Digital assessment of the relationship between facial and dental midline with various anatomical landmarks of face and oral cavity

Abstract

Abstract:

Introduction And Objectives:Symmetry plays a vital role in the perception of dentofacial aesthetics, and an understanding of the facial midline enhances the overall assessment and planning of dentofacial aesthetics. The central incisors should be positioned coincident with the midline in fixed or removable partial dentures. This study aims to evaluate the relationship between facial and dental midlines with various intraoral and extraoral anatomical landmarks of the face and oral cavity and relationship between maxillary and mandibular dental midline with the help of digital photographs in a dentulous population. Method: Three commonly used anatomical landmarks—the tips of the nasion, nose, and philtrum—were clinically identified in 150 participants. A frontal full-face digital photograph was utilized to analyse the midline based on the aesthetic framework. Deviations of these three landmarks from the facial midline were measured, with the maxillary midline serving as a fourth reference point. The discrepancy between the maxillary and mandibular dental midlines was also assessed. Alginate impressions were taken, and the resulting casts were evaluated under standardized conditions, with the labial frenum and incisive papilla marked for reference. Results And Conclusion:It can be concluded that the maxillary midline did not align with the facial midline and demonstrated a significant degree of deviation in terms of distance. Furthermore, the mandibular and maxillary dental midlines were not in alignment. Of all the facial landmarks examined, the nasion was found to be the closest to the facial midline, whereas the tip of the nose showed the highest degree of deviation. The tip of the philtrum displayed a deviation like that of the maxillary midline, making it a useful reference point for establishing the maxillary dental midline during prosthodontic treatment of missing anterior teeth. The labial frenum showed less deviation from the dental midline compared to the incisive papilla.