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Osseous and integuemental cephalometric study of the Puerto Rican ethnic group utilizing public opinion in the concept of esthetics

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Osseous and integuemental cephalometric study of the Puerto Rican ethnic group utilizing public opinion in the concept of esthetics

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Content OSSEOUS AND INTEGUEMENTAL CEPHALOMETRIC
STUDY OF THE PUERTO RICAN ETHNIC GROUP
UTILIZING PUBLIC OPINION IN THE
CONCEPT OF ESTHETICS
BY
JAZMIN E. OLIVA
A thesis presented to the
FACULTY OF THE SCHOOL OF DENTISTRY
DEPARTMENT OF ORTHODONTICS
UNIVERSITY OF SOUTHERN CALIFORNIA
In partial fulfillment of the requirements
for the certificate in the specialty of orthodontics
June 1983

UNIVERSITY OF SOUTHERN CALIFORNIA
SCHOOL OF DENTISTRY
This thesis, written by
Jazmm E. Oliva Lebron, D.M.D.
under the direction of her Thesis Committee, and approved by all its
members, has been presented to and accepted by the Director of
Advanced Dental Education, in partial fulfillment of the require
ments for Certificate of Study for Advanced Dental Education.
Director
Date ZTXA/HC'. .(f. . . ?.3
THESIS COMMITTEE

TABLE OF CONTENTS
PAGE
ACKNOWLEDGMENTS ii
LIST OF ILLUSTRATIONS 111
LIST OF TABLES iv
CHAPTER
I. INTRODUCTION 1
II . STATEMENT OF THE PROBLEM. . 4
III . REVIEW OF THE LITERATURE. . 5
IV. METHODS AND MATERIALS 24
V. FINDINGS 57
VI. DISCUSSION 79
VII. SUMMARY AND CONCLUSION 83
VIII. APPENDICES 86
IX. BIBLIOGRAPHY 113

ACKNOWLEDGMENTS
The author hereby expresses her appreciation to
Dr. Harry L. Dougherty and Dr. Julian Singer for their
guidance and advice. Dr. John Kishibay and Dr. Sakae
Tanaka furnished useful advice and help during the
investigation and their effort is deeply appreciated.
Special gratitude is extended to Dr. Eusebio Diaz
for his inspiration, encouragement and assistance in the
data collection.
Thanks are given to Mr. Carlos Reyes for his
cooperation in computing the data.
Finally, indebtedness is expressed to my husband
Julio, my parents Eulogio and Carmen Oliva and my
brother Carlos for their encouragement, support and
understanding.
ii

LIST OF ILLUSTRATIONS
Page
Figure
1. Skeletal Landmarks 28
2. Soft Tissue Landmarks 30
3. Orientation Planes. . 33
Steiner Analysis
Tweed Analysis
Neger Analysis
Peck and Peck Analysis
Peck and Peck Analysis
Peck and Peck Analysis
Subtelny Analysis
Burstone Analysis
Burstone Analysis
Ricketts Analysis
Holdaway Analysis
Part of University of Connecticut Soft
Tissue Analysis
Part of University of Connecticut Soft
Tissue Analysis
Part of University of Connecticut Soft
Tissue Analysis
Scattergram, Bivariate Correlation
Between the Puerto Rican Young Sample
Group and the Caucasian Samples for the
Tweed, Peck and Peck, Holdaway, and the
Subtelny Analyses
4. 34
5. 37
6. 39
7. 40
8. 41
9. 42
10. 44
11. 45
12. 48
13. 51
14. 52
15.
53
16.
54
17.
56
18.
78
iii

LIST OF TABLES
Page
Steiner Cephalometric Analysis for the
Puerto Rican Young Adult Sample Group . .
Tweed Analysis for the Puerto Rican
Young Adult Sample Group
1.
65
2.
66
Neger Soft Tissue Analysis for the
Puerto Rican Young Adult Sample Group . .
3.
66
Peck and Peck Profilometric Analysis
for the Puerto Rican Young Adult Sample
Group
4.
66
Burstone Extension Analysis for the
Puerto Rican Young Adult Sample Group . .
5.
67
University of Connecticut Soft Tissue
Analysis for the Puerto Rican Young Adult
Sample Group
Holdaway H Angle Analysis for the Puerto
Rican Young Adult Sample Group
Ricketts E Line Analysis for the Puerto
Rican Young Adult Sample Group
Subtelny Profile Convexity Analysis for
the Puerto Rican Sample Group
Comparison of Puerto Rican Male and
Female with T-Test by Steiner Analysis. .
Comparison of Puerto Rican Male and
Female with T-Test by Tweed Analysis. . .
Comparison of Puerto Rican Male and
Female with T-Test by Neger Analysis. . .
Comparison of Male and Female with
T-Test by Peck and Peck Analysis
Comparison of Puerto Rican Male and
Female with T-Test by Burstone Analysis. .
Comparison of Puerto Rican Male and Female
with T-Test by University of Connecticut
Soft Tissue Analysis
6.
67
7.
68
8.
68
9.
68
10.
69
11.
69
12.
70
13.
70
14.
71
15.
71
IV

LIST OF TABLES
(Continued)
Page
Comparison of Puerto Rican Male and Female
with T-Test by Holdaway H Angle Analysis .
Comparison of Puerto Rican Male and Female
with T-Test by Ricketts E Line Analysis. .
Comparison of Puerto Rican Male and Female
with T-Test by Subtelny Profile Convexity
Analysis
Comparison of the Puerto Rican Young
Adult Sample Group with the Caucasian
Means by Steiner and Alabama Analyses. . .
Comparison of the Puerto Rican Young
Adult Sample Group with the Caucasian
Means for the Tweed Analysis ^
Comparison of the Puerto Rican Young Adult
Sample Group with the Caucasian Means for
the Neger Soft Tissue Analysis
Comparison of the Puerto Rican Young Adult
Sample Group with the European Means for
the Peck and Peck Profilometric Facial
Analysis
16.
72
17.
72
18.
72
19.
73
20.
74
21.
74
22.
74
Comparison of the Puerto Rican Male
Sample Group with the Caucasian Male Means
for the Burstone Integumental Extension
Analysis
23.
75
Comparison of the Puerto Rican Female
Sample Group with the Caucasian Female
Means for the Burstone Integumental
Extension Analysis
24.
76
Comparison of the Puerto Rican Young Adult
Sample Group with the Caucasian Mean for
the Holdaway H Angle Analysis
Comparison of the Puerto Rican Male Sample
Group with the Caucasian Male Means for
the Subtelny Profile Convexity Analysis .
25.
77
26.
77
V

Page
Comparison of the Puerto Rican Female
Sample Group with the Caucasian Female
Means for the Subtelny Profile Convexity
Analysis
Raw Data for Puerto Rican Female Young
Adult Sample Group
27.
77
28.
96
Raw Data for Puerto Rican Male Young
Adult Sample Group
29.
99
vi

1
INTRODUCTION
In the past many authors have searched for defini
tion, lines and values which could be used as guidelines
to orthodontists depicting the stable occlusion and
desired or accepted face (Downs (1948), Steiner (1953),
Riedel (1957), Neger (1959), Subtelny (1959), Altemus
(1963), Merrifield (1966) and Peck and Peck (1970).
Perhaps the first attempt to obtain esthetic idealism was
made by the Egyptians, Greek and Romans through paint
ings, scultures and drawings. Since then, many
approaches have been used to develop the concept of
esthetics (Riedel, 1957; Burstone, 1958; Peck and Peck,
1970).
Orthodontists have recognized that occlusion and
facial esthetics are interdependent and must simul
taneously be considered in the goals of treatment (Downs,
1948; Steiner, 1953, 1959; Tweed, 1954).
Edward H. Angle was one of the first to write about
facial harmony, emphasizing the importance of soft
Tweed (1954) contemplated esthetics as a
satisfactory face with a stable denture with uncrowded,
upright incisors. Downs standards (1948) were based on
tissue.

2
a study of variations in facial relationships on a group
of persons with clinically excellent occlusions. Downs
utilized lateral headfilms in the study. Other standards
from lateral headfilms were drawn by Margolis (1943) and
Stoner and Lindquist (1944), both based on the lower
incisor's axial inclination.
Burstone (1958) studied the integumental profile,
stressing the importance of the lower face in considering
facial beauty and harmony. He also found that the soft
tissue may vary in thickness, length, and postural tone
in individuals, emphasizing the direct measurement of the
integument in each case.
Wylie (1950) made reference to popular faces in
fashion magazines. Hollywood stars were selected for
certain outstanding characteristics, many having nothing
to do with facial esthetics. In few instances have
American orthodontists considered public opinion in the
judgment of faces considered as being esthetic,
and Peck and Peck (1970) used public opinion as
Riedel
(1957),
the criteria for the selection of their sample of
subjects. The subjects had been previously acclaimed in
some manner by a segment of the general population as
beautiful.
From studies performed in the past (Garcia, 1975;
Uesasto, 1978; Hajighadimi, 1979; Kwon, 1981) it was
inferred that no standards have been determined to be of

3
universal application,
importance to investigate facial esthetics for specific
For this reason it was of
ethnic groups. In very few cases have soft tissue and
osseous structure been considered to attain a compre
hensive view of the osseous integumental esthetic face
commplex.
Facial integumentum, dental and skeletal patterns
vary between races and on individual bases. A well
planned cephalometric analysis aimed to relate the
osseous and integumental tissues is of great importance
to aid as a guide in diagnosis and treatment planning in
Caucasians and other ethnic groups. Never before had an
osseous and integumental cephalometric study been
reported on the Puerto Rican ethnic group utilizing
public opinion in the concept of esthetics.

4
STATEMENT OF THE PROBLEM
The study was limited to an analysis of the osseous
integumental face complex for the Puerto Rican ethnic
group utilizing the general piiblic opinion in the
assessment of a concept of esthetics. The investigation
consisted of a review of the pertinent literature and a
cephalometric study of Puerto Rican young adults using
various cephalometric analyses.

5
REVIEW OF THE LITERATURE
Puerto Rican Ethnic Background
According to J.L. Vivas Maldonado, as expressed in
Historia de Puerto Rico (1974), three great groups of
natives settled in the islands of the Caribbean Sea. In
chronological order they were the Arcaicos, Araucos and
the Caribes. The historians believed that the first
settlers to arrive to the Caribbean (Arcaicos) were from
North America around 40 B.C. The second great group that
invaded the Caribbean (Araucos) were from South America,
from the vast region of the Orinoco.
The first cultural phase, brought by the
This took place
around 370 B.C.
Araucos was known as the Igneri. It was believed that
the first encounter between the Arcaicos and the Araucos
occurred in the Virgin Islands region and Puerto Rico.
Between the VII and IX century B.C., the Pretaino cul
tural phase developed. The third cultural phase was the
Taino (Taino means good or nice in the Indian language).
The Taino period, which developed around the XIII century
was mainly centered in Puerto Rico, Espahola and the
eastern part of Cuba. The third great group to invade
the Caribbean were the Caribes. These natives came from

6
South America from the Orinoco Lake region around 1400
The Caribes liked to leave their hair long, tied at
the back of their necks and were known to place ties at
their ankles and knees to develop their calves.
As stated in Puerto Rico, A Profile, by Kal WagenB.C.
heim (1975), the Tainos from Boriquen (Puerto Rico) were
copper-colored, medium statured, with thick, straight
dark hair. The cranium was almost round and faces were
long. Since the Tainos considered a back sloping fore
head a sign of beauty, they deformed the crania of their
children with tightly wrapped cottons, similar to the
Mayas. Their eyes were dark, large and slightly oblique.
The mandibles, cheekbones, and superciliary arches were
pronounced. The Tainos possessed great agility and were
experts in the use of their hands.
On the twenty-fifth of September 1493 Christopher
Columbus departed from Cadiz on his second trip where he
was to discover the new world (Kal Wagenheim, 1975). It
was on the ninteenth of November of 1493 that Boriquen
was discovered which was then named San Juan Bautista.
In 1508 Juan Ponce de Leon was granted permission to
explore the island of San Juan Bautista. The Spanish
colonization concentrated in the Caribbean, Central, and
South America, for these were lands rich in gold, silver
and precious stones. At the time of colonization there
were, in Boriquen, between 70 and 100 thousand natives.

7
By the XVI century there was an almost total extinction
The illnesses brought by the
The hard work in the
of the Taino natives.
whites were fatal to the natives.
mines (forced by the Spaniards), the killing by the
Spanish, and the attacks by the Caribes all contributed
By 1509, the first
Negro slaves were introduced to Boriquen by the Spanish.
The Negro slaves were natives of Africa. The adaptation
of the Africans to the climate and work demand was excelto the Taino natives extinction.
lent. By 1513 the importation of African slaves was a
very profitable business.
As stated on the Ponturario Historico de Puerto
Rico, by Thomas Blanco (1973), out of eighteen aggres
sions that Puerto Rico suffered at the hands of the
French, English, and Dutch, eight of these occurred
between 1595 and 1703. An increase in population brought
about the foundation of thirty towns throughout the 18th
century. Immigration was the result of many reasons,
some of which were: 1. An increase in number of guards
and their numerous marriages with the mulatas (daughter
product of a white and a black marriage) 2. The import of
confined and exiled men 3. The arrival of fugitive
foreign slaves who were given liberty in Puerto Rico
4. The relocation of families from the Canary Islands
(Spanish territory) 5. Deserters and passengers of the
Spanish fleet arriving once a year. The immigrants were

8
attracted by the abundance of food, humanity, and hospi
tality found in the island of Puerto Rico,
fleet, more than one thousand Spanish remained in Puerto
The Catholic foreigners, experts in the processing
of sugar, the French refugee from the Haitian revolution,
and Dominican natives of the Dominican Republic who
In the 1772
Rico.
preferred to live in Puerto Rico rather than under the
French government, all formed part of the immigrants to
The interior of the island was no longer a
The mingling of racial types and modifi
cations imposed by the climate brought about various
Criollo types (sons and daughters of Europeans born in
The increase in number of
Puerto Rico.
virgin forest.
other parts of the world),
inhabitants and the adaptation to conditions in Puerto
Rico led to typical characteristics of the Criollos.
On the eighteenth of October of 1898 Spain rendered
Puerto Rico to the United States of America, ending four
hundred and five years of Spanish domain in Puerto Rico
(Tomas Blanco, 1973). One more element was brought to
the ethnic background of Puerto Ricans, the North
Americans. The political relations that emerged between
both countries allowed constant flow of North Americans
to Puerto Rico and vise versa. As proven by history,
there was great heterogeneousness in the ancestry of
There was great variance in the
phenotypes of the native islanders of Puerto Rico and
Puerto Ricans.

9
contributed to the "type" present on the Island today.
Cephalometries
The cephalometer was an important contribution to
the science of orthodontics, especially in the study of
growth and development. Broadbent (1931), described and
utilized the cephalometric x-ray technique. The cephalo
metric technique made possible the visualization of the
relationship between observable facial characteristics
and the underlying osseous structures.
Downs (1948) presented a study of variations in
facial relationships. The sample consisted of twenty
individuals from ages twelve to seventeen and about
equally divided as to sex.
cephalometric and intraoral roentgenograms were taken of
All individuals possessed clinically
excellent occlusions according to Downs. Two objectives
Models, photographs,
each person.
were pursued throughout the study: 1. To study the
pattern of facial skeleton exclusive of the nose 2. To
evaluate the relationship of the teeth and alveolar
process to the facial skeleton. The study presented
means for osseous tissue measurements restricted to
Caucasians. Downs stated that facial differences were
seen on a racial basis.
Steiner (1953, 1959) reported cephalometric norms
for Caucasians. He described seventeen different linear

10
and angular measurements to analyze the craniofacialdental complex. According to Uesatao (1970), Steiner
began with the twenty-five ideal cases selected at the
University of Illinois used by Downs (1948). Then
Steiner considered eighteen cases that had been selected
at the University of Washington. Subsequently, he
selected from his practice several cases that he felt met
most of the qualifications for which he was searching.
Among these was one case he believed met the desirable
qualities of the group of patients, It was from this
single case that evolved the norms of the Steiner
analysis for the Caucasian.
Chang (1964) conducted a cephalometric investigation
of thirty-two American Japanese and twenty-one American
Chinese. The mean age was 14 years 10.5 months. Sub
jects were selected on the basis of excellence of occlu
sion and normal facial esthetics. Downs (1948) and
Steiner (1953, 1959) cephalometric analyses were utilized
in the study. A comparison was made of the means of both
oriental samples to the mean figures of the Downs and
Steiner analyses. The oriental samples were found to
have a retrognathic, convex profile with a much longer
face in relationship to the Caucasian norms. The
dentures were placed anteriorly, in relationship to the
skeletal structures, with pronounced labial version of
the maxillary and mandibular incisor teeth. The oriental

11
prognathic profile resembled that of a Caucasian double
protrusion and represented a normal balanced face for the
American-Japanese and American-Chinese.
Drummond (1968) analyzed forty American Negro
children at the Department of Orthodontics of Baylor
University in Dallas, Texas, to determine a mean and
range of normalcy using lateral cephalometric radio
graphs. Clinically acceptable occlusions and Angle Class
I molar relationships were used as criteria for selection
of the sample. Age range was eight to twenty-three
years. Tweed (1949) and the Alabama (1966) analyses were
performed to evaluate the Negro sample and compare it to
the Caucasian race. The results of the study demons
trated a marked tendency towards bimaxillary protrusion.
a steep mandibular plane and an anterior placement of the
maxilla in the American Negro population. Both the upper
and lower incisors were considerably more procumbent in
the Negro sample group.
Garcia (1975) studied fifty-nine Mexican Americans
(twenty-five girls and thrity-four boys) residing in the
East Los Angeles area. The sample was chosen based on
excellence of occlusion. Downs (1948), Steiner (1953,
1959), and Alabama (1966) analyses were performed. Norms
were established for the Mexican American sample and then
compared to the Caucasian norms of the Downs and Steiner
analyses. Skeletally, the Mexican American sample was

12
more protrusive than the Caucasian sample,
incisor of the Mexican American sample was more labially
inclined and the upper incisor more procumbent than that
of the Caucasian sample.
The lower
Uesato et al (1978) studied the post treatment
lateral cephalograms of twenty-five boys and twenty-five
girls with an average age of fourteen years. The sample
was taken from the orthodontic files of Osaka Dental
University in Japan and the private office of the author
in Hawaii. The criteria used for the selection of the
sample was acceptable occlusion, incisor relationships
and balanced facial profiles. Balanced profile was
defined as a harmonious relationship between the nose.
lips, and chin. For the selection of cases with balanced
profiles Steiner "S" (soft tissue) line and Ricketts "E"
(esthetic) lines were used. The "S" line was defined as
a line drawn tangent to the chin and through a point
midway on the lower border of the nose. The "E" line was
described as a line tangent to the chin and to the tip of
the nose. Cases where the lips protruded beyond the "E”
lines or fell behind the "S" line were rejected from the
study. The Steiner (1953, 1959) cephalometric analysis
was performed on the Japanese and Japanese-American
sample, and the mean values were compared to the Steiner
reported norms. From the fifty cases studied, one was
selected by Uesato et al as possessing the best desirable

13
qualities of the sample group, The reported values for
the ideal case were very close to the mean values of the
The ANB angle of three degrees in the
Japanese and the Japanese-American .skeletal pattern
suggested a more class II pattern than was true in the
The relationship of the mandibular
central incisor to line NB for the Japanese and
total group.
Caucasian norm.
Japanese-American groups was found to be more procumbent
than that of the Caucasian race.
Hajighadimi (1979) investigated the craniofacial
characteristics of Iranian children. Cephalometric norms
using Tweed (1949) and Steiner (1953, 1959) angular and
linear measurements were determined for Iranian children.
The sample consisted of sixty-seven Iranian girls and
boys (thirty-five girls and thirty-two boys). The sample
selection was based on normal Class I occlusion. The
average age of the sample was 12.5 years of age. A
comparison was made between the means of the Iranian
racial group and Tweed and Steiner reference norms. The
skeletal pattern of the Iranian ethnic group was flatter
as compared to those of American descent. The dental
pattern of the Iranian sample was more procumbent than
that presented by Tweed and Steiner,
plane angle and occlusal plane angle was higher in the
A longer facial height and a more
The mandibular
Iranian racial group,
convex face was found to characterize the Iranian ethnic

14
group.
Kwon (1981) formulated cephalometric norms for the
dentofacial pattern of the Korean child. The sample
consisted of fifty-one Korean children (twenty-nine boys
and twenty-two girls). The criteria used for the selec
tion of the sample was Class I molar and canine occlu
sion. The average age of the sample was fourteen years
of age. Downs (1948), Tweed (1949), Steiner (1953,
1959), and Sassouni (1955) analyses were used in the
study. A comparison was made between the means of the
%
Korean children and the Downs, Tweed, Steiner, and
Sassouni reference norms. Korean children had more
convex faces than Caucasians. Dentally, Korean children
had more protruded upper and lower incisors than Cauca
sians. Skeletally, the Korean child had a more protruded
maxilla, less chin, and steeper mandibular plane.
Gonzalez Ulloa (1982) presented a method that
facilitated the analysis of faces and helped in the
comparison of the different segments as to proportion.
The traditional Frankfort horizontal plane and a per
pendicular to it passing through nasion were used in the
analysis . Hundreds of beautiful faces from famous paintings and sculptures from various museums throughout the
world were studied. The result of the analysis demonstrated that in most of the faces, the central part of the
forehead, the root of the nose, the lips and pogonion.

15
all fell on the perpendicular to Frankfort horizontal
passing through nasion. ,From a mid-sagittal view, the
faces were divided in three parts: 1. The upper third -
defined from the hairline to the superior border of the
orbit 2. The middle third - from the superior border of
the orbit to the nasiolabial angle 3. The inferior
third - from the nasiolabial angle to the inferior border
of the chin. In the most beautiful faces, all three
segments were equal. Gonzalez Ulloa felt that there was
no definition of a universal concept of beauty,
beautiful faces all possessed a coherent and harmonious
sense of a whole and integrity between the different
but
segments.
Esthetics
Tweed (1954) presented a paper on the FMIA angle
demonstrating how cephalometries could be applied in
diagnosis and treamtnet planning for the every-day
clinical orthodontist. The sample comprised forty-five
subjects chosen by Tweed as having balanced, pleasing,
facial outlines. No attempt was made to examine the
malocclusion if one existed. Photographs and head plates
of each of the forty-five individuals were taken. The
Frankfort Horizontal Plane was constructed by drawing a
line from 4.5mm above the geometric center of the earholes to the left infraorbital rim. The incisor-

16
mandibular plane angle (IMPA) was constructed by drawing
a line through the apex and the incisal edge of the lower
central incisor, extending it to intercept the Frankfort
and Mandibular planes, The reported means for FMA, IMPA,
and FMIA on the individuals depicted as having proporesthetic faces were twenty-five degrees for FMA,
ninety degrees for IMPA and sixty-five degrees for FMIA.
No attempt was made to relate the maxilla or maxillary
teeth to the cranium.
tional,
Riedel (1957) studied thirty Seattle Seafair
princesses and their queen. Oriented, lateral headfilms
were taken of each of the girls in the Broadbent-Bolton
cephalometer. Tracings were made from the lateral headfilm with the teeth in occlusion. Various skeletal, and
denture angular and linear measurements were recorded.
The arithmetic means were derived for each measurement
and were compared to standards established by other
investigators on basis of normal occlusion (Downs, 1978;
The skeletal patterns of the sample were
very similar to those recorded in previous studies of
The dental pattern of the group
indicated relatively greater axial inclination of the
mandibular incisor, relatively normal overall protrusion,
and a lesser than average inclination of the maxillary
incisors when compared to previous studies.
Steiner, 1953).
normal occlusions.

17
Burstone (1958) concluded that the soft tissue
veneer was of great importance in case analyses due to
the influence of soft tissue upon facial form and
esthetics, and the stability of the anterior dental
segment (muscle balance), Two sample groups, which
possessed good or excellent facial profiles, were
selected from a group of photographs by a panel of
artists and housewives. The criteria for sample
selection were age, race (Caucasian), and facial form.
In the younger age sample, the mean age was 14.7 years.
The adult group had a mean age of 23.8 years, The sample
consisted of thirty-seven subjects for the adolescent
group and forty for the adult group. The method of study
was the lateral headplate, using the Broadbent (1931)
technique.
extension of integumental landmarks from adjacent
A method which measured the amount of
skeletal points relative to one common plane was used.
The common plane of reference for the horizontal
extension measurements was the nasal floor. For vertical
extension measurements, a perpendicular to the nasal
floor was utilized. The nasal floor was defined by a
line connecting the anterior and posterior nasal spines.
Seven horizontal and three vertical extension readings
were described. Means, standard deviations, and standard
errors of the mean were reported for the sample as to age
and sex. Sex differences were noted in integumental

18
extension. Areas inferior to the nose in the male
generally had greater horizontal extension of the soft
tissue than the females.
Neger (1959) introduced a method for the evaluation
of the soft tissue profile in a quantitative manner.
Profile photographs or cephalometric radiographs were
Six profile angles were selected as being
Angular
utilized.
significant in the soft tissue profile,
relationships were established between the upper lip, the
lower lip, and the chin. A group of persons with excel
lent occlusion and acceptable facial form and other
groups of various malocclusions were evaluated using the
Neger found that a straight
profile did not necessarily accompany normal occlusion
and that one could not rely entirely on dentoskelatal
analysis for accurate information on the facial soft
tissue and the changes throughout orthodontic treatment.
Subtelny (1959) reported an attempt to determine
soft tissue analysis.
whether soft tissue profile was related to the underlying
skeletal profile, It was also his purpose to define the
soft tissue profile development on a longitudinal basis.
Serial cephalometric radiographs taken on thirty sub
jects, ages three months to eighteen years of age, were
The results of the study indicated
that all parts of the soft tissue profile did not
directly follow the underlying skeletal profile.
traced and studied.
The

19
integumental chin tended to be closely related to the
degree of prognathism of the underlying skeletal frameLip posture was closely related to underlying
From the analysis, the soft tissue profile,
excluding the nose, showed a tendency to remain relaConvexity soft tissue
work.
structures.
tively stable as to convexity,
changes were not analogous to those manifested by
skeletal profile.
Altemus (1963) studied the soft tissue profiles of
two groups of North American children, One group consisted of thirty-seven Caucasians thirteen to fifteen
years old and the other group consisted of fifty Negros,
ages twelve to sixteen years old. The Caucasian and
Negro subjects had acceptable facial form and normal
occlusions. Lateral headfilms were taken of each of the
subjects. Osseous and integumental tissues were care
fully traced. Measurements from soft tissue to adjacent
hard tissue points using a common plane of reference were
made. The plane of reference in the horizontal plane was
the nasal floor, described as a line passing through the
anterior and posterior nasal spines, A perpendicular to
the nasal floor was used as a reference plane for the
vertical measurements. Ten integumental extension
measurements were recorded for the Caucasian and Negro
One of the major areas of dissimlarity between
The lips and
samples.
the two groups was in the oral region.

20
teeth were more protrusive in the Negro sample. Graphic
means demonstrated individual variability in the soft
tissue covering of the face.
Hambleton (1964) suggested that orthodontists had a
goal of creating a functional occlusion and an obligation
to produce a harmonious soft tissue profile. He believed
that the orthodontic analysis of a patient should include
. soft tissue as well as a dentoskeletal diagnosis,
the functional requirements of treatment of the denture
Once
were accomplished, consideration was given to the esthe
tics of the teeth, face and what the public considered
beautiful. A review of art throughout history revealed a
constantly changing concept of facial beauty. Hambleton
stressed the importance of knowing what changes occurred
to the soft tissue with or without treatment and what an
orthodontist could accomplish throughout treatment. The
greatest influence on soft tissue was in the area of
lips, which played an important part in the harmony of
the face. Hambleton felt that the changes accomplished
by the orthodontist throughout treatment should be
harmonized with the many variations that would have taken
place regardless of orthodontic treatment in order to
gain a desirable end result.
Merrifield (1966) analyzed one hundred and twenty
individuals from his and Tweed's files. Eighty of the
subjects had received orthodontic treatment, the

21
remaining forty had not been treated orthodontically and
were considered normals by Merrifield.
were taken and traced by standard procedures. ;
tissue profile and osseous structures were traced,
profile line was regarded as the line of reference and
was established by drawing a line tangent to the soft
tissue chin and the most anterior point of either the
Lateral headfilms
Soft
The
lower or upper lip, whichever was more protruding, and
extending it upward to the Frankfort Horizontal plane.
The angle thus formed was used to describe the relationship of the lower face. It was termed the Z angle.
The reported mean for the Z angle was 81.4 degrees with a
range of 71 to 89 degrees, In the ten most pleasing
subjects, judged by Merrifield on basis of soft tissue
contours, balance and pleasing esthetics, the upper lip
was found to be tangent to the profile line and the lower
lip tangent or slightly behind it.
Ricketts (1968) described the esthetic plane as a
reference line to relate the mouth to adjacent strucThe esthetic plane was constructed as a straight
line from the tip of the nose to the most prominent point
Ricketts reported
tures.
of the chin in a mid-sagittal plane.
that the lips in Caucasian adults were contained within
the esthetic plane, and the lower lip was closer to the
plane than the upper lip. In treatment of patients
completed between twelve to fourteen years of age. the

22
mean relation of lower lip to the esthetic plane was -2mm
±3mm. The lower lip position for adults relative to the
esthetic plane was found to be -4mm ±3mm.
Peck and Peck (1970), presented a paper on concepts
of facial esthetics. It was pointed out that the ulti
mate judge of esthetic values should have been the
public, not the orthodontists. It was stated that the
public shared a common basis for esthetic judgment
regardless of nationality, age, sex or occupation. Peck
and Peck reported a study based on public opinion. The
studied sample consisted of fifty-two subjects of various
nationalities. Each subject had been previously acclaimed
in some manner by a segment of the general population as
possessing beautiful faces. Frontal and lateral photo
graphs and cephalometric radiographs were taken of each
subject. According to Peck and Peck, the sample means
almost always favored a full, protrusive dentofacial
pattern compared to Steiner (1953, 1959) norms. The mean
values for the upper and lower incisors were suggestive
of a forward positioned dentition rather than a forward
inclined dentition. From the photographs, it was deter
mined that facial esthetics could tolerate a detectable
degree of soft tissue assymetry. The Profilometric line
was used as a reference plane and was constructed from
tragion to point P. Point P was the mid-point of the
facial line (Nasion-Pogonion). Seven angular measure-

23
ments were described in the Profilometric analysis,
angles were measured in lateral photographs and related
three profile elements; the lips, nose, and the chin.
Mean values based on the fifty-two beautiful adult sample
The
were established.

24
METHODS AND MATERIALS
The study consisted of one hundred and five Puerto
Rican young adults (fifty males and fifty-five females)
The age range of the subjects
The subjects
residing in Puerto Rico,
was twenty to twenty-five years of age.
were selected at random from the freshman and sophomore
classes of the School of Dentistry, University of Puerto
Rico Medical Sciences campus. Each subject was photo
graphed from a frontal and lateral view. A thirty-five
millimeter camera with a forty foot subject to camera
distance was used.
Forty Puerto Ricans selected at random from various
professions (University professors, models, accountants,
medical doctors, architects, students, engineers, house
wives, etc.) served as judges of the one hundred and five
subjects. Specific standardized instructions were read
out loud by the investigator (Appendix A). Each subject
was ranked by the judges on a scale of one to three. On
a scale of one to three, three was described as "beauti
ful or handsome face," two as an "acceptable face", and
one as a not acceptable face.

25
A sample size statistical analysis was performed
Fourteen individuals (seven males and
seven females) with the highest scores out of the origi
nal one hundred and five subjects were then analyzed
The mean age of the female group was
(a.05, 3-20, $5).
cephalometrically.
23 years with a standard deviation of 1.73 years. The
mean age of the male group was 23.6 years, with a
standard deviation of 1.27 years.
The Broadbent-Bolton cephalostat was employed, The
head of each individual was oriented to the Frankfort
Horizontal plane in centric occlusion with lips slightly
The facial outline and bony structures were
The midline of double contour
together.
traced on acetate paper,
bilateral structures was drawn in order to minimize the
error due to head positioning. Angular and linear
measurements were taken to the nearest 0.5 degree or 0.5
millimeter. Fifty-three different measurements were made
of each subject. Two of the female subjects were under
going orthodontic treatment, therefore the original
malocclusion cephalograms were used for the analyses.
A personal information questionnaire and a consent
form (Appendices B, C) were filled out by each of the
fourteen subjects, In order to obtain information on the
occlusion of the subjects, an oral examination of each
was performed (Appendix B).

26
The analyses utilized were those of Steiner
(Fig. 4), Tweed (Fig. 5), Neger (Fig. 6), Peck and Peck
(Fig. 7, 8, 9), Subtelny (Fig. 10), Burstone (Fig. 11,
12), Ricketts (Fig. 13), Holdaway (Fig. 14), and part of
University of Connecticut's soft tissue analysis (Fig.
15, 16, 17). The landmarks and planes used were those
employed by Steiner, Tweed, Neger, Peck and Peck,
•Subtelny, Burstone, Ricketts, and Holdaway. Steiner had
established "norms," and not arithmetic means, therefore,
the Puerto Rican sample group was compared to the nine
values of the Alabama analysis (1966) found in the
Steiner analysis. The nine values of the Alabama
analysis utilized were: SNA, SNB, ANB, GoGnSn, Occl. to
Sn, Interincisal angle. Upper incisor to Na (angle), and
lower incisor to NB (Angle and mm).
Two sample t tests and Pearson correlation analyses
were performed to evaluate the statistical significance
In cases where the raw data, sample
size, or standard deviation was not reported by the
investigator, a Pearson correlation analysis was utilized
to compare the findings.
The skeletal landmarks used in this study were
of the results.
(Fig. 1):
Sella Turcica (S) - The center of the profile of the
bony cript occupied by the Hypophysis Cerebi.
1.

27
2. Glabella (G) The most prominent point in the
midsagittal plane of the forehead.
Nasion (N) The suture between nasal and frontal
bone, in the midsagittal plane.
Point L - A point representing the most anterior
point of the mandible (chin), registered on the
cranial base plane, and perpendicular to SN.
Point E - A point representing the most posterior
limit of the mandibular condyle, registered on the
cranial base plane, and perpendicular to SN.
Orbitale (0) - The lowermost point on the inferior
3.
4.
5.
6.
bony margin of the orbit.
Porion (P) - The most superior point of the ear rod
registration.
Subspinale (A) - The deepest point of the midline on
the premaxilla close to the upper incisor apices
which could be between the prosthion and anterior
nasal spine.
Supramentale (B) - The deepest point of the midline
on the mandible close to the lower incisor apices.
Gnathion (Gn) - A point on the chin, determined by
bisecting the angle formed by mandibular and facial
planes.
Gonion (Go) - A point on the angle of the mandible,
determined by bisecting the angle formed by the
ramal plane and the mandibular plane.
7.
8.
9.
10.
11.

28
-MiS
-Po
i Gn
Fig. 1
SKELETAL LANDMARKS

29
12. Pogonion (Po) The most anterior point on the
contour of the chin.
13. Menton (Me) - The lowermost point of the mandibular
symphysis.
The mid-point of the sagital section of
the mandibular symphysis.
Anterior Nasal Spine (ANS) - This point was the tip
of the anterior nasal spine seen on the x-ray film
from norma lateralis.
Posterior Nasal Spine (PNS)
terior spine of the palatine bone in the hard
palate.
The tip of the pos14. Point D
15.
16.
The soft tissue landmarks used in this study were
(Fig. 2):
1. Glabella (G' ) The most prominent point in the
midsagittal plane of the forehead.
Nasion (N' ) - The point at the root of the nose in
the region of the fronto-nasal suture at the median
sagittal plane.
Pronasale (Prn)
nose in the median sagittal plane.
Midnasal point (Mn) - The point between nasion and
pronasale in a midsagittal plane.
Subnasale (Sn) - The point at which the nasal septum
between the nostrils merges with the upper cutaneous
The most anterior point of the
2.
3.
4.
5.

30
Sn
--SLS
-LS
s
LI
1 LS
I
Me'
. Fig. 2
SOFT TISSUE LANDMARKS

31
lip in the midsagittal plane.
Superior labial sulcus (SLS) - The point of greatest
concavity in the midline of the upper lip between
subnasale and labiale superius.
Labiale superius (Ls) - The point on the upper lip
lying on the median sagittal plane at the upper
margin of the vermilion border.
Stomion (s) - The juncture in the midline of the
upper and lower lips.
Labiale inferius (Li) - The point on the lower lip
lying on the median sagittal plane at the lower
border of the vermilion border.
10. Inferior labial sulcus (ILS) - The point of greatest
concavity in the midline of the lower lip (between
labiale inferius and pogonion).
11. Pogonion (pg')
point on contour of the chin. In cases where there
was a deficiency without a well defined chin promi
nence, the most anterior point below the mentolabial
sulcus was selected for this landmark.
12. Menton (Me) - The lowest point on the symphyseal
6.
7.
8.
9.
The most prominent and anterior
outline of the chin.
The orientation planes used throughout the study
were (Fig. 3):
1. The Frankfort Horizontal Plane - The horizontal line
running through Orbitale and Porion. The plane had

32
been introduced by Von Ihring in 1872. In 1884, it
accepted by the Anthropological Congress in
Frankfort, and named Frankfort Plane.
The Mandibular Plane - A tangent to the lower border
was
2.
of the mandible.
Cranial base plane - A line from Sella to Nasion.
Profilometric Orientation Plane Constructed from
3.
Porion to point P, the midpoint of the facial line
4.
(NPg).
Nasal Floor Plane - A line connecting the anterior
and posterior nasal spines.
5.
The measuring point and planes used in this study
were:
Steiner Analysis (Fig. 4).
The cranial base plane (SN) - The line from Sella to
A.
1.
Nasion.
The NA plane - The line from Nasion to A point.
The NB plane - The line from Nasion to B point.
The Occlusal plane The line extended from the
2.
3.
mid-point of vertical overbite of the incisors to
4.
the occlusal level of molars.
GoGn plane - The line drawn from Go to Gn.
Angle SNA - The angle formed by SN plane and NA
plane.
5.
6.

33
Cranial Base Plane
Frankfort Horizontal Plane
Profilometric Orientation Plane
Nasal Floor Plane
Mandibular Plane
1.
\
2.
3.
4.
5.
Fig. 3
ORIENTATION PLANES

34
1- SNA, 2- SNB, 3- ANB, 4- SND, 5- U1 to NA (mm
6- U1 to NA (angle), 7- LI to NB (mm), 8- LI to NB (angle),
9- Po to NB (mm), 10- U1 to LI, 11- Occ to SN, 12- GoGn to SN,
13- SL (mm), 14- SE (mm), 15- U Lip to S (mm), 16- L Lip to S (mm).
Fig. 4
STEINER ANLYSIS

35
7. Angle SNB - The angle foinned by SN plane and NB
plane.
8. Angle ANB - The difference between SNA and SNB.
9. Angle SND - The angle formed by SN plane and ND
plane.
10. U1 to NA (angle) - The angle formed by the long axis
of the upper incisor and NA plane.
11. U1 to NA (mm) - The perpendicular distance of the
most anterior point of the upper incisor to NA
plane.
12. LI to NB (angle) - The angle formed by the long axis
of the lower incisor and NB plane.
13. LI to NB (mm) - The perpendicular distance of the
most anterior point of the lower incisor to NB
point.
14. U1 to LI (interincisal angle) - The angle formed by
the long axis of the upper and lower incisors.
15. Po to NB (mm) - The perpendicular distance from Po
to NB plane measured in millimeters.
16. Occlusal plane to SN (angle) - The angle formed by
the occlusal plane and SN plane.
17. GoGn to SN (angle) - The angle formed by GoGn plane
and SN plane.
18. SL (mm) The distance from point S to point L,
measured in millimeters.

36
19. SE (mm) The distance from point S to point E,
measured in millimeters.
S Line - The line constructed from a point tangent
to the chin to a point bisecting the lower border of
20.
the nose.
21. U Lip to S (mm) - The distance from the most
anterior point of the upper lip to S line. Positive
value was given when the lip lay anterior to S line,
and negative value was given when the lip lay
posterior to S line.
22. L Lip to S (mm)
anterior point of the lower lip to S line, measured
in millimeters.
The distance from the most
Tweed Analysis (Fig. 5).
FMIA - The angle formed by the Frankfort Horizontal
plane and the long axis of the lower incisor.
IMPA - The angle formed by the long axis of the
lower incisor and Mandibular Plane.
FMA - The angle formed by the Mandibular Plane and
the Frankfort Horizontal Plane.
B.
1.
2.
3.
C. Neger Analysis (Fig. 6).
1. LS N' LI angle - Formed by the intersection of a
line drawn from soft tissue Nasion to Labiale
Superius and Nasion to Labiale Inferius.

37
\
Fig. 5
TWEED ANALYSIS

38
Formed by the intersection of a line
drawn from Nasion to Labiale Inferius and Nasion to
2. LI N' Pg
Pogonion.
LSN'Pg’ - Formed by the intersection of a line drawn
from Nasion to Labiale Superius and Nasion to
3.
Pogonion.
Peck and Peck Analysis (Figs. 7, 8, 9).
Facial Angle (F) - Formed by the intersection of the
profilometric orientation plane with the facial line
(N-Pg) at point P.
Maxillofacial angle (Mf) - Related the upper lip to
the chin horizontally and was considered a soft
tissue analog to cephalometric ANB as in Steiner's
D.
1.
2.
analysis (1953, 1959).
Nasomaxillary angle (Nm) - Related the upper lip to
the nasal apex by drawing a line through Labiale
Superius and Pronasale. At the intersection of
3.
Prn-Ls line with the orientation plane, the inside
superior angle was read.
Nasal angle (Na) - Measured nasal height from Nasion
to Pronasale. The vertex of the angle was at
4.
Porion.
Measured maxillary height
from Pronasale to Labiale Superius. The vertex of
the angle was at Porion.
5. Maxillary angle (Mx)

39
LS N’ Li
LI N' Pg
LS N' Pg
T
1.
2.
3.
I
Fig. 6
NEGER ANALYSIS

40
Fig. 7
PECK AND PECK ANALYSIS

41
1. Nasomaxillary Angle (Nm)
1
Fig. 8
PECK AND PECK ANALYSIS

42
Nasal Angle (Na)
Maxillary Angle (Mx)
Mandibular Angle (Mn)
Total Vertical Angle (Tv)
1.
2.
3.
4.
1
2
4
^3
Fig. 9
PECK AND PECK ANALYSIS

43
Mandibular angle (Mn) Recorded mandibular height
from Labiale Superius to Pogonion.
the angle was at Porion.
6.
The vertex of
Total vertical angle (Tv) Represented the total
vertical dimension from Nasion to Pogonion.
7.
Subtelny (Fig. 10)
Convexity angle (N'SnPg) - Determined the degree of
convexity obtained from the union of the lines drawn
from Nasion to Subnasale and Subnasale to Pogonion.
E.
1.
Total Profile Convexity - Measured the total degree
The angle was defined by
the union of the lines drawn from Nasion to Proof convexity of the face.
2.
nasale and from Pronasale to Pogonion.
Burstone (Figs. 11, 12)
Horizontal extension measurements represented
F.
the distance in millimeters between a dental or skeletal
landmark and a corresponding integumental landmark as
measured along the nasal floor. Definition of the dental
or skeletal (S) and integumental (I) landmark, according
to Burstone (1958):
1. Glabella (I) - Glabella (S)
Glabella (I) Determined by a tangent to the forehead
from a line passing through Subnasale.

44
Convexity Angle - N' Sn Pg
Total Profile Convexity Angle
f
I
Fig. 10
SUBTELNY ANALYSIS

45
Glabella - Glabella
Subnasale - Suspinale
Superior Labial Sulcus -Suspinale
Labrale Superius - Incision Superius
Labrale Inferius - Incision Inferius
Inferior Labial Sulcus - Supramentale
Pogonion - Pogonion
I
I
1.
2.
3.
4.
5.
6.
7.
= Soft tissue landmark I
Fig. 11
BURSTONE ANALYSIS

46
Glabella (S) - The intersection of the outer plate
of the frontal bone with a horizontal line (parallel
to nasal floor) drawn from frontal point.
Subnasale - Subspinale
Subnasale (I) - The point where maxillary lip and
nasal septum form a definite angle, If the depres2.
sion was a gentle curve, Subnasale was interpreted
as the most concave point in this area as measured
by a line angled 45 degrees from nasal floor.
Siibspinale (S) - The deepest point between anterior
nasal spine and prosthion relative to nasal floor.
Superior Labial Sulcus - Subspinale
Superior Labial Sulcus (I)
the upper lip as determined by a line drawn from
Subnasale inclined so that it formed a tangent with
Labrale Superius.
Subspinale (S) - The deepest point between anterior
nasal spine and prosthion relative to nasal floor.
Labrale Superius - Incision Superius
Labrale Superius (I) - The most prominent point on
the upper lip as measured from a perpendicular to
nasal floor.
Incision Superius (S) - The most prominent point on
the maxillary incisor as determined by a tangent to
the incisor passing through subspinale.
The deepest point on
3.
4.

47
5. Labrale Inferius - Incision Inferius
Labrale Inferius (I) - The most prominent point on
the lower lip as determined by a perpendicular from
nasal floor.
Incision Inferius (S) - The most anterior point on
the lower incisor determined from a line tangent to
the chin and mandibular incisor.
Inferior Labial Sulcus - Supramentale
Inferior Labial Sulcus (I) - The most concave point
as measured by a line tangent to menton and Labrale
6.
Inferius.
Supramentale (S) Deepest point between Pogonion
and infradentale as determined from a line tangent
to lower incisor and Pogonion.
Pogonion (I) - Pogonion (S)
Pogonion (I) - Most anterior point on the chin deter7.
mined by a line tangent to the lower lip and chin.
Pogonion (S) Most anterior point on the chin as
determined from a perpendicular to nasal floor.
Vertical extension measurements depicted the dis
tance in millimeters between a dental or skeletal and a
corresponding integumental landmark measured along a
perpendicular to nasal floor, If the integumental point
was superior to the dental or skeletal one, the reading
was given a plus sign, if inferior, a minus sign.

48
Superior Labial Sulcus - Subspinale
Incision Superius - Stomion
Supramentale- Inferior labial sulcus
1.
2.
3.
Fig. 12
BURSTONE ANALYSIS

49
Definition of landmarks according to Burstone:
Superior Labial Sulcus Subspinale (vertical
relationship).
Superior Labial Sulcus (I) - The deepest point on
the upper lip as determined by a line drawn from
Subnasale inclined so that it formed a tangent with
1.
Labrale Superius.
Subspinale (S) - The deepest point between anterior
nasal spine and prosthion relative to nasal floor.
2. Incision Superius - Stomion (vertical relationship).
Incision Superius (S) - The most inferior point on
the maxillary incisor.
Stomion (I) - The juncture in the midline of the
upper and lower lips.
3. Supramentale (S) - Inferior Labial Sulcus (vertical
relationship).
Supramentale (S) - Deepest point between Pogonion
and infradental as determined from a line tangent to
lower incisor and the chin.
Inferior Labial Sulcus (I) - The most concave point
as measured by a line tangent to menton point and
Labrale Inferius.
G. Ricketts (Fig. 13).
1. "E" Line - A line drawn from soft tissue Pogonion
passing through Pronasale.

50
Holdaway (Fig. 14).
Formed by the intersection of a line
H.
1. "H" Angle
drawn from soft tissue Pogonion tangent to the upper
lip and a line drawn from Nasion to point B
(supramentale).
Part of University of Connecticut soft tissue
analysis (Orthodontic Syllabus 1979-1980) (Figs. 15, 16,
I.
17).
1. Nasal Profile Angle - Determined by the intersection
of a line drawn from soft tissue Nasion to soft
tissue Pogonion and soft tissue Nasion tangent to
the nasal profile.
2. Prn-Sn-LS - The angle formed by the intersection of
a line drawn from Pronasale to Subnasale and from
Subnasale to Labiale Superius.
Sn-N'-Prn - The angle formed by the intersection of
a line drawn from subnasale to soft tissue Nasion
3.
and from soft tissue Nasion to Pronasale.
The distance in millimeters measured I
4. Ls-Sn-Pg
from a line drawn from Subnasale to soft tissue
Pogonion and Labiale Superius parallel to Frankfort
Horizontal plane.
5. Li-Sn-Pg The distance in millimeters measured
from a line drawn from Subnasale to soft tissue
Pogonion and Labiale Inferius parallel to Frankfort

51
1. E Line
Fig. 13
RICKETTS ANALYSIS

52
1. H Angle
Fig. 14
HOLDAWAY ANALYSIS

53
1. Nasal Profile Angle
2 . Sn - Stm
3. ILS - Stm
I
Fig. 15
PART OF UNIVERSITY OF CONNECTICUT
SOFT TISSUE ANALYSIS

54
Prn - Sn - LS
I
Sn - N - Prn
I
Fig. 16
PART OF UNIVERSITY OF CONNECTICUT
SOFT TISSUE ANALYSIS

55
Horizontal plane.
6. G'-Sn The distance in millimeters between soft
tissue Glabella and Subnasale measured horizontally.
parallel to Frankfort Horizontal plane.
7. Sn-Me The distance in millimeters from Siibnasale
to Menton measured along a horizontal line parallel
to Frankfort Horizontal plane.
8. Prn-Sn - The distance in millimeters from Pronasale
to Subnasale, measured parallel to Frankfort Hori
zontal plane.
9. Sn-Stm - The distance in millimeters from subnasale
to stomion measured along a perpendicular to Frank
fort Horizontal plane.
10. ILS-Stm The distance in millimeters from the
Inferior Labial Sulcus to stomion measured along a
perpendicular to the Frankfort Horizontal plane.

56
I
1. LS Sn Pg
LI Sn Pg
G' - Sn
Sn - Me
I
2.
3.
4.
5. Prn - Sn
= Soft tissue landmark I
Fig. 17
PART OF UNIVERSITY OF CONNECTICUT
SOFT TISSUE ANALYSIS

57
FINDINGS
The compiled data was analyzed with the following
objectives:
To report the results of the Puerto Rican
studied sample for the Steiner (1953, 1959), Tweed
A.
(1954), Neger (1959), Peck and Peck (1970), Subtelney
(1959), Burstone (1958), Ricketts (1964), Holdaway
(1964), and part of the University of Connecticut Osseous
and soft tissue analyses (Orthodontic Syllabus 1979-
1980).
B. To find sex differences within the results of
the Puerto Rican sample group.
C. To compare Puerto Rican findings with Caucasian
or European norms.
Mean and standard deviation of males and females for
the Puerto Rican studied sample were established.
Table 1 displayed Steiner analysis for the Puerto
Rican young adult sample group.
Table 2 displayed Tweed analysis for the Puerto
Rican young adult sample group.
1.
2.

58
Table 3 displayed Neger soft tissue analysis for the
Puerto Rican young adult sample group.
Table 4 displayed Peck and Peck Profilometric analy
sis for the Puerto Rican young adult sample group.
Table 5 displayed Burstone Integumental extension
analysis for the Puerto Rican young adult sample
3.
4.
5.
group.
Table 6 displayed part of University of Connecticut
soft tissue analysis (from Syllabus) for the Puerto
Rican young adult sample group.
Table 7 displayed Holdaway H angle analysis for the
Puerto Rican young adult sample group.
Table 8 displayed Ricketts E line analysis for the
Puerto Rican young adult sample group.
Table 9 displayed Subtelny Profile Convexity
analysis for the Puerto Rican young adult sample
6.
7.
8.
9.
group.
T-tests were used to compare sex differences within
the Puerto Rican sample group.
Table 10 (Steiner analysis) displayed comparison of
None of the variables were
1.
male and female.
statistically different.
Table 11 (Tweed analysis) displayed comparison of
male and female. None of the variables were
2.
statistically different.

59
Table 12 (Neger analysis) displayed comparison of
male and female. None of the variables were
3.
statistically different.
4. Table 13 (Peck and Peck analysis) displayed
comparison of male and female. None of the
variables were statistically different.
5. Table 14 (Burstone) displayed comparison of male and
female. Male and female were significantly differ
ent on Glabella-Glabella', Subnasale-Subspinale,
Superior labial sulcus-Subspinale, Labrale superiusIncision superius and Subspinale-Superior labial
sulcus (vertical relationship). The rest of the
variables were statistically non significant.
Glabella-GlabellaI
Mean SD P value
Male 6.21 .39
Female 5.29 .91
Difference .92 < .05
Subnasale-Subspinale Mean SD P value
Male 19.07 3.32
Female 14.36 1.35
Difference 4.71 < .01

60
Superior Labial Sulcus -
Subspinale Mean SD P value
Male 17.57 2.98
Female 13.43 0.61
Difference 4.14 < .01
Labrale Superius-Incision
Superius Mean SD P value
Male 12.79 1.63
Female 11.21 1.35
Difference 1.58 < .01
Subspinale-Superior
Labial Sulcus (vert, rel.)
Male
Mean SD P value
-7.0 2.25
Female -2.79 2.50
Difference 4.21 < .01
(-) Neg. Sign - The integumental landmark was inferior
to the skeletal landmark.
6. Table 15 (Part of Univ. of Connecticut soft tissue
analysis taken from the 1979-1980 Orthodontic
Syllabus) displayed comparison of male and female.
None of the variables were significant different.

61
7. Table 16 (Holdaway H angle and analysis) displayed
comparison of male and female. There was no
statistically significant difference.
8. Table 17 (Ricketts E line analysis) displayed
comparison of male and female. None of the
variables were statistically different.
Table 18 (Subtelny analysis) displayed comparison of
male and female. None of the variables were
9.
significantly different.
T-tests and Pearson correlation analyses were used
to compare Puerto Rigan findings with Caucasian or
European means.
1. Table 19 (Steiner analysis) displayed comparison of
the Puerto Rican young adult sample and the
Caucasian sample. The Alabama analysis was used to
compare the means, SNA and Occl to Sn were found to
be significantly different (p<.05).
SNA Mean SD T-value
Puerto Rican 83.68 3.76
Caucasian 81.00 3.20
Difference 2.68 2.577

62
Occl to Sn Mean SD T-value
Puerto Rican 12.25 . 3.41
Caucasian 16.70 4.10
Difference 4.45 3.638
Table 21 (Neger soft tissue analysis) displays com
parison of the Puerto Rican young adult sample group
and the Caucasian sample. Puerto Ricans and Cauca
sians were significantly different on LI N’ PgI
2.
and LsN'Pg' .
LI N» Pg»
Puerto Rican
Mean SD T-value
3.39 1.33
Caucasian 4.80 1.70
Difference 1.41 3.055
LS N'Pq
Puerto Rican
f
Mean SD T-value
6.68 2.50
Caucasian 8.70 1.90
Difference 2.02 3.252
Table 23 (Burstone Integumental analysis) displayed
comparison of the male Puerto Rican young adult and
3.
Caucasian male. All variables except Labrale
Superius
Incision Inferius were statistically non significant.
Incision Superius and Labrale Inferius -

63
Labrale Superius -
Incision Superius
Puerto Rican male
Mean SD T-value
12.79 1.63
Caucasian male 15.00 1.92
Difference 2.21 2.746
Labrale Inferius -
Incision Inferius Mean SD T-value
Puerto Rican male 14.14 1.28
Caucasian male 16.30 1.45
Difference 2.16 3.368
Table 24 (Burstone Integumental analysis) displayed
comparison of the female Puerto Rican young adult
4.
and the Caucasian female Glabella-Glabella’,
Subspinale-Superior
Supramentale-Inferior
significantly different.
Labial Sulcus, and
Labial Sulcus were
Glabella-Glabella' Mean SD T-value
Puerto Rican female 5.29 0.91
Caucasian female 6.10 0.78
Difference 0.81 2.707

64
Subspinale-Superior
Labial Sulcus Mean SD T-value
Puerto Rican female -2.79 2.50
Caucasian female -4.50 1.36
Difference 1.71 2.420
SupramentaleInferior Labial Sulcus Mean SD T-value
Puerto Rican female -1.41 2.48
Caucasian female -2.50 1.52
Difference 1.09 2.739
Table 20 (Tweed analysis). Table 22 (Peck and Peck
Analysis), Table 25 (Holdaway H angle analysis).
Table 26 (Subtelny profile convexity analysis for
males) and Table 27 (Subtelny profile convexity
analysis for females) displayed comparison of the
Puerto Rican young adult sample and the Caucasian
samples. The mean scores for the measurements of
the Tweed, Peck and Peck, Holdaway, and Subtelny
analyses for the Puerto Rican sample group were
plotted on a scattergram with the mean scores of the
Caucasians. The Bivariate correlation (scattergram)
resulted in a Pearson product-moment correlation
coefficient of .99. This high correlation coeffi
cient was significant to the p<.0001 level.
5.

65
There was no statistical difference between the
Puerto Rican sample and the Caucasian samples.
(Refer to Scattergram Fig. 18).
TABLE 1
STEINER CEPHALOMETRIC ANALYSIS FOR THE
PUERTO RICAN YOUNG ADULT SAMPLE GROUP
N=14 Male N=7 Female N=7
Variable Mean SD Mean SD Mean SD
SNA (Angle) 83.68 3.76 84 4.00 83.34 3.79
SNB (Angle) 79.86 3.15 80.64 3.35 79.07 2.96
ANB (Angle) 3.82 2.35 3.21 2.81 4.43 1.80
SND (Angle) 78.57 2.96 79.93 2.99 77.21 2.41
U1 to NA (mm) 5.11 3.10 5.50 3.49 4.71 2.86
U1 to NA (Angle) 21.21 7.27 21.79 6.87 20.64 8.16
LI to NB (mm) 5.85 2.30 5.93 2.28 5.79 2.51
LI to NB (Angle) 26.28 5.51 24.71 4.79 27.86 6.10
Po to NB (mm) 3.17 1.72 3.21 2.14 3.14 1.35
U1 to LI (Angle) 127.46 7.46 128.00 6.06 126.93 9.13
Occ to SN (Angle) 12.25 3.41 10.43 3.40 12.64 5.52
GoGnSn (Angle) 30.71 5.31 29.00 5.71 32.43 4.66
SL (mm) 55.07 6.18 58.21 4.55 51.93 6.23
SE (mm) 20.53 2.56 20.29 2.93 20.79 2.34
U Lip to S line (mm) -.857 1.823 -1.714 2.34 0 0
L Lip to S line (mm) -.286 1.868 -1.071 2.280 .5 .957

66
TABLE 2
TWEED ANALYSIS FOR THE
PUERTO RICAN YOUNG ADULT SAMPLE GROUP
Female N=7
Mean SD
Male N=7
Mean SD
N=14
Variable Mean SD
FMA (Angle) 23.25 5.63 22.29 5.40 24.21 6.11
IMPA (Angle) 95.11 5.83 94.00 3.48 96.21 7.66
FMIA (Angle) 61.32 6.44 63.71 5.84 58.93 6.52
TABLE 3
NEGER SOFT TISSUE ANALYSIS FOR THE
PUERTO RICAN YOUNG ADULT SAMPLE GROUP
Female N=7
Mean SD
Male N=7
Mean SD
N=14
Variable Mean SD
LS N' LI (Angle) 3.39 1.38 2.86 1.75 3.93 0.61
LI N' Pg‘ (Angle) 3.29 1.33 2.57 1.95 3.57 0.79
LS N' Pg' (Angle) 6.68 2.50 5.86 3.36 7.50 0.87
TABLE 4
PECK AND PECK PROFILOMETRIC ANALYSIS
FOR THE PUERTO RICAN YOUNG ADULT SAMPLE GROUP
Male N=7
Mean SD
Female N=7
Mean SD
N=14
Variable Mean SD
Facial Angle 107.35 4.25 109.00 4.86 105.71 3.04
Nasal Angle 22.28 2.27 21.86 1.57 22.71 2.87
Maxillary Angle 14.29 1.88 15.14 2.21 13.43 1.02
Mandibular Angle 16.54 1.61 16.79 1.70 16.29 1.60
Nasomaxillary Angle 104.00 4.61 103.36 5.38 104.64 4.02
Total Vert. Angle 52.39 3.39 52.36 2.15 52.43 4.49

67
TABLE 5
BURSTONE INTEGUMENTAL EXTENSION ANALYSIS FOR
THE PUERTO RICAN YOUNG ADULT SAMPLE GROUP
Female N=7
Mean SD
Male N=7
Mean SD
N=14
Variable Mean SD
Glabella-Glabella'(mm)
Subnasale-Subspinale(mm) 16.71
Superior Labial SulcusSubspinale (mm)
Labrale Superius-Incision
Superius (mm)
Labrale Inferius-Incision
Inferius (mm)
Inferior Labial SulcusSupramentale (mm)
Pogonion-Pogonion' (mm) 11.75
Subspinale-Superior
Labial Sulcus (mm)
Supramentale-Inferior
Labial Sulcus (mm)
Incision SuperiusStomion (mm)
5.75
15.50
12.00
13.43
12.00
-4.11
-0.21
2.50
0.83 6.21 0.39 5.29 0.91
3.45 19.07 3.32 14.36 1.35
2.98 17.57 2.98 13.43 0.61
1.65 12.79 1.63 11.21 1.35
2.15 14.14 1.28 12.71 2.67
1.59 12.50 1.41 11.50 1.71
1.92 12.50 2.10 11.00 1.50
4.20 -7.00 . 2.25 -2.79 2.50
2.04 0.71 0.95 -1.14 2.48
1.81 2.36 1.55 3.50 1.68
TABLE 6
UNIV. OF CONNECTICUT SOFT TISSUE ANLYSIS FOR THE
PUERTO RICAN YOUNG ADULT SAMPLE GROUP
Female N=7
Mean SD
N=14
Mean
Male N=7
Variable SD Mean SD
Nasal Profile (Angle)
Prn Sn Ls (Angle)
Sn N' Prn (Angle)
LS Sn Pg' (mm)
LI Sn Pg' (mm)
G-Sn (mm)
Sn-Me (mm)
Prn-Sn (mm)
Sn-Stm (mm)
ILs-Stm (mm)
26.82 4.75 27.29 5.00 26.36 4.84
128.61 6.93 129.71 4.82 127.50 8.83
20.39 2.35 16.93 6.70 21.00 2.94
2.68 2.25 1.86 2.64 3.50 1.55
1.89 1.94 1.36 2.06 2.43 1.81
8.07 4.50 9.86 5.11 6.29 3.20
22.46 6.83 24.93 4.23 22.86 2.48
15.75 2.33 15.86 2.39 15.64 2.46
22.07 2.10 22.79 2.51 21.36 1.44
18.14 2.03 18.71 2.41 17.57 1.54
= Soft tissue landmark I

68
TABLE 7
HOLDAWAY H ANGLE ANALYSIS FOR THE
PUERTO RICAN YOUNG ADULT SAMPLE GROUP
N=14 Male N=7 Female N=7
Variable Mean SD Mean SD Mean SD
II H" Angle 9.93 3.46 10.50 4.54 9.36 2.17
TABLE 8
RICKETTS E LINE ANALYSIS FOR THE
PUERTO RICAN YOUNG ADULT SAMPLE GROUP
N=14 Male N=7 ' Female N=7
Variable Mean SD Mean SD Mean SD
E Line to UL (mm) -5.04 2.75 -5.93 3.32 -4.14 1.86
E Line to LL (mm) -2.68 2.40 -1.07 4.58 -1.86 1.70
TABLE 9
SUBTELNY PROFILE CONVEXITY ANALYSIS FOR THE
PUERTO RICAN SAMPLE GROUP
N=14 Male N=7 Female N=7
Variable Mean SD Mean SD Mean SD
N'Sn Pg' (Angle) 161.75 5.31 161.21 6.25 162.29 4.62
Total Profile
Convexity (Angle) 131.96 4.12 131.14 3.48 132.79 4.79
= soft tissue landmark

69
TABLE 10
COMPARISON OF PUERTO RICAN MALE AND FEMALE
WITH T-TEST BY STEINER ANALYSIS
Female N=7 T-value P-value
Mean SD
Sex
Diff.
Male N=7
Variable Mean SD
SNA 84 4.00 83.34 3.79 0.317 >.10 NS
SNB 80.64 3.35 79.07 2.96 0.929 >.10 NS
ANB 3.21 2.81 4.43 1.80 0.967 >.10 NS
SND 79.93 2.99 77.21 2.41 1.874 >.05 NS
U1 to NA (mm)
U1 to NA
LI to NB (mm)
LI to NB
PO to NB (mm)
U1 to LI
5.50 3.49 4.71 2.86 0.463 >.10 NS
21.79 6.87 20.64 8.16 0.285 >.10 NS
5.93 2.28 5.79 2.51 0.109 >.10 NS
24.71 4.79 27.86 6.10 1.075 >.10 NS
3.21 2.14 3.14 1.35 0.073 >.10 NS
128.00 6.06 126.93 9.13 0.258 >.10 NS
Occ to Sn 10.43 3.40 12.64 5.52 0.902 >.10 NS
GoGnSn 29.0 5.71 32.43 4.66 1.231 >.10 NS
SL (mm)
SE (mm)
U Lip to S-Line(mm) -1.714 2.34
U Lip to S-Line(mm) -1.071 2.280
58.21 4.55
20.29 2.93
51.93 6.23 2.154 >.05 NS
20.79 2.34 0.353 >.10 NS
0 0 1.938 >.05 NS
0.5 0.957 1.681 >.10 NS
TABLE 11
COMPARISON OF PUERTO RICAN MALE AND FEMALE
WITH T-TESTS BY TWEED ANALYSIS
Female N=7 T-value P-value
Mean SD
Male N=7
Mean SD
Sex
Variable Diff.
FMA 22.29 5.40 24.21 6.11 0.623 >.10 NS
IMPA 94.00 3.48 96.21 7.66 0.695 >.10 NS
FMIA 63.71 5.84 58.93 6.52 1.445 >.10 NS
NS = Not Significant (p>.05)

70
TABLE 12
COMPARISON OF PUERTO RICAN MALE AND FEMALE
WITH T-TESTS BY NEGER ANALYSIS
Female N=7 T-value P-value
Mean SD
Sex
Diff.
Male N=7
Variable Mean SD
LS N' LI (Angle) 2.86 1.75 3.93 0.61 1.528 >.10 NS
LI N' Pg' (Angle) 2.57 1.95 3.57 0.79 1.258 >.10 NS
LS N' Pg' (Angle) 5.86 3.36 7.50 0.87 1.250 >.10 NS
TABLE 13
COMPARISON OF MALE AND FEMALE
WITH T-TEST BY PECK AND PECK ANALYSIS
Female N=7 T-value P-value
Mean SD
Sex
Diff.
Male N=7
Variable Mean SD
Facial Angle 109.00 4.86 105.71 3.04 1.518 >.10 NS
Nasal Angle 21.86 1.57 22.71 2.87 0.687 >.10 NS
Maxillary Angle 15.14 2.21 13.43 1.02 1.859 >.05 NS
Mandibular Angle 16.79 1.70 16.29 1.60 0.567 >.10 NS
Nasomaxillary Angle 103.36 5.38 104.64 4.02 0.504 >.10 NS
Total Vert. Angle 52.36 2.15 52.43 4.49 0.037 >.10 NS
= soft tissue landmark
NS = Not significant (p>.05)

71
TABLE 14
COMPARISON OF PUERTO RICAN MALE AND FEMALE
WITH T-TEST BY BURSTONE
T-value P-value Sex
Diff.
Female N=7
Mean SD
Male N=7
Variable Mean SD
Glabella-Glabella' 6.21 5.29 0.91 2.459 <■05 S
SubnaslaeSubspinale
Superior Labial
Sulcus-Subspinale 17.57
Labrale SuperiusIncision Superius 12.79
Labrale InferiusIncision Inferius 14.14
Inferior Labial Sul
cus -Supramentale
Pogonion-Pogonion' 12.50
Subspinale-Superior
Labial Sulcus
Supramental-Inferior
Labial Sulcus
Incision SuperiusStomion
19.07
12.50
-7.0
0.71
2.36
0.39
3.32 14.36 1.35 3.477 <.01 S
2.98 13.43 0.61 3.601 <.01 S
1.63 11.21 1.35 1.975 <.01 S
1.28 12.71 2.67 1.278 >.10 NS
1.41 11.50 1.71 1.194 >.10 NS
2.10 11.00 1.50 1.538 >.10 NS
2.25 -2.79 2.50 3.312 <.01 S
0.95 -1.14 2.48 .428 >.05 NS
1.55 3.50 1.68 1.320 >.10 NS
TABLE 15
COMPARISON OF PUERTO RICAN MALE AND FEMALE
WITH T-TEST BY UNIV. OF CONNECTICUT SOFT TISSUE ANALYSIS
T-value P-value Sex
Diff.
Male N=7
Mean SD
Female N=7
Variable Mean SD
Nasal Profile
(Angle)
PRN Sn LS (Angle) 129.71
SN N' Prn (Angle) 16.93
LS Sn Pg' (mm)
LI Sn Pg' (mm)
G-Sn (mm)
Sn-Me (mm)
Prn-Sn (mm)
Sn-Stm (mm)
ILS-Stm (mm)
27.29
1.86
1.36
9.86
24.93
15.86
22.79
18.71
0.354
0.581
1.472
1.417
1.032
1.567
1.117
0.170
1.307
1.055
>.10
>.10
>.10
>.10
>.10
>.10
>.10
>.10
>.10
>.10
5.00 26.36 NS
4.82 127.50
6.70 21.00
2.64
2.06
5.11
4.23 22.86
2.39 15.64
2.51 21.36
2.41 17.57
NS = Not Significant (p>.05)
-sign = The integumental landmark was
inferior to the skeletal landmark
4.84
8.83
2.94
1.55
1.81
3.20
2.48
2.46
1.44
1.54
NS
NS
3.50 NS
2.43
6.29
NS
NS
NS
NS
NS
NS
' = soft tissue landmark
S = Significant (p<.05)

72
TABLE 16 IT'
COMPARISON OF PUERTO RICAN MALE AND FEMALE
WITH T-TEST BY HOLDAWAY H ANGLE ANALYSIS
P-value Sex
Diff.
Female N=7 T-value
Mean SD
Male N=7
Variable Mean SD
H" Angle 10.50 4.54 9.36 2.17 0.599 >.10 NS
TABLE 17
COMPARISON OF PUERTO RICAN MALE AND FEMALE
WITH T-TEST BY RICKETTS E LINE ANALYSIS
P-value Sex
Diff.
Female N=7 T-value
Mean SD
Male N=7
Variable Mean SD
E Line to UL(mm) -5.04 2.75 -5.93 3.32 1.244 >.10 NS
E Line to LL(mm) -2.68 2.40 -1.07 4.58 0.428 >.10 NS
TABLE 18
COMPARISON OF PUERTO RICAN MALE AND FEMALE
WITH T-TEST BY SUBTELNY PROFILE CONVEXITY ANALYSIS
T-value P-value Sex
Diff.
Female N=7
Mean SD
Male N=7
Variable Mean SD
N' Sn Pg' (Angle) 161.21 6.25 162.29 4.62 0.368 >.10 NS
Total Profile
Convexity (Angle) 131.14 3.48 132.79 4.79 0.737 >.10 NS
‘ = soft tissue lancbnark
NS = Not Significant (p>.05)

TABLE 19
COMPARISON OF THE PUERTO RICAN YOUNG ADULT
SAMPLE GROUP WITH THE CAUCASIANS MEANS BY
STEINER AND ALABAMA ANALYSES
Puerto Rican
N = 14
Mean SD
Caucasian
Alabama N = 40
Mean SD
Caucasian
Steiner Norms
N = Not Available
Race
Variable T-Value P-Value Diff.
SNA 82 83.68 3.76 81.00 3.20 2.577 <■02 S
SNB 80 79.86 3.15 78.2 2.90 1.803 >.05 NS
ANB 2 3.82 2.35 2.80 2.00 1.569 >.10 NS
SND 76 78.57 2.96
U1 to NA (mm) 4 5.11 3.10
U1 to NA 22 21.21 7.27 23.20 5.00 1.134 >.10 NS
LI to NB (mm) 4 5.85 2.30 5.40 1.60 0.805 >.10 NS
LI 25 26.28 5.51 27.30 5.80 0.573 >.10 NS to NB
Po to NB 3.17 1.72
U1 to LI 131 127.46 7.46 126.80 8.40 0.260 >.10 NS
Occl to Sn 14 12.25 3.41 16.70 4.10 3.638 <.001 S
GoGn to Sn 32 30.71 5.31 32.00 4.50 0.881 >.10 NS
SL (mm)
SE (mm)
U Lip to S Line
L Lip to S Line
51 55.07 6.18
22 20.53 2.56
0 -0.86 1.82
0 -0.29 1.87
S = Significant (p<.05) NS = Not Significant (p>.05)
CO

74
TABLE 20
COMPARISON OF THE PUERTO RICAN YOUNG ADULT SAMPLE GROUP
WITH THE CAUCASIAN MEANS FOR THE TWEED ANALYSIS
Puerto Rican
n=14
Caucasian
n=4
Mean
Pearson Correl
Coef.* P-Value
Race
Variable Mean SD Diff.
FMA 23.3 5.6 25.0 0.99 <.0001 NS
IMPA 95.1 5.8 90.0 0.99 <.0001 NS
FMIA 61.3 6.4 65.0 0.99 <.0001 NS
TABLE 21
COMPARISON OF THE PUERTO RICAN YOUNG ADULT SAMPLE GROUP
WITH THE CAUCASIAN MEANS FOR THE NEGER SOFT TISSUE ANALYSIS
Puerto Rican
n=14
Caucasian
n=48
Mean SD
Race
Variable Mean SD T-Value P-Value Diff.
LS N' Li 3.39 1.38 3.90 1.30 1.274 >.10 NS
LI N' Pg
LS N' Pg
I 3.29 1.33 4.80 1.70 3.055 <.001 S
6.68 2.50 8.70 1.90 3.252
= soft tissue landmark
NS = not significant (p>.05)
S = significant (p<.05)
I
<.001 S
TABLE 22
COMPARISON OF THE PUERTO RICAN YOUNG ADULT SAMPLE GROUP WITH
THE EUROPEAN MEANS FOR PECK AND PECK PROFILOMETRIC FACIAL ANALYSIS
Puerto Rican ’
n=14
European
n=4
Mean
Pearson Correl
Coef.* P-Value
Race
Variable Mean SD Diff.
Facial Angle
Nasal Angle
Maxillary Angle
Mandibular Angle
Nasomaxil. Angle 104.0
Total Vert. Angle 52.4
107.4
22.3
14.3
16.5
102.5
23.3
14.1
17.1
106.1
54.5
* As the Pearson correl coef approaches 1.0,
the stronger the correlation between the
two studied groups (p<.0001).
Refer to Scattergram (Fig. 18)
4.3 0.99 <.0001
2.3 0.99 <.0001
1.9 0.99 <.0001
1.6 0.99
0.99
0.99
<.0001
<.0001
<.0001
4.6
3.4
NS
NS
NS
NS
NS
NS

75
TABLE 23
COMPARISON OF THE PUERTO RICAN MALE SAMPLE GROUP
WITH THE CAUCASIAN MALE MEANS FOR THE BURSTONE INTEGUMENTAL
EXTENSION ANALYSIS
Caucasian
Male n=15
Mean SD
Puerto Rican
Male n=7
Mean SD
Race
Variable T-Value P-Value Diff.
GlabellaGlabella ' (mm) 6.21 0.39 6.20 1.01 0.025 >.10 NS
SubnasaleSubspinale(mm) 19.07 3.32 19.30 1.74 0.216 >.10 NS
Superior Labial Sulcus-Subspinale(mm) 17.57 2.98 17.20 1.83 0.056 >.10 NS
Labrale Superius-Incision Super.(mm) 12.79 1.63 15.10 1.92 2.746 <.02 S
Labrale Inferius-Incision Infer.(mm) 14.14 1.28 16.30 1.45 3.368 <.01 S
Inferior Labial Sulcus
-Supramentale(mm) 12.50 1.41 11.90 1.24 1.013 >.05 NS
Pogonion-Pogonion I 12.50 2.10 13.60 1.82 1.259 >.05 NS
Subspinale-Superior
Labial Sulcus(mm) -7.00 2.25 -6.2 2.08 0.820 >.10 NS
Supramentale-Inferior
Labial Sulcus(mm) 0.71 0.95 1.1 3.21 0.311 >.10 NS
Incision SuperiusStomion(mm) 2.36 1.55 2.3 2.56 0.199 >.10 NS
' = Soft tissue landmark
NS = Not significant (p>.05)
S = Significant (p<.05)
Neg. Sign = Integumental landmark was inferior to
the skeletal landmark.

76
TABLE 24
COMPARISON OF THE PUERTO RICAN FEMALE SAMPLE GROUP
WITH THE CAUCASIAN FEMALE MEANS FOR THE BURSTONE INTEGUMENTAL
EXTENSION ANALYSIS
Puerto Rican
Female n=7
Mean SD
Caucasian
Female n=25
Mean SD T-Value P-Value
Race
Variable Diff.
GlabellaGlabella' (mm) 5.29 0.91 6.10 0.78 2.407 <.05 S
SubnasaleSubspinale(mm) 14.36 1.35 15.50 1.64 1.681 >.10 NS
Superior Labial Sulcus-Subspinale{mm) 13.43 0.61 13.80 1.44 0.657 >.10 NS
Labrale Superius-Incision Super.(mm) 11.21 1.35 11.80 1.54 0.917 >.10 NS
Labrale Inferius-Incision Infer.(mm) 12.71 2.67 13.40 1.68 0.841 >.10 NS
Inferior Labial Sulcus
-Supramentale(mm) 11.50 1.71 10.90 1.10 1.126 >.10 NS
Pogonion-Pogonion I 11.00 1.50 11.60 1.35 1.016 >.10 NS
Subspinale-Superior
Labial Sulcus(mm) -2.79 2.50 -4.50 1.36 2.420 <.05 S
Supramentale-Inferior
Labial Sulcus(mm) -1.14 2.48 -2.50 1.52 2.739 <.02 S
Incision SuperiusStomion(mm) 3.5 1.68 3.70 1.68 0.278 >.10 NS
= Soft tissue landmark
NS = Not significant (p>.05)
S = Significant (p<.05)
Neg. Sign = Integumental landmark was inferior to
the skeletal landmark.
I

77
TABLE 25
COMPARISON OF THE PUERTO RICAN YOUNG ADULT SAMPLE GROUP
WITH THE CAUCASIAN MEAN FOR HOLDAWAY H ANGLE ANALYSIS
Puerto Rican
n=14 Caucasian Pearson Correl
Coef.* P-Value Diff.
Race
Variable Mean SD Mean
H Angle 9.93 3.46 9.82 0.99 <.0001 NS
Holdaway norm for ANB 1-3 is 7-9 degrees,
is increased, H angle should also increase by one.
For each degree ANB
TABLE 26
COMPARISON OF THE PUERTO RICAN MALE SAMPLE GROUP WITH THE
CAUCASIAN MALE MEANS FOR THE SUBTELNY PROFILE CONVEXITY ANALYSIS
Puerto Rican
n=7
Mean SD
Caucasian
n=15
Mean
Pearson Correl
Coef. P-Value
Race
Variable Diff.
N' Sn Pg <.0001
Total Profile
Convexity
t 161.2 6.3 163.5 0.99 NS
131.1 3.5 133.0 0.99 <.0001 NS
TABLE 27
COMPARISON OF THE PUERTO RICAN FEMALE SAMPLE GROUP WITH THE
CAUCASIAN FEMALE MEANS FOR THE SUBTELNY PROFILE CONVEXITY ANALYSIS
Puerto Rican
n=7
Mean SD
Caucasian
n=15
Mean
Pearson Correl
Coef. P-Value
Race
Variable Diff.
N' Sn Pg' 162.3 4.6 163.3 0.99 <.0001 NS
Total Profile
Convexity 132.8 4.8 133.0 0.99 <.0001 NS
= soft tissue landmark I
* As the Pearson Coef. approaches 1.0, the
stronger the correlation between the two
studied groups (p<.0001).
Refer to Scattergram (Fig. 18)

JAZM|.<4 SruOY 05/04/63 PACE 2
fCREATlUN DATE = 03/04/831
(DOWN) VZ
17.615 32*645 48*0 75
FILE ONE
SCArTEMGPAM OF {ACROSS) V3
63«305 78*535 93*765 108*995 24.225 139.455 I 54*685
■4— > — ♦
• ♦ 4
163.500 ♦ 4 163*500
■f
♦
148*080 4 4 148.080
4
4 4
4
4 4
132*660 132.660
4 4 ■
4
4
4
I I 7*240 4 4 117.240
4
4
101*820 101.820
4
4
4
♦
86.400 86.400
4
4
4
4 4
70*980 4 70.980
4 4
4 4 4
4
4 4
55*560 4 4 55*550
4
4 4
4
4
40*140 40.140
4
♦
4
4 4
24.720 444 24.720
4
4
4 4 4
•4
4
9.300 44
4.
131.840 147.070 162.300
9.300
*4 4 ♦ 4-
25* 230
♦
10.000 40.460 55.690 70.920 86*150 101*380 * lloteiO ^ *
Bivariate correlation between the Puerto Rican
young adult sample group and the Caucasian
samples for the Tweed, Peck and Peck, Holdaway,
and the Subtelny Analyses
Scattergam
<1
Fig. 18 oo

79
DISCUSSION
The findings of the present study demonstrated that
the Puerto Rican general public opinion held views of
facial esthetics consistent with the Caucasian or
American esthetic standard as defined by the ortho
dontists and the American pxiblic. It was also demons
trated that fine faces generally possessed equally fine
skeletal foundations. Generally speaking, most of the
fifty-three linear and angular measurements recorded fell
within the range of the pre-established standards.
Riedel (1957) and Peck and Peck (1970) reported in
their studies of publicly-selected beauties a preference
towards a fuller, more protrusive dentofacial pattern
than that expressed by the Steiner norm (1953, 1959). In
comparison with the Riedel and Peck and Peck studies.
Puerto Rican young adults showed significant
similarities.
The SNA angle was found to be greater in the Puerto
Rican group than in the Caucasian norm (p<.02).
expressing maxillary protrusion. Cephalometric indi
cators of mandibular position showed a well developed
mandible with a flatter occlusal plane (p<.001). In the

80
Steiner analysis the indicators of dental position
related the upper incisor to the NA line and the lower
incisors to the NB line. The mean values for the UI to
NA and LI to NB measurements were more suggestive of a
forward positioned dentition than a forward inclined
The forward positioned dentition provided a
fuller look around the orofacial area.
dentition.
The soft tissue analyses demonstrated a highly
significant correlation (p<.0001) between the Puerto
Rican young adult sample means and those reported by
Ricketts (1968), Peck and Peck (1970), Holdaway (1964),
Subtelny (1959), and Steiner's S line (1953, 1959) for
the Caucasian samples. Significant difference between
the Caucasians and the Puerto Rican young adults was
revealed by the Neger (1959) soft tissue analysis where
the Puerto Ricans showed a more prominent chin, and
flatter profile than the means for the Caucasian sample
(p<.001). The means for LI N' Pg' and LS N' Pg' for the
Puerto Rican sample fell within the range of results for
the Caucasian sample.
A distinction between the male Puerto Rican young
adults and the male Caucasian sample for the Burstone
(1958) integumental analysis was related to the hori
zontal extensions between Labrale Superius-Incision
Superius and Labrale Inferius-Incision Inferius. In both
instances the integumental extension measurements were

81
lower in the Puerto Rican sample than in the Caucasian
sample (p<.,02). In the comparison of the female groups
between the Caucasian and Puerto Rican ethnic groups, the
vertical extension measurement of Subspinale-Superior
Labial Sulcus was found to be smaller in the Puerto Rican
sample than in the Caucasian sample (p<.05). Both
Steiner S line and Ricketts E plane were not found to be
significantly different between the Caucasian and Puerto
Rican samples.
The data related to the Puerto Rican sample group
delineated a maxillary protrusion, a forwardly positioned
dentition and a well developed mandible. The integumental or soft tissue analysis in the perioral region was
found to be smaller than the reported means for the
Caucasians. It was therefore suggested that the
integumentum has compensated for the skeletal protrusion
resulting in a facially harmonious and balanced profile,
similar to the one accepted as ideal by Steiner (1953,
1959) and Ricketts (1968) for the Caucasians.
The distinction between the male and female young
adult sample groups of Puerto Rican ethnic background was
related to the horizontal integumental extension measure
ments of the Burstone (1958) analysis. The female group
had smaller integumental extensions than the male group.
This was found to be consistent with Burstone's reported
results for the Caucasian young adult.

82
The Puerto Rican public concept of acceptable facial
esthetics were in good agreement with the standards
established by orthodontists on the basis of normal
occlusion. The skeletal and dental cephalometric
analysis of the Puerto Rican young adult sample seemed to
be similar to those recorded in previous studies of
normal occlusion. Facial esthetics seemed to be related
to good skeletal patterns. It must be clarified that the
integumentum was variable and a complete diagnosis must
be based on both osseous and soft tissue analyses.
Treatment planning should consider the skeletal, dental
and soft tissue patterns of each patient, taking into
account the ethnic background and preferences as to
Since the sample chosen for the
present study was selected on the basis of facial
esthetics, it would be interesting to conduct a similar
study with a sample selected on the basis of excellence
of occlusion.
facial esthetics.

83
SUMMARY AND CONCLUSION
A cephalometric study of fourteen Puerto Rican
young adults with beautiful or handsome faces was carried
1.
out by means of Steiner (1953, 1959), Tweed (1954),
Burstone (1958), Neger (1959), Subtelny (1959), Holdaway
(1964), Ricketts (1964), and Peck and Peck (1970) osseous
and soft tissue analyses. Part of University of Connecti
cut's soft tissue analysis was also utilized (syllabus
1979-1980). The fourteen subjects were selected on basis
of facial esthetics by a jury of forty Puerto Ricans of
various professions, selected at random. The mean age of
the subjects was twenty-three years with a standard
deviation of 1.50 years.
2. The cephalometric means for the Puerto Rican
young adult sample was established utilizing Steiner
(1953, 1959), Tweed (1954), Burstone (1958), Neger
(1959), Subtelny (1959), Holdaway (1964), Ricketts
(1964), and Peck and Peck (1970) osseous and soft tissue
analyses. The cephalometric means for part of the
University of Connecticut's soft tissue analysis were
also established.

84
A comparison was made by means of T-tests and
correlation analyses between, the means of the Puerto
Rican young adults and the Steiner (1953, 1959), Tweed
(1954), Burstone (1958), Neger (1959), Subtelny (1959),
Holdaway (1964), Ricketts (1964), and Peck and Peck
(1970) osseous and soft tissue means or norms. The
3.
Puerto Rican young adult sample group was characterized
by maxillary protrusion, forwardly positioned dentition,
and a well developed mandible. The integumentum in the
perioral area for the Puerto Rican studied group was
smaller in a horizontal plane than the reported means of
Burstone.
Puerto Rican young adults presented a flatter
occlusal plane mean than the reported norm by Steiner
(1953, 1959).
4.
The Puerto Rican concept of acceptable facial
esthetics were in good agreement with the standards
established by orthodontists on the basis of normal
occlusion (Steiner, 1953, 1959; Tweed, 1954; Neger, 1959;
Subtelny, 1959; Holdaway, 1964; and Ricketts, 1964).
The distinction between Puerto Rican male young
adults and female young adults was related to the hori
zontal extension measurements as described by Burstone
The female group had smaller integumental
extensions than the male group,
consistent with Burstone's for the Caucasians.
5.
6.
(1958).
This finding was

85
The present investigation pointed out the
differences between Puerto Rican young adults and
7.
Caucasians. What was considered normal for the Caucasian
was generally considered normal for the Puerto Rican
young adult group.

86
APPENDIX A
PROYECTO DE INVESTIGACION EN ORTODONCIA
INSTRUCTONES PARA EL JURADO
Estoy realizando un estudio de investigacion
Ortodoncia donde necesito la opinion de ustedes sobre lo
que consideran caras bonitas, aceptables y no aceptables.
Se les presentaran una serie de fotografias
cada uno de ustedes le den la puntuacion correspondiente
desde un maximo de tres (3) a un minimo de uno (1).
Les presentaremos una fotograf.ia de frente y otra de
Si en su opinion de cara es
bonita (o guapo si es varon) escriban tres (3) en el
espacio correspondiente a la derecha del numero
papel. Si es aceptable le dan dos (2),
aceptable uno (1).
Favor
puntuacion.
No se les dara para atras a las fotografias.
en
para que
perfil de la misma persona.
en su
si no es
de no consultar entre ustedes para dar

87
APPENDIX B
Personal Consent Form
I understand that
the primary objective of this research is to determine
specific standard values related to soft tissue and
osseous face structures for the Puerto Rican culture.
These will be identified by the public of the
culture ^ beautiful. It is the purpose of this
investigation to provide specific values to orthodontists
of Puerto Rico in treating Puertorrican patients. I
agree to be subjected to the methodology chosen by the
investigators. This includes: front view and lateral
photographs, oral examination, cephalometric X-Rays and
the completion of a personal questionnaire. I understand
that there are no risks pertaining to this matter with
the exception of the X-Rays where I will be exposed to
short time radiation. The X-Ray technique to be used is
not an experimental procedure.
I agree that in the event of physical injury,
resulting from this research study, no financial
compensation is available, but I will receive medical
treatment free of charge at the University District
Hospital.
same

88
As participant in this investigation I will receive
a free oral examination and orientation concerning oral
treatment I may need.
Any questions pertaining to the objectives of the
research, or the methodology used will be answered by any
of the participating investigators at any time. After
this study is complete I will have no objection that
data, photographs or other information regarding my
person in the conduct of the study be published.
It is understood that I am free to withdraw this
consent and to discontinue my voluntary participation in
this project at any time I choose to.
Date Signature

89
APPENDIX C
Personal Information Questionnaire
Name
Address Age
Phone No.
Have you ever had extraction performed?
When?
Have you had orthodontic treatment?
At what age?
How Long?
Did you ever have finger sucking or tongue habits?
Have you ever been subjected to radiotherapy?
When?
How long?
Women Only: Are you presently pregnant?
Oral Examination
Missing Teeth
Molar Relationship
Cuspid Relationship
Rotated Teeth
Midline deviation
Overjet mm
Overbite mm

90
Observations:

91
APPENDIX D
PROYECTO DE INVESTIGACION EN ORTODONCIA
EVALUACION DE FOTOGRAFIAS
ESCALA: 3 = Bonita o Guapo 2 = Aceptable 1 = No aceptable
Numero de Fotografias Puntuacion
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

92
Numero de Fotografias Puntuacion
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45

93
Numero de Fotografias Puntuacion
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70

94
Numero de Fotografias Puntuacion
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95

95
Numero de Fotoqrafias Puntuacion
96
97
98
99
100
101
102
103
104
105
Fecha Ocupacion

96
APPENDIX E
TABLE 28
RAW DATA FOR PUERTO RICAN
FEMALE YOUNG ADULT SAMPLE GROUP
Variable SUBJECTS
M. C. W. D. M. M. A.
CANALS CORDERO GARCIA ROSICH MALDONADO ALVARADO DELATORRE
SNA 82° 86° 83° 76° 87° 86.5° 83°
SNB 78 79.5 81.5 74 81 82.5 77
ANB 4 6.5 2.5 2 6 4 6
SND 76 77.5 79 73 79 80 76
L to NA 25 8.5 26.5 31 11.5 19 23
L to NA(inm) 6 0 6.5 8.5 2 5 5
T to NB 37 20.5 22 23 30 31 31.5
T to NB(mm) 8.5 4 4 4 4 6 10
Po to NB(mm) 4 3 1 5 3 2 4
LT 113 142 129 124.5 131 129 120
Occl to SN 13 13.5 13.5 18/5 11 16 13
GoGnSn 30 33.5 32 39 25 30.5 37
SL(nun) 54 41 56 53 59 54.5 46
SE(mm) 19 22.5 18 20 19 24 23
FMA 23 26 19 32 15 23.5 31
IMPA 108 92 94 85.5 104 92.5 97.5
FMIA 49 62 67 59 60 64 51.5
H 10 10 6 6.5 11 11 11
LsN'Li 4 4 3 4 5 4 3.5
LiN'PgI
3.5 3 3.5 2.5 3.5 4 5

97
TABLE 28
(Continued)
Variable SUBJECTS
M. C. W. D. M. M. A.
CANALS CORDERO GARCIA ROSICH MALDONADO ALVARADO DELATORRE
LsN'Pg* 7.5 7 6.5 6.5 8.5 8 8.5
Facial Ang. 103 105 106 103 105 106 112
Nasal Angle 25 24 20 26 18 22 24
Max. Angle 13 14 13 12.5 13 13 15.5
Mand. Angle 17.5 17 16 18.5 14.5 14 14
Nas.Max.Ang. 106.5 108.5 100 109 106.5 104 99
Tot.Vert. 55.5 55 49 57 45.5 49 56
Nasal Prof 27.5
Convexity
N'SnPg
Tot. Profile
Convexity 131
162
21 29 25 34 28 20
161 167.5 166.5 154 165 160
134 138 134 123 135.5 134
Prn-Sn-Ls 122.5 137.5 121 133 138 115 125.5
Sn-N-Prn 24 22 25 20 21 18 17
Glabella 6 6.5 4 5 5 6 4.5
Subnasale
Super. Labial
Sulcus
13.5 16.5 13 15.5 15 14 13
13 14 13.5 14 14 13 12.5
Labrale
Superius
Labrale
Inferius
9 13 11 12 11.5 12 10
7 13.5 13.5 14 15 14 12
Inf. Labial
Sulcus 10 9.5 12 12 10 14 13
Pogonion
Subspinale-Superior Sulcus -6.5
9 12.5 13 10 10.5 12 10
-5.5 -3 0 -2 0 -2.5

98
TABLE 28
(Continued)
Variable SUBJECTS
M. C. W. D. M- M. A.
CANALS CORDERO GARCIA ROSICH MALDONADO ALVARADO DELATORRE
Supramentale
Inf. Sulcus
IncisionStomion
-5 1 0 -4 0 +2 0
+2 +4 +4.5 +2.5 +5.5 +5 +1
LsSnPg 3 1 4 5 2 5 4.5
LiSnPg 1 0 3 3 1 4 5
G-Sn 4 10 6 1 10 7 6
Sn-Me 22.5 21.5 19.5 23 24 22 27.5
Prn-Sn 16 14.5 13 19 19 14 14
Sn-Stm 21 20 22 22 20 20.5 24
ILs-Stm 18 17.5 20 16.5 16 16 19
S"plane-UL II 0 0 0 0 0 0 0
IIS"plane-LL 0 -1 +1 0 +0.5 +1 +2
"E"Line-UL -3 -5 -5 -7 -5 -2 -2
"E"Line-LL -1 . -4 -2 -4 -2 -0.5 +0.5

99
TABLE 29
RAW DATA FOR PUERTO RICAN
MALE YOUNG ADULT SAMPLE GROUP
Variable SUBJECTS
M. A. A. R. M. E. D.
FERRAN RAMOS GARCIA BAEZ LOPEZ JUSTINIANO HILMAN
SNA 85.5® 81.5° 83° 80° 90.5° 87.5° 80°
SNB 82 75 83 77 84 82.5 81
ANB 3.5 6.5 0 3 5.5 5 -1
SND 80.5 77.5 81.5 74.5 83.5 80.5 81.5
L to NA 24 8.5 25 22 18.5 24 30.5
L to NA(mm) 6 3 6.5 3.5 0.5 8 11
T to NB 30 27 17 22.5 22.5 30.5 23.5
T to NB(min) 8 8.5 3 4 4 8 6
Po to NB(mm) 3 1.5 6 2.5 5.5 0 4
LT 121 132 136 130.5 131.5 120 125
Occl to SN 10.5 15 5 14 8 10.5 10
GoGnSn 28 38 22 30 22 32.5 30.5
SL{mm) 64 52.5 56 60.5 61 61 52.5
SE (nun) 17 18 24 22 21 17 23
FMA 21 26.5 14.5 25 16 29 24
IMPA 100 92 92 97 95 91.5 90.5
FMIA 59 61.5 73.5 58 69 59.5 65.5
H Angle 13 16.5 15 7 8 10 4
LsN'Li 4 6 1 2 2 3.5 1.5
LiN'Pg 4.5 5 1 2.5 3.5 4 .5

100
TABLE 29
(Continued)
Variable SUBJECTS
M. A. A. R. M. E. D.
FERRAN RAMOS GARCIA BAEZ LOPEZ JUSTINIANO HILMAN
LsN'Pg* 8.5 11 2 4.5 5.5 7.5 2
Facial Ang. 115 113 103 102 110 109 111
Nasal Angle 23 24 21 20 23 20 22
Max. Angle 12 16 15 19 13.5 16 14.5
Mand. Angle 18 19.5 15 17 15 15.5 17.5
Nas.Max.Ang. 101 99 103.5 108 107 95 110
Tot.Vert. 53 49.5 51 56 51.5 51.5 54
Nasal Prof 21.5
Convexity
N'SnPg
Tot. Profile
Convexity 131
159
27.5 33.5 29 32 20 27.5
159.5 166.5 170 152 156.5 165
129 137 135 128 129 129
Prn-Sn-Ls 125 125 138 133 131 130 126
Sn-N-Prn 18 19 19.5 22 19 19 22
Glabella 6 6.5 6 6 6 7 6
SUbnasale
Super. Labial
Sulcus
20 18 19 14 20 17.5 25
18 17 18 11.5 19.5 18 21
Labrale
Superius
Labrale
Inferius
Inf. Labial
Sulcus
14.5 15.5 12.5 12 11.5 11 12.5
13 15.5 15.5 13 15.5 13 13.5
14.5 13 11 12 10.5 13 13.5
Pogonion
Subspinale-Superior Sulcus -6.5
13 13 10 11.5 10 15 15
-5 -7 -8 -3.5 -9 -10

101
TABLE 29
(Continued)
Variable SUBJECTS
M. A. A. R. M. E. D.
FERRAN RAMOS GARCIA BAEZ LOPEZ JUSTINIANO HILMAN
Supramentale
Inf. Sulcus
IncisionStomion
0 0 0 +2 +1 0 +2
+2 +1/5 +2 +5 +4 +1 +1
LsSnPgI
3 6 5 1.5 -1.5 4 -.5
LiSnPg 2 4 0 2 -1 3.5 -1
G-Sn 13 5 10 2 17 13 9
Sn-Me 22 31 20 23.5 30 26 22
Prn-Sn 15 17 15 18.5 12.5 14 19
Sn-Stm 23 25 24 18 22 25.5 22
ILs-Stm 20 16 20 20 15.5 17.5 22
S"plane-UL II 0 2 -3.5 -3.5 -3 0 -4
II S"plane-LL 0 1.5 -3 -2 -2 +2 -4
"E"Line-UL -4 -1 -7 -7 -7 -4 -11.5
"E"Line-LL -2 -0.5 -5 -4 -4 -0.5 -8.5

102
APPENDIX F
(

103
PUERTO RICAN
FEMALE SAMPLE GROUP

104

105
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i ''
t\\
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V
'■.'f-:’<^K
\
-A \-rf
\
\

106
A
i

107
X

108
PUERTO RICAN MALE
SAMPLE GROUP

109

110
fljw' t J
41
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Ill

112

113
BIBLIOGRAPHY
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2. Blanco, Thomas: Pontuario Historico de Puerto Rico,
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3. Broadbent, B.H.: A New X-Ray Technique and Its
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1931.
4. Burstone, Charles: Integumental Contour and Extension
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5. Burstone, Charles: Univ. of Connecticut Soft Tissue
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6. Chang, Thomas: An Evaluation of the Norms in the
Oriental Face and Its Comparison to Downs I
and
Steiner's Standards, Master Thesis, University of
Southern California, 1964.
7. Downs, W.: Variations in Facial Relationship: Their
Significance in Treatment and Prognosis, Am. J.
Orthod. 34:812-840, 1948.
8. Drummond, R.: A Determination of Chephalometric
Norms for the Negro Race, Am. J. Orthod. 54:670-
682, 1968.

114
9. Garcia, C.: Cephalometric Evaluation of Mexican
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Am. J. Orthod. 68:67-74, 1975.
10. Gonzalez-Ulloa, Mario: Perfiloplastia, Tribuna
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Hajighadimi, Mohammad: Cephalometric Evaluation of
the Iranian Children and its Comparison to the
11.
Tweed’s and Steiner’s Standards, Certificate Thesis,
University of Southern California, 1979.
12. Hambleton, R.S.: Soft Tissue Covering of the Skeletal
Face as Related to Orthodontic Problems. Am. J.
Orthod. 50:405-419, 1964.
13. Instituto de Culture Puertoriquena, Publicacion de
Apuntes Historicos, Impreso en Barcelona, Espana por
M. Pareja. San Juan, Puerto Rico, 1973.
14. Kwon, Joon Gun: A Roentgenographic Cephalometric
Study for Korean Children Using the Steiner, Alabama,
Downs, Tweed, and Sassouni Analyses, Certificate
Thesis, University of Southern California, 1981.
15. Margolis, H.: The Axial Inclination of the Mandibular
Incisors, Am. J. Orthod. and Oral Surg. 29:571-582,
1943.
Margolis, H.: A Basic Facial Pattern and Its Appli
cation in Clinical Orthodontics, Am. J. Orthod.
16.

115
33:631-641, 1947.
17. Merrifield, Levern: The Profile Line as an Aid in
Critically Evaluating Facial Esthetics, Am. J.
Orthod. 52:804-822, 1966.
18. Neger, Milton: A Quantitative Method For the Evalu
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Orthod. 45:738-750, 1959.
19. Peck and Peck, H. and J.: A Concept of Facial
Esthetics, Am. J. Orthod. 40:284-317, 1970.
20. Ricketts, R»M.: Foundation for Cephalometric
Communication. Am. J. Orthod. 46:330-357, 1960.
21. Ricketts, R-M.: Cephalometric Analysis and Synthesis,
Angle Orthod. 31:141-156, 1961.
22. Riedel, Richard: An Analysis of Dentofacial Relation
ships, Am. J. Orthod. 43:103-119, 1957.
23. Speidel, T.D.
Mandibular Incisor Axis in Adult Normal Occlusion,
and Stoner, M.M.: Variation of the
Am. J. Orthod. 30:536-545, 1944.
24. Steiner, C.: Cephalometries for You and Me, Am. J.
Orthod. 39:729-755, 1953.
25. Steiner, C.: Cephalometries in Clinical Practice,
Angle Orthod. 29:8-29, 1959.
26. Steiner, C.: The Use of Cephalometries as an Aid

116
to Planning and Assessing Orthodontic Treatment. Am.
J. Orthod. 46:721-735, 1960.
27. Sxibtelny, J.D.: A Longitudinal Study of Soft Tissue
Facial Structures and Their Profile Characteristics
JDefined in Relation to Underlying Skeletal
Structures, Am. J. Orthod. 45:481-507, 1959.
28. Tweed, Charles:
in Orthodontic Diagnosis.
Planning and Prognosis, Am.
The Frankfort-Mandibular Plane Angle
Classification, Treatment
J. Orthod. 32:175-221,
1946.
29. Tweed, C.: Evolutionary Trend in Orthodontics
Present and Future. Am. J. Orthod. 39:81-108
Past,
, 1953.
30. Tweed, C.’ The Frankfort Mandibular Angle (FMIA) in
Orthodontic Diagnosis
Prognosis, Angle Orthod. 24:121-169, 1954.
i Treatment Planning, and
31. Uesato, G., Kinoshita, E Kawamoto, T., Koyama, I.,
and Nakanishi, Y.: Steiner Cephalometric Norms for
• /
Japanese and Japanese Americans, Am. J. Orthod.
73:321-327, 1978.
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Asset Metadata

Creator Oliva Lebron, Jazmin E. (author)

Core Title Osseous and integuemental cephalometric study of the Puerto Rican ethnic group utilizing public opinion in the concept of esthetics

School School of Dentistry

Degree Certificate in Orthodontics

Degree Program Orthodontics

Degree Conferral Date 1983-06

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag OAI-PMH Harvest

Format theses (aat)

Language English

Contributor Digitized from Wilson Dental Library copy by USC Digital Imaging Lab in 2024 (provenance)

Advisor Dougherty, Harry L. (committee chair), Singer, Julian (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113998T8W

Unique identifier UC113998T8W

Identifier etd-OlivaLebron-1983.pdf (filename)

Legacy Identifier etd-OlivaLebron-1983

Document Type Thesis

Format theses (aat)

Rights Oliva Lebron, Jazmin E.

Internet Media Type application/pdf

Type texts

Source 20240806-usctheses-OstrowDental (batch), University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright.

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu