Evaluation of diagnostic criteria for clinical assessment of anterior malar projection in relation to midface esthetics

Introduction: There is a shortage of diagnostic criteria of midfaceesthetics in orthodontics literature. Orthodontists focus entirely on the premaxilla for classification of maxillary skeletal development because of difficulty in assessment of midface in lateral cephalogram. So, the lack of cephalometric landmark preclude the availability of normative data, making analysis and malar augmentation largely subjective. Aim: To determine whether visual classification of anterior malar projection using vector relationship is supported by cephalometric analysis. Material and Method: Pretreatment lateral cephalogram and profile photograph of 40 subjects were included in the study. Based on visual assessment of negative and positive vector relationships, subjects were equally divided into two groups of 20 each. Group Aexhibiting a positive vector relationship, comprised 20 subjects (10 male, 10 female). Group B displaying a negative vector relationship, comprised 20 subjects (10 male, 10 female).Toevaluate the subjects anteroposterior position of the malar eminence relative to the cranial base, SNO angulations were measured in both the groups. Mann-Whitney U-tests has been used for assessment of Gender differences and significant differences in SNO measurements between groups A and B Results: There was no statistically significant difference between genders. SNO angulations in the negative vector group were smaller than the positive vector controls by an average of 6.8 degrees. Highly significant difference were seen in anterior malar projection in patient with positive and negative vector relationship. Conclusion: Compared with subjects exhibiting a positive vector relationship, individuals displaying a negative vector relationship had significantly reduced malar support.