Cephalometric norms and esthetic profile preference for the Japanese: a systematic review

Bronfman, Caroline Nemetz; Janson, Guilherme; Pinzan, Arnaldo; Rocha, Thais Lima

doi:10.1590/2177-6709.20.6.043-051.oar

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Articles • Dental Press J. Orthod. 20 (6) • Nov-Dec 2015 • https://doi.org/10.1590/2177-6709.20.6.043-051.oar copy

Cephalometric norms and esthetic profile preference for the Japanese: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To determine the cephalometric parameters and esthetic preferences of a pleasant face for the Japanese population.

Methods:

For the present study, the following databases were accessed: PubMed, Embase, Scopus and Web of Science. Initial inclusion criteria comprised studies written in English and quoting cephalometric norms and/or facial attractiveness in Japanese adults. No time period of publication was determined. The quality features evaluated were sample description, variables analyzed and how cephalometric standards or facial profile were evaluated.

Results:

Initially, 60 articles were retrieved. From the selected studies, 13 abstracts met the initial inclusion criteria. They were divided into two groups; seven articles were included in Group I and six articles in Group II, according to the criteria of evaluation: cephalometric or facial analyses.

Conclusion:

Japanese are characterized by having a less convex skeletal profile, bilabial protrusion, less prominent nose, more retruded chin and protruded mandibular incisor. Despite living in a society with homogeneous patterns, they seem to get an esthetic preference for white-like features. Therefore, in addition to ethnic normative values, patient's preferences to establish individual treatment plans should always be considered.

Japan; Face; Dental radiography; Review

Database	Keywords	Results	Selected	% of total selected abstracts
PubMed	Cephalometric, Japanese, norms or profile	60	7	5
Embase	Cephalometric, Japanese, norms or profile	37	8	5
Scopus	Cephalometric, Japanese, norms or profile	36	11	6
Web of Science	Cephalometric, Japanese, norms or profile	52	11	9
Cochrane	Cephalometric, norms, Japanese	0	0	0
Hand search		12	6	6
Total		23*	22*	13*

Article	Year of publication	Quality feature
Article	Year of publication	Ethnic group compared	Sample size	Balanced sample of man and woman	Provides table with measurements	Measures soft and hard tissues	Inclusion criteria of sample
Reitz et al¹³	1973	X	X	X	X	X	X
Miyajima et al²	1996	X	X	X		X	X
Alcade et al⁴	1998	X	X	X	X	X	X
Alcade et al⁷	2000	X	X	X	X		X
Scavone et al¹⁵	2006	X	X	X	X		X
Ioi et al⁹	2007	X	X	X	X	X	X
Shindoi et al³	2013	X	X		X	X	X

Article	Year of publication	Quality feature
Article	Year of publication	Kind of raters	Sample size	Balanced sample of man and woman	Elimination of distracting variables	Measures soft and hard tissues	Inclusion criteria of sample
Mantzikos T.¹¹	1998	X	X	X	X
Ioi et al⁸	2005	X	X	X	X	X	X
Ioi et al¹⁰	2008	X	X	X	X	X	X
Nomura et al¹²	2009		X	X	X	X	X
Kuroda et al⁶	2009	X	X			X	X
Shimomura et al¹⁶	2011	X	X	X	X	X	X

Article	Year of publication	Cephalometric landmarks	Ethnic group compared with the Japanese
Reitz et al¹³	1973	The authors describe lines and planes to create 17 angular measurements.	Caucasian - American
Miyajima et al²	1996	McNamara	European - American
Alcade et al⁴	1998	Burstone and Leagan	White American
Alcade et al⁷	2000	Ricketts Epker et al Legan and Burstone Holdaway	White
Scavone et al¹⁵	2006	Arnett et al	White American
Ioi et al⁹	2007	Riolo et al McNamara Miyajima et al Legan and Burstone Bishara Burstone and Marcotte	Caucasian
Shindoi et al³	2013	Arnett et al	White

Japanese men	Reitz et al,¹³ 1973	Miyajima et al,² 1996	Alcalde et al,⁴ 1998	Alcalde et al,⁷ 2000	Scavone et al,¹⁵ 2006	Ioi et al,⁹ 2007	Shindoi et al,³ 2013
Skeletal relationship	More retruded mandibular A-P position						X
	Shorter maxilla in A-P dimension			X	X			X
	Reduced midfaces		X
	Smaller facial axis angle		X
	Larger Frankfort to mandibular plane angle						X
Soft tissue	Bilabial protrusion	X	X	X	X	X	X	X
	Smaller nasolabial angle		X				X
	Less prominent nose	X			X	X
	Retruded chin				X			X
	Larger labiomental sulcus						X
	Smaller Z-angle						X
Dental relationship	More protruded lower incisor		X				X	X

Japanese women		Reitz et al,¹³ 1973	Miyajima et al,² 1996	Alcalde et al,⁴ 1998	Alcalde et al,⁷ 2000	Scavone et al,¹⁵ 2006	Ioi et al,⁹ 2007	Shindoi et al,³ 2013
Skeletal relationship	More retruded mandibular A-P position						X
	Shorter maxilla in A-P dimension			X	X			X
	Reduced midfaces		X
	Larger lower facial height						X	X
	Steeper mandibular plane angle		X
Soft tissue	Bilabial protrusion	X	X	X	X	X	X	X
	Smaller nasolabial angle		X
	Less prominent nose	X			X	X
	Retruded chin				X	X
Dental relationship	More protruded lower incisor		X				X	X

Article	Year of publication	Methods to evaluate the profiles	Examiners	Results
Mantzikos et al¹¹	1998	Five facial profile types were computer-generated to represent distinct facial types.	Japanese cultural and educational background that have immigrated from Japan within the past 5 years.	The profiles preferred were (in descending order): orthognatic, bimaxillary dentoalveolar retrusion, bimaxillary dentoalveolar protrusion, mandibular retrognathism and mandibular prognathism.
Ioi et al⁸	2005	Series of facial silhouettes with varying anteroposterior lip position.	Japanese orthodontists and young adult Japanese dental students.	Both orthodontists and students preferred a profile with slightly retruded lips.
Ioi et al¹⁰	2008	Series of facial silhouettes with varying anteroposterior lip position.	Young Korean and Japanese adults.	Both the Korean and Japanese tended to prefer slightly more retruded lip position.
Nomura et al¹²	2009	Silhouette profiles with various distances from lip to E-line.	Lay judges of European American, Hispanic American, Japanese and African.	All judges preferred lips located posterior to the E-line.
Kuroda et al⁶	2009	Profile images with point B and Menton anteriorly or distally moved by software.	Male and female Japanese laypeople.	Moderate mandibular retrusion was the most favored profile. A slight mandibular retrusion is more favorable than the mean image, and mandibular protrusion is less attractive.
Shimomura et al¹⁶	2011	Series of facial silhouettes with varying anteroposterior lip position.	Male and female orthodontic Japanese patients.	Patients tended to prefer a lip position that was slightly retruded compared with the average facial profile for both men and women.

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