Soft Tissue Analysis (Orthodontics)

1. SOFT TISSUE ANALYSIS
Reported By:
Dr. Kristel

2. A) PROFILE VIEW
1. Facial 3rd Ratio
2. Assessment of the Nose & Lips
3. Analysis of Chin & Neck
4. Rickett’s E-Line
5. Steiner’s S-Line
B) HOLDAWAY’S SOFT TISSUE ANALYSIS

4. PROFILE VIEW

5. Facial 3rd Ratio
Ideal profile can be divided into 3 equal parts:
a) Frontal Third (Tr-N)
b) Nasal Third (N-Sn)
c) Gnathic Third (Sn-Gn)
with the exception of:
Midface N-Sn (45%)
Lower Face Sn-Gn (55%)

7. Assessment of the Nose & Lips
Angular Profile Analysis (Subtelny)
*Soft Tissue Profile (N-Sn-Pog)
Ave. Value = 161˚
(Note: Convexity does not change with age.)
*Full Soft Tissue Profile (N-No-Pog)
Ave. Value = 137˚ (M) & 133˚ (F)
(Note: Convexity increases with age bec. Of the anterior growth
of the nose.)
- According to Subtelny, there is greater increase in the Maxillary
than the Mandibular soft tissue profile which explains why the soft
tissue grows convex with age.

10. Analysis of the Lips
* Length of the Upper Lip (Sn-Sto)
Mean Values
BURSTONE
Boys - 24mm
Girls - 20mm
RAKOSI
Boys - 22.5mm
Girls - 20mm
CLASS II - 22mm
CLASS III - 20.9mm

12. * Length of the Lower Lip (Sto-Gn)
Mean Values
BURSTONE
Boys - 50mm
Girls - 46.5mm
RAKOSI
Boys - 45.5mm
Girls - 40mm
CLASS II - Retraction of upper incisors – lower lip curls up and
moves forward.
CLASS III - Lingual tip of lower incisors – lip moves backward.

14. *Thickness of the Upper Lip
(From the labial surface of the Maxillary Incisor up to the Labrale Superius point)
Ave. Size: 11.5mm (RAKOSI)
CLASS II: Upper lip is thin due to angulation of upper incisors.
CLASS III: Upper lip thicker as it rests on lower lip.
During the course of treatment:
CLASS II: Lips grows thicker
CLASS III: Lips grow thinner

15. * Thickness of the Lower Lip
(From the labial surface of the Maxillary Incisor up to the Labrale Superius point)
Ave. Size: 12.5mm (RAKOSI)
CLASS II: Lower lip is thicker (14mm)
CLASS III: Lower lip is thinner (11.9mm)
During the course of treatment:
CLASS II: Lips becomes thinner
CLASS III: Lips becomes thicker

17. Assessment of the Chin & Neck
*Lower Face Throat Angle
Landmarks: Sn to Gn, Gn to C
Mean Value: 100˚
Diagnosis: A decrease in value
indicates a prominent chin.

18. Rickett’s Lip Analysis (E-Line)
Reference point: Tip of the Nose & Pogonion.
Note: Lips are analyze based on the distance of the lips to
this reference line.
Normal Values:
Upper: 2-3mm
Lower: 1-2mm
*LIP PROTRUSION - if the measurement exceeds the normal
range of values.
*LIP RETRUSION- if the measurement is below the normal range of
values.

20. Steiners’s Lip Analysis (S-Line)
Reference point: Center of the S-shaped Curve (bet. Tip of the
Nose and Sub Nasale) & Pogonion.
*LIP PROTRUSION - if the lips are positioned ahead of the
S-Line.
*LIP RETRUSION - if the lips are positioned behind the S-Line.

22. Holdaway’s Soft Tissue Analysis
*Facial Angle & Upper Lip Curvature
FACIAL ANGLE’s Reference line: FH plane & N-Pog
Ave. Value: 90-92˚
> Ave. Value: Protrusive lower jaw
< Ave. Value: Retrusive lower jaw
UPPER LIP’s Reference line: FH plane & a line drawn vertical to
the Tip of the Upper Lip.
Note: the distance from the depth of the sulcus of the
upper lip up to the line drawn from the Tip of the nose.
Ave. Value: 1.5 - 4mm

24. *H-Line Angle & Skeletal Convexity at Point A
H-LINE ANGLE’s Reference Line: H-Line & N-Pog
Ave. Value: 7-15˚
Purpose: It measures the upper lip prominence or retrognathism
of the soft tissue chin.
SKELETAL CONVEXITY’s Reference Line: A vertical line
drawn from point A & N-Pog
Ave. Value: +2 to -2mm
Purpose: It assess facial skeletal convexity relating to the position
of the upper lip.

25. Relationship between H-Line Angle & Skeletal
Convexity at Point A:
Convexity of Pt. A to Na-Pog
(in millimetres)
H-Line Angle
-5
-4
-3
-2
-1
0
1
2
3
4
5
6
7
8
9
10
5
6
7
8
9
10
11 BEST RANGE
12
13
14
15
16
17
18
19
20

27. *Nose Tip to H-Line & Upper Sulcus Depth
NOSE TIP TO H-LINE’s Reference: Tip of the Nose & H-Line
Ave. Value: 12mm
UPPER SULCUS DEPTH’s Reference: Sub Spinale & H-Line
Ave. Value: 5mm

28. *Upper Lip Thickness & Upper Lip Strain
UPPER LIP’S THICKNESS - is measured horizontally from a
point, 2mm below point A up to the outer border of the upper lip.
Ave. Value: 15mm
UPPER LIP’S STRAIN - is measured from the labial surface of
the Maxillary central incisor up to the Vermillion border of the
lip.

29. *Lower Sulcus Depth & Soft Tissue Chin
Thickness
LOWER SULCUS DEPTH - is measured from the deepest point
in the curvature between the lower lip and the chin.
Reference for Measurement: Lower Sulcus Depth & H-Line
Ave. Value: 5mm
SOFT TISSUE THICKNESS’ Reference: Pogonion of the Hard
& Soft Tissues.
Ave. Value: 10-12mm

31. According to Holdaway, a PERFECT PROFILE
should have:
*ANB: 2˚
*H-Line Angle: -7 to 8˚
*Lower Lip should touch the H-Line.
*H-Line should bisect the S-curve between the
Pro Nasale and Sub Nasale.
*Tip of the Nose should be 9mm anterior to the
H-Line and there should be NO LIP STRAIN
factor.
(Lip Strain – Prominent thickness of either the
lower or upper lip.)

32. -END-THANK
YOU