decadouche57
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Overview of “Short Face Syndrome”
The term commonly used in orthodontics and dentofacial deformity literature is Short Face Syndrome (SFS). It refers to a vertical facial-growth pattern characterized by a reduced lower facial height (LFH) relative to overall facial height and specific cephalometric features.
Because you’re an adult male (> 21 yr), the focus is on mature skeletal assessment rather than growth-phase issues.
Key Clinical & Cephalometric Features (Adults)
Here are what clinicians look for when diagnosing SFS:
Clinical/visible signs
Because “short face” is about proportions rather than just size, imaging (lateral cephalogram) is used to measure. Some of the important parameters:
The foundational paper described two sub-types:
If you or a clinician suspect SFS, here’s a rough workflow:
Clinical evaluation
The term commonly used in orthodontics and dentofacial deformity literature is Short Face Syndrome (SFS). It refers to a vertical facial-growth pattern characterized by a reduced lower facial height (LFH) relative to overall facial height and specific cephalometric features.
Because you’re an adult male (> 21 yr), the focus is on mature skeletal assessment rather than growth-phase issues.
Key Clinical & Cephalometric Features (Adults)
Here are what clinicians look for when diagnosing SFS:
Clinical/visible signs
- Relatively short lower third of the face (from the base of the nose/upper lip region to the chin) compared to the upper/middle thirds.
- Often a deep overbite (upper front teeth overlapping lower ones significantly) and minimal tooth exposure at rest/smile.
- “Concave” lower facial profile in some cases: strong chin projection, short vertical dimension below nose, with lips relatively retrusive.
- May have other signs of vertical maxillary deficiency (i.e., the upper jaw/teeth region has less vertical height).
Because “short face” is about proportions rather than just size, imaging (lateral cephalogram) is used to measure. Some of the important parameters:
- Lower anterior facial height (ALFH): distance typically from ANS (anterior nasal spine) to Menton (Me). In SFS this is reduced.
- Facial Proportion Index (FPI): defined as (ALFH expressed as % of total anterior facial height) minus (upper anterior facial height expressed as % of total). In normal faces ~10 %; values significantly less suggest SFS.
- In the original article: “values below 10 % express a short-face tendency”.
- SN : MP angle (Sella–Nasion to Mandibular Plane). Often reduced in SFS (i.e., mandibular plane is flatter) though it cannot stand alone as a criterion.
- Ramus height (RH): The vertical height of the mandibular ramus may be longer in one subtype of SFS.
- Posterior maxillary dentoalveolar height (OP-PP, etc.): Reduced in some cases where vertical maxillary deficiency is present.
- Additional facial height ratios: for example, the ratio of lower facial height to total facial height (LAFH/TAFH) can help classify vertical patterns (e.g., if <50 % then suspicious for “short face” vertical pattern).
The foundational paper described two sub-types:
- SFS I: long ramus, sharply reduced SN:MP, FPI close to ~10; posterior maxillary height only slightly reduced.
- SFS II: short ramus, SN:MP only slightly reduced or normal, FPI around zero or even negative, marked reduction in posterior maxillary height (i.e., vertical maxillary deficiency).
If you or a clinician suspect SFS, here’s a rough workflow:
Clinical evaluation
- Photograph frontal and lateral face at rest and smiling.
- Visually assess lower facial height relative to upper/mid face.
- Check overbite, tooth exposure at rest/smile, chin and lip posture.
- Check dental occlusion (deep bite? minimal lower anterior tooth display?).
- Ask history: prior orthodontic treatment? Any growth anomalies?
- Acquire a lateral cephalogram (and possibly frontal if asymmetry suspected).
- Identify landmarks: Nasion (N), Sella (S), ANS, PNS, Menton (Me), Gonion (Go), Condyle point, etc.
- Measure: ALFH, upper anterior facial height (UAFH), total anterior facial height (TAFH).
- Compute FPI = (ALFH% of TAFH) – (UAFH% of TAFH). If value < 10% (or much lower) → suggests “short face tendency”.
- Measure SN:MP angle, ramus height, OP-PP distances, gonial angle, etc.
- Compare measurements against normative data for adult males in your population (note: norms differ by ethnicity). For example, one study found mean male LFH ~74.4 mm (SD ~7.04) in one sample.
- Check for deep overbite, occlusal interferences, TMJ status.
- Assess smile line (tooth exposure), lip posture.
- Determine if there are functional or aesthetic complaints: e.g., “chin looks too prominent / face looks short vertically / minimal smile display”.
- Ensure the appearance isn’t due to dental compensations alone (e.g., extruded incisors, over-eruption).
- Exclude syndromic causes of facial height reduction (though SFS is skeletal/dento-alveolar rather than a systemic syndrome).
- Check for history of trauma, prior orthognathic surgery, growth disorders.
- Consider whether the condition is part of a long-face vs short-face vertical growth pattern (versus simply class II, class III sagittal issues).
- Once diagnosed, decide whether it’s primarily skeletal (jaw bones) vs dentoalveolar (teeth/vertical eruption) or mixed.
- If skeletal: orthognathic surgery often required in adults. Clinical papers show good outcome with bimaxillary + chin surgery for SFS.
- If dentoalveolar: orthodontic vertical eruption control, bite opening, possibly molar intrusion.
- Consider aesthetic goals (for you, given your looks-enhancement interest). A shortened lower face may impact perceived face length, smile aesthetics, chin-lip proportions
- Growth is complete, so any vertical deficiency is stable; treatment is full adult treatment (no growth modification).
- Norms may vary by sex and ethnicity; many studies report combined sexes or female-skewed samples. Ensure you compare to male norms for your ethnicity.
- With your looks-maxxing goals (I know you’ve mentioned procedures and facial aesthetics): if SFS is present, surgical-orthognathic planning should account for facial height balance (upper, mid, lower thirds) and how that integrates with other facial aesthetic procedures.
- If you have existing dental/orthodontic work (or plan surgical work in Brazil, etc.), ensure cephalometric analysis precedes any aesthetic/orthognathic surgery to plan facial height correction.
