AP Relationship of the Maxillary Central Incisors to the Forehead

Objectives: To evaluate and compare the anteroposterior relationship of the maxillary central incisors to the forehead in adult white males with harmonious profiles and adult white male orthodontic patients. 

Methods: 101 photographs of adult white males with good facial harmony (control sample) were compared with 97 photographs of adult white males seeking orthodontic treatment (study sample).  All were profile images with the maxillary central incisors and foreheads in full view.  The images were imported into Adobe Photoshop™, resized and rotated to the upright head position.  Reference lines were constructed to assess the anteroposterior positions of the maxillary central incisors and forehead inclinations. 

Results: In the control sample, 91% had maxillary central incisors positioned between the FFA point and glabella, 8% posterior to the forehead facial axis (FFA) point, and <1% anterior to the glabella. The position of the maxillary central incisors were moderately correlated with forehead inclination (r²=0.37).   In the study sample, 34% had maxillary central incisors positioned between the FFA point and glabella, 59% posterior to the FFA point, and 7% anterior to glabella.  Maxillary central incisor position and forehead inclination were strongly correlated (r²=0.53). The difference between the means for the anteroposterior maxillary incisor position was statistically significant (P=0.0001). 

Conclusions: The forehead is an important landmark for anteroposterior maxillary incisor positioning for adult white male patients seeking improved facial harmony.