Prevalence of long face pattern in Brazilian individuals of different ethnic backgrounds

Abstract

Objective:The long face pattern is a facial deformity with increased anterior total facial height due to vertical excess of the lower facial third. Individuals with long face may present different degrees of severity in vertical excess, as well as malocclusions that are difficult to manage. The categorization of vertical excess is useful to determine the treatment prognosis. This survey assessed the distribution of ethnically different individuals with vertical excess according to three levels of severity and determined the prevalence of long face pattern. Material and Methods:The survey was comprised of 5,020 individuals of Brazilian ethnicity (2,480 females and 2,540 males) enrolled in middle schools in Bauru-SP, Brazil. The criterion for inclusion of individuals with vertically impaired facial relationships was based on lip incompetence, evaluated under natural light, in standing natural head position with the lips at rest. Once identified, the individuals were classified into three subtypes according to the severity: mild, moderate, and severe. Then the pooled sample was distributed according to ethnical background as White (Caucasoid), Black (African descent), Brown (mixed descent), Yellow (Asian descent) and Brazilian Indian (Brazilian native descent). The Chi-square (χ2) test was used (p<0.05) to compare the frequency ratios of individuals with vertically impaired facial relationships in the total sample and among different ethnicities, according to the three levels of severity. Results:The severe subtype was rare, except in Black individuals (7.32%), who also presented the highest relative frequency (45.53%) of moderate subtype, followed by Brown individuals (43.40%). In the mild subtype, Yellow (68.08%) and White individuals (62.21%) showed similar and higher relative frequency values.Conclusions:Black individuals had greater prevalence of long face pattern, followed by Brown, White and Yellow individuals. The prevalence of long face pattern was 14.06% in which 13.39% and 0.68% belonged to moderate and severe subtypes, respectively.

Prevalence of the Short Face Pattern in Individuals of Bauru-Brazil

“…This method can be considered as an easier alternative for use in surveys, with good reproducibility as long as examiners are calibrated [19, 20]. …”

“…Eighty-eight of the 139 participants had moderate severity, representing 1.99% of the sample; this differed markedly from the prevalence of vertical excess (34.94%) reported by Cardoso et al . [20]. The prevalence of the short face pattern with mild severity was 1.11%, while severe cases accounted for 0.02% of the sample.…”

“…Contrary to the results of this study, research by Cardoso et al . [20] found a higher prevalence of vertical excess in Black patients, followed by Brown, White, and Yellow individuals. Considering this as a reflection of the direction of growth, these conflicting results appear only logical, as vertical excess predominates in Black subjects, while horizontal excess predominates in Whites.…”

“…All individuals were evaluated under natural light, in standing natural head position, with the lips at rest and without the aid of any special equipment. Examination was performed by one of the authors, who is experienced in orthodontics and was properly calibrated for facial morphology evaluation [20]. …”

“…In epidemiological surveys, division of data by ethnic group is essential, as many studies have reported racial differences in facial features [20]. The Brazilian population features a high degree of miscegenation, and has been classified as the most heterogeneous population in the world [21].…”