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International Journal of Dentistry and Oral Science (IJDOS)  /  IJDOS-2377-8075-08-7017

Prevalence And Gender Association Among Different Types Of Nasolabial Angles


John Rozar Raj1, Nivethigaa .B2*, Nivedhitha M.S3

1 Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai – 600 077, TN, India.
2 Senior Lecturer, Department of Orthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, Poonamallee High Road, Chennai - 600077, Tamil Nadu, India.
3 Professor, Department of Conservative Dentistry & Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, Poonamallee High Road, Chennai - 600077, Tamil Nadu, India.


*Corresponding Author

Nivethigaa .B,
Senior Lecturer, Department of Orthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, Poonamallee High Road, Chennai - 600077, Tamil Nadu, India.
Tel: 9791972324
E-mail: nivedhigaab.sdc@saveetha.com

Received: May 28, 2021; Accepted: June 16, 2021; Published: July 03, 2021

Citation:John Rozar Raj, Nivethigaa .B, Nivedhitha M.S. Prevalence And Gender Association Among Different Types Of Nasolabial Angles. Int J Dentistry Oral Sci. 2021;8(7):3002-3005.doi: dx.doi.org/10.19070/2377-8075-21000611

Copyright: Nivethigaa .B©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.



Abstract

Various pre-treatment soft tissue analyses have always been used to determine facial aesthetics, thus offering an important diagnostic tool to clinicians. A frequently used soft tissue parameter in orthodontic diagnosis is the nasolabial angle. The nasolabial angle is defined as the angle between the line drawn through the midpoint of the nostril aperture and a line drawn perpendicular to the Frankfurt horizontal while intersecting subnasale. This study was done to determine the prevalence and gender association of different types of nasolabial angles. This was a retrospective study. Samples were collected from the patient record archive from a private dental institution and used for the purpose of the study. Data of different types of nasolabial angles were collected for patients of all the age groups. Excel tabulation was done and SPSS results were obtained. In the present study, the prevalence of straight nasolabial angle was 95%, prevalence of acute nasolabial angle was 4% and the prevalence of obtuse nasolabial angle was 1% and the results were statistically significant (p<0.05). From the present study, we can conclude that the prevalence of straight nasolabial angles was more common in both male and female population and among various age groups when compared to acute and obtuse nasolabial angles.


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1.Keywords
2.Introduction
6.Conclusion
8.References

Keywords

Nasolabial Angle; Nasolabial Fold; Orthodontic Diagnosis; Orthodontic Treatment Planning.


Introduction

In orthodontics, various pre-treatment soft tissue analyses have always been used to determine facial aesthetics, thus offering an important diagnostic tool to clinicians. A frequently used soft tissue parameter in orthodontic diagnosis is the nasolabial angle. Nasolabial angle is defined as the angle between the line drawn through the midpoint of the nostril aperture and a line drawn perpendicular to the Frankfort horizontal plane while intersecting subnasale. Studies on facial profile have demonstrated that facial balance should have been obtained if a proportional relationship between the nose, upper lip and chin exists. Thus the nasolabial angle becomes a clinical and cephalometric parameter for the determination of soft tissue profile alterations. The nasolabial angle is formed by two lines, one from the nose, another from the upper lip and both independent of each other. The angular measurement described by these two lines is a resultant of the individual inclinations. The nasolabial angle of a person may be within the normal range. Small or large the measurement of this angle alone provides inadequate information as it does not reveal which component is responsible for the variability. It could be the nose, lip or both. Therefore, it is important to analyze each component of the angle to assist in the differential diagnosis of normal from its variation. Fitzgerald [1] developed a new method of constructing the nasolabial angle [2, 3]. There are three types of nasolabial angles: straight, acute and obtuse. An arbitrary range of 90 to 120 degrees is stated as the ideal nasolabial angle [4]. When the nasolabial angle is over 130 degrees, the nasolabial angle is described as obtuse nasolabial angle, while an angle of 90 degrees or less is described as an acute nasolabial angle. An acute nasolabial angle can cause airway interference. It can be seen in patients with repaired cleft lip and palate who experienced some horizontal and vertical collapse of the maxilla. The obtuse nasolabial angle is often seen with anteroposterior maxillary deficiency. Generally, the more obtuse the nasolabial angle, the more prominent the nostrils become. It can even cause a gummy smile and lip competence. Nasolabial between 90 to 120 degrees is considered more aesthetic [5, 6]. Thus the nasolabial angle plays a very important role in orthodontic diagnosis and aesthetics.Previously our team has a rich experience in working on various research projects across multiple disciplines [7-21]. This study was done to determine the prevalence and gender association of different types of nasolabial angles.


Materials And Methods

This was a retrospective study. The study setting was a university setting. Ethical approval was obtained from the Institutional ethical committee(SDC/SIHEC/DIASDATA/0619-0320). Samples were collected from the patient record archive from a private dental institution and used for the purpose of the study. Cross verification was done with another examiner to avoid any missing data values .Sampling bias was minimised by including all available data without any sorting process. Data of different types of nasolabial angles were collected for patients of all the age groups and entered in a methodological manner. Excel Tabulation and SPSS importing was done. Incomplete data were excluded from the study. Independent variables were age and gender. Dependent variable was types of nasolabial angles. Data was analyzed using SPSS software (IBM SPSS Statistics, Version 24.0, Armonk, NY: IBM Corp]. Chi-square test was performed to find the association between the variables. The level for a statistical significance was set at p<0.05.


Results And Discussion

In this study, out of 41,190 patients, 23930 were males and 17251 were females. Higher prevalence of straight nasolabial angle was seen in the population under all age groups with the percentage of 95%, acute nasolabial angle was seen with the percentage of 4% and obtuse nasolabial angle was seen the least with the percentage of 1% (Figure 1). Straight nasolabial angles were distributed more commonly among all the age groups. Acute nasolabial angle was distributed more between the age group of 19-35 years. Obtuse nasolabial angle was found lesser than the other two types of nasolabial angle. In the study done by Owen.et.al [22], the nasolabial angle was reported to be small in younger patients. In the study done by Nanda.et.al [23], they reported that the nasolabial angle changes little after 7 years. The nasolabial angle decreased slightly from 7 to 18 years of age in both the sexes with the mean being 107.8° for boys and 114° for girls. At 18 years, the means were 105.8 for men and 110.7° for women.

Higher prevalence of straight nasolabial angles was seen among both male and female population compared to other forms ( Figure 2) and the results obtained were statistically significant. Straight nasolabial angles were distributed more in male patients. Acute and obtuse nasolabial angles were distributed equally in both male and female patients. In the study done by Fitzgerald. et.al [1], No statistical significance was seen between men and women, but the women did have a slightly larger nasolabial angle. But in our study, there was statistical significance. In the study done by Kommi.et.al [24], No statistically significant difference was observed between male and female, but males recorded a more obtuse nasolabial angle of 101.73°and females recorded a nasolabial angle of 98°. In the study done by Vinay. et.al [25], Males had shown higher nasolabial angle values in comparison to females in the Indian population. Various other studies have demonstrated that soft tissues which vary considerably in thickness are a major factor in determining a patient’s profile [26, 27]. This study showed about the different types of nasolabial angles and it’s efficiency in orthodontic diagnosis and treatment planning. Our institution is passionate about high quality evidence based research and has excelled in various fields [28-38].

The findings of the present study add to the consensus of the previous study. Smaller sample size could not provide results of the entire population. So future studies can be done with a larger sample size. Factors like all age groups can be considered. Different types of nasolabial angles and its association with malocclusion can be analysed.


Figure 1. Bar chart depicts the prevalence of different types of nasolabial angles in different age groups. X-axis denotes age groups. Y-axis denotes the number of patients with different forms of nasolabial angle. (Chi-square test, p value- 0.001; ( <0.05) hence statistically significant). Higher prevalence of straight nasolabial angles (Blue) was seen in the population under all age groups, compared to acute(green) and obtuse(beige) nasolabial angle and the results obtained were found to be statistically significant.

Figure 2. Bar chart depicts the gender distribution of different forms of nasolabial angle. X-axis denotes different forms of nasolabial angle and Y-axis denotes the number of patients in each category. (Chi-square test, p value- 0.001(<0.05, hence statistically significant). Higher prevalence of straight nasolabial angles was seen among both male(red) and female(purple) populations compared to other forms and the results obtained were statistically significant.

Conclusion

From the present study, we can conclude that the prevalence of straight nasolabial angles(95%) was more compared to acute(4%) and obtuse(1%) nasolabial angle. Gender and age association revealed that in the population studied, the presence of straight nasolabial angle was seen more in both the gender and in all the age groups. Thus greater emphasis needs to be placed on their evaluation in formulating treatment plans for dentofacial disharmonies. Multicentric studies should be done to establish the norms as well as prevalence in various populations.


Author’s Contribution

All authors have equal contribution in bringing out this research work.


Acknowledgement

The study was supported by Saveetha Dental College and Hospitals who provided insights and expertise that greatly assisted the study. We could also like to thank the reviewers of the article for their insights.


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