians
  59. 59. Acco. to Hrdlicka – 4 grades of shovelling 1. Shovel- enamel rim has well developed fossa 2. Semi shovel- enamel rim is distinct but with shallower fossa 3. Trace shovel- enamel rim has distinct traces 4. No shovel- enamel rim has no fossa HELLMAN –marked, medium, trace, and absent
  60. 60. 4.Diastema It is a space or gap present between the maxillary central incisors or between the lateral incisors and canines Former – median diastema (combined with small laterla incisors or large labial frenum) Latter – lateral diastema (found in anthropoid apes & certain fossil men )
  61. 61. 5. Crowding Lasker – inheritence of large teeth from one parent and a small jaw from the other 6. Cingulum or lingual cusp A shelf or swelling which is found on the tooth just above the central line Site of development of many supernumerary cusps
  62. 62. 7. Occlusion Relationship between the masticatory surfaces of the maxillary and mandibular teeth when the mouth is closed -heriditory factors -environmental factors The term ‘malocclusion’ is illdefined and biased - corrucini & whitley
  63. 63. 1. Overjet – normal (2-4mm), - positive (>5mm) - extreme positive(>7mm) - negative, extreme negative 2. Overbite- 3. Posterior cross bite 4.buccal segment relation
  64. 64. FORENSIC ODONTOLOGY Deals with the identification & study of human teeth identification of a person involved in mass disasters ( autobobile/aircraft accidents, floods, building collapse and industrial hazards)
  65. 65. ODONTOMETRY Tooth size standards based on odontometry can be used in the age & sex determination of skeletal and also living population Studies – males have larger teeth (mesio distal crown diameters ) - canines show greatest amount of sexual dimorphism -Europeans have smaller teeth than mangolians or other racial groups
  66. 66. Dr.V. Rami reddy conducted a retrospective cross sectional study on population of Gulbarga disrtict (1971-1975) 1. Eruptiion pattern 2. Dental caries 3. Dental morphology . .
  67. 67. AIMS & OBJECTIVES 1. To indicate the general and detailed eruption pattern of different types of deciduous and permanent teeth by variables such as sex, age and economic status. 2. To indicate the general and detailed prevalence of caries in both deciduous & permanent teeth by above variables 3. To indicate the general & detailed frequency occurrence of various morphological traits.
  68. 68. Deciduous & permanent dental eruption  The times of onset as well as completion of eruption are earlier in females than males  Mandibular teeth precedes over maxillary teeth in both sexes  Teeth eruption is fast in higher income group children
  69. 69. Dental caries – deciduous dentition By sex  Male children (33.4%)>female children( 26.8% ) By income  Lower income group > upper income group By age  Central incisors –5 years  Lateral incisors – 3 years  Canines – 6 years  First & second molars – 7 to 10 years
  70. 70. Dental caries – permanent dentition By sex  Difference is insignificant (females > males ) By income  Upper income group > middle & lower By age  Incisors – 22 to 23 years  Canines – free from the disease  Premolars & molars – 22-23 years
  71. 71. Dental morphology Supernumerary teeth Permanent dentition ( 0.86% ) > deciduous dentition ( 0.06% ) Maxilla > mandible – Ruffer ( 1920 ) Carabelli’s anomaly 35% out of total deciduous teeth& 27% of permanent dentition Female > male
  72. 72. Dental morphology Crowding both dentitions Female > male Diastema Deciduous teeth > permanent teeth -Male > female
  73. 73. “Epidemological transition” Phenomenon of changes in frequencies of certain serious diseases – omeron (1971) ‘diseases of civilisation’ or ‘western diseases’ – Trowell & Burkitt
  74. 74. “Epidemolodic transition in minor diseases”  Chronic allergy – cow’s milk, dust, pollution and food additives  Oral breathing – facial collapse syndrome - narrowing of the upper arch - buccal cross bites
  75. 75. Bite force studies normal adult chewing – 15-17kg of force maximum - 28-39kg of force Bite force is relevant to the functional aspects of dento-facial dysplasia. Ordinary chewing and maximum bite forces were significantly higher among more traditional rural Punjabi youths than among urban youths - Corruccini & Kaul
  76. 76.  Solution is the restoration of proper function by means of chewing hard , fibrous foods – stimulate the masticatory apparatus - greater flow of the alkaline saliva
  77. 77. Evolution of teeth  Non mammalian vertebrates – Polyphyodonty  During growth of the animal – increase in the jaw size is associated with tooth size (Trout – number will increase )  In mammals –Diphyodonty (2 dentitions )
  78. 78. Dentition of fishes ( agnatha ) EX; Sea lamprey  No true calcified teeth  Arranged circumferentially  Horny teeth are also seen on the tongue
  79. 79. Chondrichthyes (bony fishes )  All types of dental specialisations  Homodont & polyphyodont  Teeth are covered by enameloid lower jaw of shark
  80. 80. osteochthyes  Haplodont – prehention  Polyphyodont  Teeth- vomer, palatine bones roof of the mouth & tongue
  81. 81. Amphibia  Small, homodont, polyphyodont – prehension  In the frog – small teeth on the upper jaw & no teeth on the lower jaw
  82. 82. Reptiles  Homodont & polyphyodont  Tend to be tricuspid or cone shaped  Egg teeth – in embryos of lizards & snakes - used to break the shell
  83. 83. Dentition of mammals  Heterodont ( 4 types )  Restricted to 2 rows  Ability to masticate – improves digestive efficiency for high rate of metabolism
  84. 84. Other features  TMJ articulation  Salivary glands  Prismatic enamel  Diphyodonty  Secondary palate  Significant muscle development
  85. 85. Dentition of protheria  Spiny ant eater – edentulous  Duck bulled platypus – 3 functional posterior teeth in each jaw quadrant  A No. additional teeth develop but do not erupt or resorb
  86. 86. Metatheria  An unusual feature – only last premolar will have a successor  Anteriorly many teeth are present but not functional  Morphology is same with placental animals  Dental formula – 3/3, 0/0, 1/1, 4/4
  87. 87. Eutheria  Insectivoral Ex; hedge hog  Molars – primitive trabacular form with sharp, high cusps which interdigitate with those of the opposite jaw  Suitable for crushing the shells of insects
  88. 88. Rodentia Ex; rat  Heterogenous  Continuously growing incisors  DF 1/1, 0/0. 0/0, 3/3
  89. 89. Carnivora  Enlarged canines – offensive weapons  More prominent specialisations are in cat family
  90. 90. Primates Prosimian Ex; lemur Herbivorous & insectivorous DF – 2/2, 1/1, 3/3, 3/3 Lower incisors & canines are prominent mid line diastema
  91. 91. Anthropoidea  Macaca monkey  DF – 2/2, 1/1, 2/2, 3/3  Canines are long & prominent ( esp. in male )  Lateral diastema
  92. 92. Differences between apes & man Apes man  ‘U’ shaped arches parabolic  Edge to edge overlap of upper & incisor relation lower incisors  Male canines are no sexual dimorphism large  Lateral diastema no lateral diastema  Pointed cusps rounded cusps
  93. 93. ANTHROPOSCOPY Anthropos – human Skopein - examine  Judging the body by inspection  Cannot be expressed numerically  Head must be in the rest position – the relationship of paired features will be assessed
  94. 94. Criteria for judgment  examiner’s esthetic perception & experience  Paired features are judged for level, contour & size
  95. 95. Qualitative signs  Head 1.Hairline – distinctive, indistinctive 2.Forehead – unilaterally protruding forehead
  96. 96. Face 1. FACIAL PROFILE – Normal Bird like Dish like
  97. 97. Shape of the face Proportionate Long& short& narrow wide
  98. 98. Shape of the face square triangular trapezoid
  99. 99. Facial mid axis quality In midline concave with dislocated chin
  100. 100. Chin contour Indented flat
  101. 101. ANTHROPOMETRY “It is a systematised art of measuring and taking observations of man, his skeleton, his brain or other organs, by the most reliable means and methods for scientific purposes” -ALES HRDLICKA
  102. 102. Anthropos -human & metron -measure Anthropometry represents the typical and traditional tool of physical anthropology Johann Friedrich Blumenbach (1752-1840) 3 types of head form 1. Square 2. Long 3. Laterally compressed
  103. 103. Broca, Flower, Turner further developed the study of the skulls on the foundations laid by Blumenbach Father of Anthropometry – BROCA Broca’s methods were universal until 1870 In 1874, Ihering pointed out the weaknesses in Broca’s method craniometric conferences were held at Munich(1877) and Berlin(1880)
  104. 104. Kollmann, Ranke, and Virchow prepared a scheme for craniometric techniques. This was presented and approved at the 13th general congress of the German Anthropological Society held at Frankfurt (1882)
  105. 105. SUBDIVISIONS OF ANTHROPOMETRY  SOMATOMETRY -Living body including head and face  Osteometry -Skeletal long and short bones  Craniometry -Skull  Physiometry -Bodily & mental functions
  106. 106. MEASURING TOOLS & TECHNIQUES REQUISITES 1. Should be accurate 2. Not easily distorted 3. Handy or easy to manipulate 4. Easily transportable for field work
  107. 107. sliding caliper - it measures the linear projective distances between 2 land marks in the same plane Ex; eye fissure length,mouth width The standard instruments
  108. 108. 2. Spreading caliper When the projective linear distance has to be determined between distant surfaces and various planes Ex; length of the head & width of the head
  109. 109. Soft metric tape Used for determining the tangential linear distances taken along the skin surface between 2 land marks Ex; maxillary & mandibular arcs of the face
  110. 110. Large double sliding calipers with levels –used when measuring projective distances involving the vertex and the opisthocranion land marks of the head
  111. 111. Measuring tools with various modifications  Nose deviation protractor  Nostril inclination protractor  Nasal root and alar- slope angle meter
  112. 112. Multipurpose facial angle meter  Pointed portion –measuring nasofrontal,nasolabial, mentolabial angles  Small & large forked portions – determining the nasal tip & mentocervical angles
  113. 113. Commercial angle meter
  114. 114. Selection of subjects Selection will be on the basis of  Blood – 1.between individuals of same race 2. Between individuals of different race  Normalcy – pathologic conditions & anomalies alter the size, shape, & other characters ( rachtis, pagets disease, & clefts )  Age & sex
  115. 115.  Age – 1. Eruption of teeth 2. Union of epiphysis 3. Condition of teeth 4. Condition of cranial structures - sutures 5. General condition of the weight of the bones
  116. 116. Positioning the subject Subjects to be seated in the dental chair with the head resting on the head support Head of the examiner must be level with the head of the subject Standard orientation of the head –FH plane  Projective measurements
  117. 117. FACIAL MID LINE 3 anatomic points  The nasion ( root of the nose )  The subnasale (base of the columella )  The gnathion / menton (lower edge of the mandible
  118. 118. Land marks ‘Certain anatomic points used to take body measurements’ Short abbreviations used instead of full names ( small letters ) ex; nasion – n Land marks may have similar name but differ in location Ex; porion To avoid errors – they should be marked on the skin
  119. 119. Head  Vertex – highest point of the head  Glabella – most prominent midline point between eyebrows  Opisthocranion – most posterior point of the line of greatest head length  Eurion – the most prominent lateral point on each side of the skull
  120. 120. Land marks
  121. 121. Measurements of head region HORIZONTAL HEAD POSITION 1. Width of the head – eu to eu 2. Width of the forehead - ft to ft 3. Skull base width - t to t
  122. 122. Perpendicular head position 1. Height of the culvarium – v-tr 2. Anterior height of the head v-n 3. Specific height of the head – v-en 4. Height of the head & nose – v to sn 5. Combined height of the head & face – v to gn
  123. 123.  Length of the head g to op  Circumference of the head
  124. 124. Face  Width of the face zy to zy  Width of the mandible go to go
  125. 125.  Height of the upper profile – tr to prn  Height of the lower profile – prn to gn  Lower half of the cranio- facial height – en to gn
  126. 126. Facial arc measurements  Supra-orbital arc  Maxillary arc  Mandibular arc
  127. 127.  Height of the mandibular ramus – go to cdl  Depth of the body go to gn
  128. 128. Depth measurements of the face 1. Tragion-glabellar depth 2. Tragion-nasion depth 3. Tragion-subnasaledepth 4. Tragion-gnathion depth
  129. 129. Nose  Nasofrontal angle Angle between the proximal nasal bridge contour and the anterior surface of the forehead below the glabella
  130. 130.  Nasal tip angle Angle between columella & nasal bridge
  131. 131.  Naso labial angle ( septolabial angle or columella labial angle) Angle between columella & upper lip skin
  132. 132. Lips & mouth  Width of the mouth ( inter commisural distance ) ch to ch
  133. 133.  Upper lip height Sn to sto  Height of the skin portion of the upper lip sn to ls  Height of the skin portion of the lower lip li to sl  Lower lip height - sto to sl
  134. 134.  Vermilion height of the upper lip ls to sto  Vermilion height of the lower lip sto to li
  135. 135.  Labio mental angle – between skin surface of the lower lip and the surface contour of the chin
  136. 136. Sources of errors in anthropometry & anthroposcopy Commonest sources of error:  Improper identification of landmarks  Inadequate use of measuring equipment  Improper measuring technique
  137. 137. anthropometry Improper identification of land marks: Soft tissue land marks – easy to locate in a healthy person’ face & difficult in a deformed face Bony land marks – palpation easy to locate – orbitale difficult to locate – gonion In congenitally deformed faces – reference to adjacent structures
  138. 138. Head  Vertex – depends upon the FH plane  Eurion – difficult to locate on irregular surface  Glabella – replaced by a point in the mid axis of the face at the level of the upper ridge of the eyebrows  Trichion – difficult to locate in early childhood, & at the first stages of baldness
  139. 139. Face  Zygion – difficult to locate in 1st & 2nd brachial arch syndromes  Gonion – difficult if they are covered with thick skin & hypo plastic mandible  Pogonion – difficult in receding chin & ‘falso pogonion protrusion’  Gnathion – markedly receding lower jaw
  140. 140. Nose  Nasion – difficult after injuries, noses with silastic implants, deep naso-frontal angle  Subnasale – at the bottom of the curve of the curve but difficult to locate in sharp angle  Pronasale – best viewed from profile difficult in bifid nose with uneven tip heights
  141. 141. Lips & mouth  Stomion – mid point of the labial fissure dislocated mouth- philtrum  Labrale superious – position varies after surgery of cleft lip  Chelion – points at right & left commisures of the labial fissure difficult in older patients because of a fine shallow ridge of the skin repeated inspection
  142. 142. Problems with measuring tools  Standard measurements are not used  If they are used improperly  examiner should be familiar with the areas  Accuracy varies with instruments sliding calipers – accurate sliding calipers – up to 3mm error tape –shortens the distance when pressed & should be tightened to eliminate the effect of the hair fabric tape follows the contours of the face
  143. 143. Improper measuring technique  POSITION OF THE HEAD – improper measurements ( especially projective measurements )  Head tends to return to the rest position during examination – must be checked before measurement  50 to 100 of error in inclination  In patients with asymmetric FHs, the difference between two horizontals must be assessed Farkas – left FH is closer to the rest position
  144. 144. FACIAL MID LINE – border between right & left halves Errors can be made in judging the facial asymmetry Nasion is the most stable point The heights will be changed with expressions on the face ( crying, smiling )
  145. 145. Anthroposcopy  Errors result from 1. Incorrect positioning of the patient’s head 2. Wrong angle of view of the examiner’s eyes 3. Poor lighting 4. Poor esthetic assessment & talent
  146. 146. Head Visual judgment of the height of the fore head depends on the 1. Position of the head during inspection 2. Inclination of the fore head 3. Position of the ears Face  Lower face height would appear small in the presence of a receding mandible
  147. 147. Lips & mouth Frontal view – size of the upper lip depends on the naso-labial angle & the position of the skin surface Curved nasolabial angle & protruding skin – short upper lip Vertical upper lip & obtuse angle – longer lip
  148. 148. Nose
  149. 149. Applied anthropometry
  150. 150. Anthropometry in cleft lip & palate patients  Combined orthodontic & surgical treatment  Poor esthetics and nasal deformity ( displacement of the soft tissue elements )  Esthetics – no uniform definition  Goals - Balance & harmony  Accepted standards
  151. 151.  Common technique – visual assessment based on the rating scale - subjective & unreliable  Radiographic cephalometry  Photographs  Physical anthropometry – objective documentation of facial features - determination of need for surgery -comparison of facial features before & after surgery
  152. 152.  Morphological study of growth patterns of nasolabial region – Farkas  6 measurements in 1593 north American Caucasians ( 1 to 18 yrs )  Age 1 – highest growth of the cutaneous portion of the upper lip & width of the nose  Age 5 – upper lip reaches adult size  Age 14 to 15 – nose is fully developed
  153. 153. In craniomaxillo- facial surgery “Anthropometry is the objective analysis that replaces subjective judgement”  Mean , standard deviations of key facial measurements at varied ages  Rate of growth of each facial region  Growth completion of each region  Times of maturation
  154. 154.  Diagnosis of dysmorphology  Treatment of syndromic patients  In cosmetic surgery  Reconstructive surgery  Ortyhognathic surgery
  155. 155. In forensic medicine  Identification of missing children age 8 age 18

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