Differentiation between maxillary and malar midface position within the facial profile

AIMS: To define midfacial position differentiating maxillary and zygomatic regions and to evaluate the corresponding cephalometric characteristics discerning midfacial flatness and fullness. MATERIAL AND METHODS: A total of 183 pretreatment lateral cephalometric radiographs of non-growing orthodontic patients (age 25.98 ± 8.43 years) screened at our university orthodontic clinic. The lateral cephalographs of the orthodontic patients were stratified in four groups: flat, normal toward flat, normal toward full, full,according to distances from nasion and sella to points J and G (NJ, SJ, NG and SG). J is the midpoint of the distance connecting orbitale to point A, and G the center of the triangle connecting orbit, key ridge and pterygomaxillary fissure. Statistics included the Kendall tau-b test for best associations among measurements. RESULTS: All measurements were statistically significantly different between flat and full groups. The highest associations were between NJ and SJ (τb = 0.71; p < 0.001) and NG and SG (τb = 0.70; p < 0.001). Flat midfaces were characterized by canting of the cranial base and palatal plane, hyperdivergent pattern and maxillary retrognathism. The opposite was true for fuller midfaces. CONCLUSION: Midface skeletal location was assessed differentially in the naso-maxillary and malo-zygomatic structures differentially. Craniofacial characteristics were identified according to this stratification, indicating the potential for application in facial diagnosis and need for testing on 3D cone-beam computed tomography images.