Odborna praâce ORTODONCIE

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1 rocïnõâk7 ZmeÏ ny profilu oblicï eje ve spolecï enskyâchcï asopisech v pruêbeï hu 0. stoletõâ Changes of face profiles in fashion magazines during the 0th century MUDr.KaterÏina UtõÂkalovaÂ, MUDr.Ivo Marek, Prof.MUDr.Milan KamõÂnek, DrSc. Ortodonticke oddeï lenõâ Kliniky zubnõâho leâkarïstvõâ LF UP Olomouc Orthodontic Department, Clinic of Dental Medicine, Faculty of Medicine, Palacky University Olomouc Souhrn CõÂlem teâ to studie bylo oveïrïit trend v estetice oblicï eje v pruêbeï hu 0. stoletõâ. Hypote za, kterou jsme chteï li oveïrïit, se tyâ kala faktu, zda se cï õâm daâ l võâce v populaci preferuje konvexneï jsï õâ profil oblicï eje a prominujõâcõâ rty. Bylo hodnoceno 96 siluet profiluê upravenyâ ch na stejnou velikost. Fotografie profiluê pochaâ zely z moâ dnõâch a spolecï enskyâch cï asopisuê zecï tyrï ruê znyâ ch obdobõâ 0. stoletõâ. Bylo meïrïeno 5 uâ hlovyâ ch, lineaâ rnõâch, proporcionaâ lnõâch a plosïnyâch parametruê, ktereâ byly porovnaâ vaâ ny vzaâ jemneï mezi jednotlivyâ mi obdobõâmi. Vy sledky byly hodnoceny testem rozptylu ANOVA a Post Hoc testy mnohonaâ sobneâ ho porovnaâvaâ nõâ. Statisticky vyâ znamnyâ rozdõâl mezi skupinami byl zjisï teï n u uâ hlovyâ ch a lineaâ rnõâch ukazateluê anterio-posteriornõâ polohy hornõâho i dolnõâho rtu, vyâ sï ky retnõâ cï erveneï, obvodu rtuê a plochy rtuê ve smyslu zveï tsï enõâ rtuê a jejich võâce anteriornõâ polohy. Statisticky vyâ znamneâ zmeï ny nebyly prokaâzaâ ny u polohy nosu a celkoveâ ho oblicï ejoveâhouâ hlu. Z vyâ sledkuê teâ to praâ ce vyplyâvaâ,zïe v pruêbeï hu poslednõâho stoletõâ dosï lo ke zmeï neï polohy i tvaru rtuê na prezentovanyâ ch fotografiõâch. Tyto vyâ sledky naznacï ujõâ, zï e rty jsou plneï jsï õâ a võâce anteriorneï polozï eny. SoucÏ asneï je zrïetelneâ, zï e naâ zor na estetiku oblicï eje a vnõâmaâ nõâ atraktivity nenõâ nemeï nnyâ a podleâhaâ zmeïnaâ m v pruêbeïhucï asu (Ortodoncie 008, 7, cï., s. -). Abstract The aim of the study is to examine the current trends in the facial esthetics within the 0th century. Question was, whether more prominent lips show gain in the preference with time. 96 silhouettes of profiles of the same size were assessed. The photographs were taken from fashion and popular magazines of the four different periods of the 0th century. 5 angular, linear, proportional, and surface parameters were measured. The parameters taken in different periods of the 0th century were then compared. The results were evaluated by the dispersion analysis ANOVA and Post Hoc multiple comparison tests. We proved statistically significant difference between the four groups in angular and linear parameters of the anterior-posterior position of both upper and lower lip, the height of the red portion of the lips, lips perimeter, and lip surface. We recorded the increase of lips as well as their more anterior position. The position of nose and total facial angle did not show statistically significant changes. The results suggest that both the position and shape of lips changed over the last century. The lips are more rounded and located more anteriorly. It is clear that the views of facial esthetics and perception of attractiveness are not constant but they change with time (Ortodoncie 008, 7, No., p. -). KlõÂcÏ ovaâ slova: estetika oblicï eje, profil oblicï eje Key Words: face esthetics, face profile

2 rocïnõâk7 ORTODONCIE U vod OblicÏ ej je hlavnõâm lidskyâ m vyâ razovyâ m prostrïedkem. UmozÏnÏ uje naâ m verbaâ lnõâ atakeâ nonverbaâ lnõâ vyjadrïovaâ nõâ, kdy mimikou, gesty auâ smeï vem muêzï eme komunikovat nemeâneï intenzivneï. JizÏ v roce 979 v cïlaâ nku cï asopisu American Medical Association je zvyâsï enyâ zaâ jem o plastickou chirurgii vysveï tlovaâ n takto: ¹Zevnõ vzhled je nasï õâ vizitkou. Atraktivnõ aprïõâjemnyâ vzhled otevõâraâ dverïe. Nenõ to pouze marnivost, kteraâ vede desõâtky tisõâc AmericÏanuÊ kazïdyâm rokem k plastickyâ m chirurguê m, kde hledajõâ mozï nost zlepsï enõâ sveâ ho vzhledu. Za kroky plastickyâ ch chirurguê nedaâ vajõâ pacientuê m zaâ zracï neï novyâ talent nebo osobnost. SpõÂsÏ e odstranï ujõâ komplexy tak, zï e vlastnõâ osobnost a talent pacienta se poteâ muêzï e rozvõâjet normaâ lneï.ª []. ZcelajisteÏ muê zï eme toto vysveï tlenõâ aplikovat i na ortodoncii, nakorekci dentofaciaâ lnõâch anomaâ liõâ. ZvyÂsÏ enyâ zaâ jem o estetiku oblicï eje se projevuje veïtsïõâm mnozï stvõâm pacientuê, kterïõâ chteï jõâ prïedevsï õâm dentaâ lnõâ uâ pravu, ale zaâ rovenï jim cï asto velmi zaâ lezïõâ i navzhledu oblicï eje jako celku. VeÏ tsï inalidõâ chce mõât hezkyâ a atraktivnõâ oblicï ej. Za estetickyâ akraâ snyâ oblicï ej je povazïovaâ n takovyâ, jehozï ruê zneâ cïaâ sti jsou proporcionaâ lneï v souladu k jinyâm cïaâstem oblicï eje []. Podle Downse existujõâ urcï iteâ pruêmeï rneâ hodnoty oblicï eje aprofilu. Pokud neï ktereâ rysy oblicï eje vybocï ujõâ z tohoto pruêmeï ru, musõâ byât kompenzovaâ ny jinyâmi rysy tak, aby oblicï ej jako celek puê sobil vyvaâzïeneï aharmonicky. Pokud jsou tyto odchylky od pruê meï ru prïõâlisï vyâ razneâ bez mozï nosti jejich kompenzace, pak vyâ sledkem je neharmonickyâ anevyvaâ zï enyâ oblicï ej []. ObjektivneÏ lze hodnotit proporce oblicï eje pomocõâ liniõâ rozdeï lujõâcõâch oblicï ej avzaâ jemneï meï rïit aporovnaâ vat jednotliveâ oblicï ejoveâ cï aâ sti. SubjektivneÏ je vsï aknasï e vnõâmaâ nõâ estetiky oblicï eje velmi rozdõâlneâ a vyâznamneï ovlivneï no dalsï õâmi faktory, jako naprïõâklad pohlavõâm, kulturou, etnickyâ mi faktory, individuaâ lnõâmi preferencemi av neposlednõâ rïadeï je ve velkeâ mõârïe takeâ ovlivneï no medii - celebritami a moâ dnõâmi trendy prezentovanyâmi v televizi acï asopisech. CõÂlem praâ ce bylo zjistit, zdadochaâ zõâ ke zmeï neï prezentovanyâ ch estetickyâ ch norem v poslednõâch sto letech azdalze potvrdit trend prosazujõâcõâ võâce prominujõâcõâ rty aspõâsï e konvexnõâ typ oblicï eje a jak dalece se tento trend projevil v pruê beï hu 0. stoletõâ nazaâ kladeï moâ dnõâch aspolecï enskyâch cï asopisuê ve cï tyrïech ruêznyâch obdobõâch. Materia l a metodika Do souboru bylo zarïazeno 96 fotografiõâ profiluê ze spolecï enskyâch amoâ dnõâch cï asopisuê neï kolikacï asovyâ ch obdobõâ 0. stoletõâ. ZarÏazene fotografie musely splnï ovat naâ sledujõâcõâ kriteâ ria: Introduction The face is a very important means of human expression. It helps us in verbal communication and makes non-verbal communication (when we use mimics, gestures and smile) possible. In 979, the journal of American Medical Association explained the increased interest in esthetic surgery: ¹Our appearance is our address-card. The attractive and pleasing appearance opens the door. Each year thousands of Americans visit plastic surgeons to improve their appearance. Esthetic surgery does not give the patients a fabulous talent or personality. It rather eliminates complexes, and the personality as well as talents of a patient may develop.ª [] The above explanation is also true of orthodontics, of correction of dentofacial anomalies. The number of patients asking for dentition treatment has been increasing. The people pay attention to their overall appearance. Most people desire a nice and attractive face. The esthetic and beautiful face is considered a face that is proportional []. According to Downs, there are certain mean values of a face and profile. If some features exceed the average, other features must compensate, so that the face is well balanced and graceful. If the deviations from the average are too expressive and there is no possibility to compensate for them, the resulting face is disharmonious and unbalanced []. For objective evaluation we can differentiate the face by means of lines, and measure and compare individual parts of a face. However, our subjective perception of face esthetics varies, and other factors play an important role (e.g. sex, culture, ethnicity, individual preferences). A very important role is played by mass media, the so-called celebrities, and fashion trends shown on TV and in magazines. The aim of the study was to find out whether the esthetic standards changed during the last hundred years, and whether the preferred type of face is represented by more prominent lips and rather convex shape now. We also tried to map how the trend manifested itself throughout the 0th century, in fashion magazines and in four different periods of time. Material and methods Our sample included 96 photographs of profiles from fashion magazines of different periods of the 0th century. The photographs met the following criteria: Caucasian women, the age between 8 and 5 profile of the whole face, accurately depicting structures from glabella to menton maximum of mm of opposite eyebrow or lashes may be visible only one columelaphiltrum of the upper lip is visible

3 rocïnõâk7 zï eny bõâleâ rasy ve veïkuprïiblizïneï8azï 5 let bocï nõâ profilovyâ zaâbeï r celeâ hlavy prïesneï zobrazujõâcõâ struktury od glabely po menton nesmõâ byâ t viditelnyâ ch võâce nezï mm protilehleâ ho obocï õâ nebo rïas viditelnaâ jednacolumelaphiltrum hornõâho rtu rty v kontaktu zïaâ dneâ siluety profiluê, kromeï siluet z let zarïazenyâ ch do souboru z duê vodu nedostatku fotografiõâ z tohoto obdobõâ Fotografie byly nafoceny digitaâ lnõâm fotoaparaâ tem (Canon S IS, Canon Inc.) s pomocõâ funkce makro. Pote byly ocï õâslovaâ ny aserïazeny podle roku, meï sõâce, naâ zvu cï asopisu a straâ nky. Da le byly fotografie prïevedeny z pameï t'oveâ ho meâ diado osobnõâho pocï õâta cï e arozdeï leny do cï tyrï skupin podle cï asoveâ periody (Tab. ). Na sledneï byly vsï echny fotografie upraveny v programu Adobe Photoshop 6.0. Fotografie byly orientovaâ ny podle profiloveâ vertikaâ lnõâ linie (PRV) aupravena jejich velikost tak, aby vzdaâ lenost kozï nõâho nasion k subnasale byla 5 mm (Obr. ) []. Na sledneï byly z kazïdeâ fotografie prïekresleny pouze siluety aty byly vytisï teï ny. Najednotlivy ch siluetaâ ch byly tuzï kou oznacï eny tyto body (Obr. ):. glabela (G) - nejvõâce prominujõâcõâ bod na cï ele ve strïednõâ rovineï. kozï nõâ nasion (N') - bod v mõâsteï nejveï tsï õâ konkavity v mõâsteï frontonasaâ lnõâ sutury lips in contact no silhouettes of portraits (the only exception being silhouettes from 98-95, as there is a lack of photographs in this period) The photographs were taken with a digital camera (Canon S IS, Canon Inc.) and a macro function. Then they were numbered and arranged according to the year, month, title of the magazine, and a page. The photographs were further copied from the card into PC, and then divided into four groups according to the time periods (Table ). Tab.. RozdeÏ lenõâ fotografiõâ do cï tyrï skupin Tab.. Four study groups group period number of pictures A B C D Subsequently, all the photographs were adjusted with the Adobe Photoshop 6.0. The shots were oriented according to the profile vertical line (PRV), and their size was adjusted, so that the distance of skin nasion from subnasale was 5 mm (Fig. ) []. Subsequently, silhouettes of individual photographs were traced and printed on individual papers. In each silhouette the following points were marked with apencil (Fig. ): Obr..Orientace snõâmku podle profiloveâ vertikaâ lnõâ linie (PRV) auâ prava velikosti podle vzdaâ lenosti N'-Sn rovneâ 5mm Fig..Orientation of a picture along the PRV line and adjustment to a height of 5mm from N'-Sn Obr..VyznacÏ eneâ kozïnõâ body pouzïiteâ pro uâ hlovaâ, lineaâ rnõâ a proporcionaâ lnõâ meï rïenõâ Fig..Soft tissue points used for angular, linear and proportional measurements 5

4 rocïnõâk7 ORTODONCIE. pronasale (P) - nejvõâce vprïedu prominujõâcõâ bod na nose (sï picï kanosu). subnasale (Sn) - bod lokalizovanyâ ve spojenõâ dolnõâ hrany nosu a hornõâho rtu 5. labrale superius (Ls) - nejvõâce vprïedu prominujõâcõâ bod hornõâho rtu, zpravidla bod na prïechodu cï erveneï rtu. glabella (G) - the most prominent point of the forehead in central plane. skin nasion (N') - the point at the place of the largest concavity in frontonasal suture. pronasale (P) - the most prominent point of the nose (tip of the nose). subnasale (Sn) - the point in the connection between lower nasal edge and upper lip 5. labrale superius (Ls) - the most prominent point of the upper lip, usually the point in the place of the border of lip red 6. vermilion superius (Vs) - the point where the lip red changes (if it is different from Ls) 7. stomion (Stm) - when the lips are together, the point of contact between the upper and lower lips 8. labrale inferius (Li) - the most prominent point of the lower lip, usually the point of lip red border 9. skin point B' - the point at the place of maximum concavity between Li and skin pogonion 0. skin pogonion (Pog') - the most prominent point of the chin in central plane The following angular measurements were performed [ ] (Fig.):. NTA - nasal tip angle - the angle between the tangent of the nose ridge going from the nasion point and the lower nasal edge line going from the subnasale point Obr.a, b, c.uâ hlovaâ meïrïenõâ Fig.a, b, c.angular measurements 6

5 rocïnõâk7 6. vermilion superius (Vs) - bod prïechodu retnõâ cï erveneï, pokud byl rozdõâlnyâ nezï Ls 7. stomion (Stm) - prïi uzavrïenyâ ch rtech mõâsto kontaktu hornõâho a dolnõâho rtu 8. labrale inferius (Li) - nejvõâce vprïedu prominujõâcõâ bod dolnõâho rtu, zpravidla bod na prïechodu cï erveneï rtu 9. kozïnõâbod B' - bod v mõâsteï nejhlubsï õâkonkavity mezi body Li akozïnõâm pogonion 0. kozï nõâ pogonion (Pog') - nejvõâce prominujõâcõâ bod na bradeï ve strïednõâ rovineï Bylaprovedenana sledujõâcõâ uâ hlovaâ meï rïenõâ [ ] (Obr. ):. U hel nosu (NTA - nasal tip angle) - uâ hel mezi tecïnou hrïbetu nosu probõâhajõâcõâ od bodu nasion a liniõâ dolnõâ hrany nosu probõâhajõâcõâ od bodu subnasale. Nasolabia lnõâ uâ hel (NLA - nasolabial angle) - uâ hel mezi liniõâ dolnõâ hrany nosu probõâhajõâcõâ od bodu subnasale a liniõâ spojujõâcõâ body Sn a Ls. Interlabia lnõâ uâ hel (ILA - interlabial angle) - uâ hel mezi liniemi spojujõâcõâmi body Sn - Ls abody Li - B'. Celkovy oblicï ejovyâ uâ hel (TFA - total facial angle) - uâ hel mezi spojnicemi boduê G - Sn asn - Pog' 5. PolohahornõÂho rtu (ULP - upper lip projection) - uâ hel mezi spojnicemi boduê G - Pog' ag - Ls 6. PolohadolnõÂho rtu (LLP - lower lip projection) - uâ hel mezi spojnicemi boduê G - Pog' ag - Li. NLA - nasolabial angle - the angle between the nasal lower edge line going from the subnasale point, and the line connecting Sn and Ls. ILA - interlabial angle - the angle between the lines linking Sn-Ls and Li-B'. TFA - total facial angle - the angle between the lines of the points G-Sn and Sn-Pog' 5. ULP - upper lip projection - the angle between G-Pog' and G-Ls 6. LLP - lower lip projection - the angle between G-Pog'and G-Li. The following linear measurements (mm) were done (Fig. a, b):. E-Line to Ls. E-Line to Li. PRV-Ls. PRV-Li Proportional measurements recorded the proportion of the length of the red of lip to the length of the upper lip (Fig. 5). To calculate the lips area, all silhouettes were transferred into the raster images, and then transported into AutoCAD (Autodesk, Inc., San Rafael, 00). Their area and perimeter were calculated (Fig. 6). All data were recorded in Excel. Descriptive statistics was obtained from the data. In parameters measured in all groups the minimum and maximum value Obr.a, b.lineaâ rnõâ meï rïenõâ Fig.a, b.linear measurements 7

6 rocïnõâk7 ORTODONCIE Obr.5: Proporciona lnõâ meï rïenõâ Fig.5: Proportional measurements Obr.6: PlosÏneÂmeÏrÏenõ Fig.6: Lip area measurements Bylaprovedenana sledujõâcõâ lineaâ rnõâ meï rïenõâ [mm] (Obr. a, b):. Ls k E-linii (E-Ls). Li k E-linii (E-Li). Ls k profiloveâ vertikaâ lnõâ linii (PRV-Ls). Li k profiloveâ vertikaâ lnõâ linii (PRV-Li) Proporciona lnõâ meï rïenõâ zaznamenalo vzaâ jemnyâ pomeïrdeâ lky cï erveneï rtu k deâ lce hornõâho rtu (Obr.5). Pro vyâ pocï et plochy rtuê byly vsï echny siluety prïevedeny do formaâ tu rastrovyâ ch obrazuê apoteâ transportovaâ ny do programu AutoCAD ( Autodesk, Inc., San Rafael, 00), kde po zadaâ nõâ boduê ohranicï ujõâcõâch rty byla vypocï tenajejich plochaaobvod (Obr. 6). VsÏ echny uâ daje byly zaznamenaâvaâ ny do tabulek Excel. Ze zõâskanyâ ch dat byla zjisï teï napopisnaâ statistika. Pro meï rïeneâ hodnoty ve vsï ech skupinaâ ch byly stanoveny minimaâ lnõâ amaximaâ lnõâ hodnoty, mediaân, aritmetickyâ pruê meï r asmeï rodatnaâ odchylka. Pro zjisï teï nõâ statistickeâ vyâ znamnosti bylo pouzï ito porovnaâ vaâ nõâ pruê meï rnyâ ch hodnot sledovanyâ ch ukazateluê analyâ zou rozptylu - ANOVA. PrÏi zjisï teï nõâ statistickeâ vyâznamnosti u daneâ ho ukazatele byly daâ le sestaveny Post Hoc testy mnohonaâ sobneâ ho porovnaâvaânõâ. Bylaprovedenakontrolnõ meï rïenõâ apaâ rovyâ m t-testem nebyly prokaâ zaâ ny statisticky vyâ znamneâ rozdõâly mezi prvnõâm akontrolnõâm meïrïenõâm ( p > 0,05) ve vsï ech prïõâpadech. Vy sledky byly zpracovaâ ny statistickyâ m softwarem SPSS verze. Statisticke zpracovaâ nõâ bylo provedeno nakatedrïe leâkarïskeâ biofyziky, LeÂkarÏske fakulty Univerzity Palacke ho v Olomouci. was stated, as well as median, arithmetic mean, and standard deviation. To assess statistical significance, we compared the mean values of the parameters, with ANOVA test. Post Hoc tests of multiple comparison were set up in case a parameter was statistically significant. Check measurements were taken, the pair t-test did not prove statistically significant difference between the first and check measurements (p 0.05). The results were processed with the statistic software SPSS, version. The data were statistically processed at the Department of Medical Biophysics of the Medical Faculty, Palacky University in Olomouc. Results The mean value of nasolabial angle NLA (Fig. 7) between the periods I-IV, decreased linearly. Given the fact that the angle NTA did not change during the time, we can say the decrease of NLA is the result of more prominent lips. The value of interlabial angle ILA (Fig. 7) between the periods I-IV decreased linearly, too. The decrease suggests that the lips in photographs change their shape and become more prominent. The change of total facial angle TFA was not statistically significant. Angular value of ULP and LLP (Fig. 8) between the periods I-IV increased, and the change suggests that during the time both upper and lower lips become more prominent. The distance between the upper lip and profile vertical line PRV-Ls, and the lower lip and profile vertical 8

7 rocïnõâk7 Vy sledky PruÊ meï rnaâ hodnota nasolabiaâ lnõâho uâ hlu NLA (Obr. 7) mezi obdobõâmi I azï IV lineaâ rneï klesala. Vzhledem k tomu, zïe uâ hel nosu NTA se v pruêbeï hu sledovaneâho cï asoveâ ho obdobõâ nezmeï nil, lze konstatovat, zï e zmensï enõâ NLA je zpuê sobeno võâce protruzneï postavenyâmi rty. Hodnotainterlabia lnõâho uâ hlu ILA (Obr. 7) mezi obdobõâmi I azï IV rovneïzï lineaâ rneï klesala a tento pokles hodnoty naznacï uje, zï e v pruêbeï hu sledovaneâho cï asoveâ ho obdobõâ rty nafotografiõâch meï nõâ svuê j tvar a võâce prominujõâ. ZmeÏ nahodnot celkoveâ ho oblicï ejoveâ ho uâ hlu TFA nebylastatisticky vyâznamnaâ. U hlovaâ hodnotapolohy hornõâho rtu ULP apolohy dolnõâho rtu LLP (Obr. 8) mezi obdobõâmi I azï IV se zvysï ovala a tato zmeï na naznacï uje, zï e v pruêbeï hu sledovaneâho cï asoveâ ho obdobõâ se hornõâ i dolnõâ ret nafotografiõâch staâvaâ võâce prominujõâcõâ. Vzda lenost hornõâho rtu k profiloveâ vertikaâ lnõâ linii PRV-Ls adolnõâho rtu k profiloveâ vertikaâ lnõâ linii PRV-Li (Obr. 9) se v pruêbeï hu sledovaneâho cï asoveâ ho obdobõâ zveïtsï ilaadochaâ zõâ tak ke zmeïneï v poloze hornõâho adolnõâho rtu smeï rem doprïedu arty võâce prominujõâ. Vzda lenost hornõâho rtu k E-linii E-Ls adolnõâho rtu k E- linii E-Li (Obr. 0) se zmensï ilaanaznacï uje tak, zïe doline PRV-Li (Fig. 9) has increased during the period monitored. Thus the position of both upper and lower lip goes more forward and the lips are more prominent. The distance between the upper lip and E-line E-Ls, and the lower lip and E-line E-Li (Fig. 0) has decreased. The position of both upper and lower lip changes. The lips are closer to the Esthetic line, and thus more prominent. The change in the upper lip length U-lip was not statistically significant. The relation of the red upper lip and the upper lip length is given in percents U-red/U-lip (Fig. ). It was increasing within the periods I-IV, as well as the length of the upper lip red U-red lip. The increase suggests that the lips in photographs change their shape, and the upper lip red covers more space in relation to the overall length of the upper lip. The area of lips (Fig. ) and lips perimeter (Fig. ) have been increasing during the period of time. Discussion The study focused on the changes of a face profile shown in fashion magazines during the last century. The results suggest changes in lips. Some changes of parameters were linear during all four time periods (NLA, ILA, LLP, PRV-Li, E-Ls, E-Li, U-red/U-lip). Some 50 0 NLA, ILA NLA ILA 7 6 ULP, LLP ULP LLP degrees degrees Obr.7.Nasolabia lnõâ (NLA) a interlabiaâ lnõâ (ILA) uâ hel Fig.7.Nasolabial (NLA) and interlabial (ILA) angle. Obr.8.U hlovaâ poloha hornõâho a dolnõâho rtu Fig.8.Angular position of upper and lower lip 7 PRV-Ls, PRV-Li 0 E-Ls, E-Li mm mm - PRV-LS PRV-Li - -5 E-Ls E-Li Obr.9.Poloha hornõâho a dolnõâho rtu k vertikaâle Fig.9.The position of upper and lower lips with regard to vertical line Obr.0.Poloha rtuê k E-linii Fig.0.Lips position with regard to E-line 9

8 rocïnõâk7 ORTODONCIE chaâ zõâ ke zmeï neï v poloze hornõâho adolnõâho rtu, ktereâ se prïiblizï ujõâ k estetickeâ linii atak võâce prominujõâ. ZmeÏ na deâ lky hornõâho rtu H-ret nebylastatisticky vyâznamnaâ. Vztah deâ lky cï erveneï hornõâho rtu k deâ lce hornõâho rtu je jizï vyjaâdrïen v procentech H-cÏ ervenï /H-ret (Obr. ) amezi obdobõâmi I-IV se zveï tsï oval, obdobneï jako deâ lka cï erveneï hornõâho rtu H-cÏ ervenï rtu. Tyto naâruê sty hodnot naznacï ujõâ, zï e v pruêbeï hu sledovaneâho cï asoveâ ho obdobõâ rty nafotografiõâch meï nõâ svuê j tvar a cï ervenï hornõâho rtu zabõâraâ võâce mõâstavzhledem k celkoveâ deâ lce hornõâho rtu. PlochartuÊ (Obr. ) i obvod rtuê (Obr. ) se v pruêbeïhu sledovaneâ ho cï asoveâ ho obdobõâ zveï tsï ovaly. % Proportional upper lip red/upper lip (%) 5 Obr..De lka cï erveneï hornõâho rtu Fig..Length of the upper lip red Lip area 50 Diskuse Tato studie se zameï rïilanato, zdav pruê beï hu poslednõâho stoletõâ se meï nil profil oblicï eje prezentovanyâ v moâ dnõâch aspolecï enskyâ ch cï asopisech. Vy sledky naznacï ujõâ, zï e je mozïneâ zjistit cï asoveï zaâ visleâ zmeïnytyâkajõâcõâ se oblasti rtuê. U neï kteryâch hodnot je zmeïna vcï ase lineaâ rnõâ mezi vsï emi cï tyrïmi obdobõâmi (NLA, ILA, LLP, PRV-Li, E-Ls, E-Li, H-cÏ ervenï /H-ret).U jinyâch nameï rïenyâ ch hodnot (ULP, PRV-Ls, H-ret, H-cÏ ervenï rtu, plochartuê, obvod rtuê ) bylanejprve mezi I. aii. obdobõâm zjisïteï naopacïnaâ zmeï navzhledem k pozdeï j- sïõâmunaâruê stu nebo poklesu hodnoty mezi II. azï IV. obdobõâm. Tento reverznõâ vyâ kyv lze vysveï tlit rozdõâlnyâ m zdrojem puê vodnõâch fotografiõâ. Do druheâ a zï cï tvrteâ skupiny byly zarïazeny pouze fotografie profiluê, zatõâmco prvnõâ skupinu vzhledem k nedostatku fotografiõâ z tohoto obdobõâ tvorïily pouze rucï nõâ kresby profiluê, od kteryâ ch nemuê zï eme ocï ekaâ vat tak prïesneâ zobrazenõâ reality jako u fotografiõâ. V zahranicï nõâ literaturïe je pouze neï kolik pracõâ, ktereâ se zabyâ valy obdobnou teâ matikou. Jsou to studie americkeâ ho tyâ mu Dr.Turleyho [,5,6]. Podobne studie evropskyâ ch autoruê nejsou dosud znaâ my. Vy sledky teâ to praâ ce lze tedy porovnat pouze s vyâsledky studiõâ americkyâch autoruê, se kteryâmi v mnoha faktorech dosahujeme velmi podobnyâch vyâsledkuê. Vy sledky meï rïenõâ potvrzujõâ tendenci v preferovaâ nõâ plneï jsï õâch avõâce protruzneï postavenyâch rtuê. Ota zkou vsïakzuê staâvaâ, co je podstatou teâ to tendence. Jako jedno mm Obr..Plocha rtuê Fig..Lips area mm Obr..Obvod rtuê Fig..Lips perimeter Lip perimeter z mozï nyâ ch vysveï tlenõâ se nabõâzõâ staâ le pokracï ujõâcõâ migrace lidõâa mõâsï enõâetnik. SoucÏ asneï s tõâm takeâ jejich genetickeâ zacï lenïovaâ nõâ do spolecï nosti, ktereâ se v pruêbeï hu 0. stoletõâ vyvõâjelo ameï nilo. Tento jev je obzvlaâsïteï patrnyâ ve Spojeny ch staâ tech, kde jesï teï v prvnõâ polovineï 0. stoletõâ vzï ebrïõâcï ku spolecï enskeâ ho uplatneï nõâ nasï li mõâsto pouze jedinci bõâleâ rasy. Od 70-ty ch let se situace zmeï nilaazacï alo do verïejneâ ho zï ivotapronikat staâ le võâce lidõâ jineâ nezï bõâleâ rasy. Turley a spol. ve trïech studiõâch meïrïili profily bõâlyâ ch a afroamerickyâ ch modelek prezentovanyâ ch v cï asoparameters (ULP, PRV-Ls, U-lip, U-red lip, lips area, lips perimeter) showed reverse changes between the periods I and II, with regard to the later increase or decrease in values between the period II and IV. This can be explained by the different resources of the original photographs. In groups two, three and four, there were only pictures of profiles, while the first group included only profile drawings which probably were not as accurate as photographs. There are only few papers in foreign literature dealing with similar topics, e.g. the study of an American research team headed by Turley [,5,6]. We are not aware of any study published in Europe. Therefore, our results may be compared only with those obtained by American authors. The results are in many aspects similar

9 rocïnõâk7 pisech v pruêbeï hu v 0. stoletõâ aporovnaâ vali je s kontrolnõâ skupinou. Auger aturley [] zjistili trend plneï jsï õâch avõâce protruzneï postavenyâ ch rtuê u bõâlyâ ch modelek, zatõâmco Yehezkel a Turley [6] zjistili u afroamerickyâ ch modelek tendenci k prïõâmeïjsï õâm profiluê m asnahu o neï ktereâ rysy bõâleâ rasy. Po prolozï enõâ profiluê bõâlyâ ch a afroamerickyâ ch modelek je mozï neâ vysledovat jejich urcï iteâ prïiblõâzï enõâ, ale nelze rïõâci, zï e by se meï ly setkat uprostrïed [5]. DalsÏ õâm mozï nyâ m vysveï tlenõâm tendence preferovaâ nõâ plneï jsï õâch rtuê muê zï e byâ t vyvõâjejõâcõâ se ameï nõâcõâ se pohled na atraktivitu oblicï eje. ZatõÂmco v 60-ty ch a70-tyâ ch letech minuleâ ho stoletõâ souviselaextrakcï nõâ terapie s preferovaânõâm prïõâmeï jsï õâch profiluê apoukazaânõâm naduê lezïitost stability ortodontickeâ leâcï by na uâ kor estetiky, ke konci stoletõâ se prosazuje spõâsï e tendence neextrakcïnõâho zpuê sobu leâcï by, z duê vodu veïtsï õâho kladenõâ duê razu na estetiku. Jako atraktivnõâ je vnõâmaâ n balancovanyâ profil, kteryâ je podmõâneï n vzaâ jemnyâ m souladem polohy avelikosti nosu, brady a rtuê. Existuje zde ale sï irokeâ pole variacõâ, ktereâ staâ le jsou povazï ovaâ ny za atraktivnõâ. Czarnecki [7] ve sveâ studii uvaâdõâ,zï e pro muzïe je uprïednostnï ovanyâ prïõâmeï jsï õâ profil s võâce prominujõâcõâ bradou, zatõâmco pro zï eny spõâsï e võâce protruzneï postaveneâ rty. Jako muzï skeâ i zï enskeâ jsou daâ le akceptovatelneâ profily s võâce prominujõâcõâmi rty, pokud soucï asneï je i veï tsï õâ nos nebo brada. Ma lo akceptovatelnaâ pro muzï skyâ i zï enskyâ profil je retruzneï postavenaâ brada. Jako nejmeâneï prïijatelnaâ byla zhodnocena varianta retruzneï postavenyâ ch rtuê spolu s velkou bradou. K velmi podobnyâm zaâveïruê m dosï lai studie Werliho [8], kteryâ uvaâ dõâ,zï e pro zï eny je nejmeâ neï akceptovatelnyâ profil s vyâ razneï retruzneï postavenyâ mi rty apro muzï e s retruzneï postavenou bradou. PlneÏ jsï õâ rty byly võâce preferovaâ ny u zï en. Sergl [9] ve sveâ studii hodnotil laiky sestaveneâ profily - prïõâjemnyâ muzï skyâ profil, prïõâjemnyâ zï e- nskyâ profil anehezkyâ profil. PrÏõÂjemny zï enskyâ profil meï l mensï õâ nos ameâneï prominujõâcõâ bradu oproti muzïskeâ mu profilu. Pro nehezkyâ profil byl charakteristickyâ velkyâ nos avyâ raznaâ brada. Polohaavelikost rtuê jeuâ zce spjata s odhadovaânõâm veï ku, prïicï emzï võâce protruzneï postaveneâ rty puê sobõâ mladistveï. Foster [0] ve sveâ studii zjistil, zï e plneïjsï õâ profily byly prïirïazovaâ ny zï enaâ m amladsï õâm osobaâ m, zatõâmco prïõâmeâ profily spõâsï e muzïuê m astarsï õâm osobaâm. Obdobne jsou i vyâ sledky studie Schlossera[], kde byly laiky i odbornõâky hodnoceny zï enskeâ profily v uâ smeï vu upraveneâ do neï kolika variant podle anterio-posteriornõâ polohy hornõâch rïezaâkuê. ObeÏ skupiny hodnotily jako atraktivneï jsï õâ zï enskyâ profil s puê vodneï nebo võâce anteriorneï postavenyâmi hornõâmi rïezaâ ky. Posuzova nõâ atraktivity je pouze urcï ityâ m vodõâtkem, ktereâ naâ m naznacï uje, co je okolõâm vnõâmaâ no jako hezkeâ i jakeâ pozï adavky od pacientuê muê zï eme prïõâpadneï ocï e- The results prove the trend to prefer more rounded and more prominent lips. However, the question is what the cause of the trend is. One reason may be the continuing migration of people and mixing of ethnics, as well as their integration in society which were subject to changes in the 0th century. This phenomenon is obvious especially in the United States - in the first half of the 0th century, only Caucasians could succeed in society and occupied the top positions. Since the 70s the situation has changed and other ethnicities found their place in public life. In three studies, Turley et al. measured profiles of Caucasian and Afro-American female models in magazines within the 0th century, and compared the results with a control group. Auger and Turley [] report the trend of more rounded and protruding lips in Caucasian women, while Yehezkel and Turley [6] found the tendency to linear profiles and some features of Caucasians in Afro- American models. When the profiles of Caucasian models and Afro-American models are compared, some approximation can be seen [5]. Another explanation is found in the altered views on face attractiveness. In the 60s and 70s of the last century, extraction therapy preferred linear profiles; at the end of the century the non-extraction therapies were preferred. A balanced profile (harmony of the position and size of a nose, chin and lips) is seen as an attractive one. However, there are a lot of variations that are still considered attractive. Czarnecki [7] concludes that in men more linear profile with aprominent chin is preferred, while in women more prominent lips are desirable. In both sexes, profiles with more prominent lips are acceptable, providing they are accompanied with a bigger nose or chin. The retrusive lips and a large chin are the least attractive. Similar results are given also by Werli [8]: in women, the retrusive lips are the least acceptable, in men retrusive chin. In women the more rounded lips are preferred. In his study, Sergl [9] assessed the profiles constructed by laymen - a favorable male and female profile, and an unattractive profile. The favorable female profile has a smaller nose and less prominent chin (compared to a male profile). The unattractive face is characterized with a big nose and a prominent chin. Lips position as well as size is closely related to the age - more prominent lips look youthful. In his study Foster [0] came to the conclusion that full profiles are assigned to women and young persons, while linear profiles to men and the elderly. Schlosser [] states similar results - laymen as well as experts assessed women profiles in smile, adjusted to several varieties according to anterior-posterior position of the maxillary incisors. Both laymen and experts evaluated the female profile with original or more anterior position of maxillary incisors as more attractive.

10 rocïnõâk7 ORTODONCIE kaâ vat. MeÏ rïenõâ proporcõâ oblicï eje a hodnocenõâ atraktivity oblicï eje podle fotografiõâ je pouze statickyâm meï rïenõâm. O tom, zdaoblicïejmuêzï eme povazïovat za kraâ snyâ avyvaâzï enyâ rozhodujõâ dalsï õâ faktory, jako jsou barva a tvar ocï õâ, barva kuê zï e, vlasuê,uâ cï es, mimikaoblicï eje acelkovyâ jeho projev. ZaÂveÏr ZvyÂsledkuÊ teâ to praâ ce vyplyâvaâ,zïe v pruêbeï hu poslednõâho stoletõâ dosï lo ke zmeïneï chaâpaâ nõâ estetiky oblicï eje podle zmeï ny polohy i tvaru rtuê naprezentovanyâch fotografiõâch v moâ dnõâch aspolecï enskyâch cï asopisech. ZmeÏ napolohy rtuê je daâ nazmeï nami uâ hlovyâ ch alineaâ r- nõâch hodnot mezi prvnõâm aposlednõâm sledovanyâ m obdobõâm. Nasolabia lnõâ uâ hel se zmensï il o 5, nakonecï nyâ ch 99, ainterlabiaâ lnõâ uâ hel o,7 nakonecïnyâ ch 05,06. PolohahornõÂho rtu vzhledem k PRV se zveï tsï ilao,mm na6,8 mm apolohadolnõâho rtu o,78 mm na,5 mm. Hornõ ret se prïiblõâzï il k E-linii o,08 mm adolnõâ ret o,8 mm s konecï nou polohou hornõâho rtu - mm adolnõâho rtu -0,66 mm. ZmeÏ natvaru rtuê vyplyâvaâ ze zmeï ny procentuaâ lnõâho pomeï ru deâ lky cï erveneï hornõâho rtu k deâ lce celeâ ho hornõâho rtu, kteryâ se zveïtsï il o,% nakonecïnyâch 7,8% asoucï asneï i zmeï ny celkoveâ plochy rtuê, kteraâ se zveïtsï ilao,99 mm nakonecïnyâch 5, mm. Tyto vyâsledky naznacï ujõâ, zï e rty jsou plneïjsï õâ avõâce anteriorneï polozï eny. SoucÏ asneï je zrïetelneâ, zïe naâ zor naestetiku oblicï eje avnõâmaâ nõâ atraktivity oblicï eje nenõâ nemeï nneâ, ale podleâhaâ zmeïnaâ m se v pruêbeïhucï asu. VyÂsledky teâ to praâ ce rovneïzï naznacï ujõâ, jak se mohou prïõâpadneï meï nit i pozï adavky na ortodontickou leâ cï bu ze strany pacientuê. Attractiveness assessment is a sort of a guideline which helps us to understand what is perceived as a beautiful face, as well as to expect the patients' requirements. Measurement of face proportions and evaluation of attractiveness according to the photographs is static. Other factors contribute to the beauty and balance of a face, e.g. colour and shape of eyes, colour of skin, hair and hairstyle, mimics, and overall expression of the face. Conclusion The results of our work suggest that the perception of face esthetics (according to the change in position and shape of lips) in the photographs published in fashion magazines changed during the last century. The change in the lips position is due to the changes in angular and linear parameters between the first and the last period. Nasolabial angle decreased by 5. to the resulting 99., and interlabial angle decreased by.7 to The position of the upper lip with regard to PRV increased by. mm to 6.8 mm, and the position of the lower lip increased by.78 mm to.5 mm. The upper lip got closer to the E-line by.08 mm, and the lower lip by.8 mm. The resulting position of the upper lip is - mm, and of the lower lip mm. The change in the shape of lips results from the change of proportion of the length of the red upper lip to the length of the whole upper lip which increased by.% to 7.8%, and of the change in the overall area of lips which increased by.99 mm to 5. mm. The results suggest that lips are more rounded and located more anteriorly. At the same time it is obvious that the perception of face esthetics and face attractiveness changes over the time. The results of our research may help us to identify the changing requirements of orthodontic treatment. Literatura/References. Holdaway, R. A.: A soft-tissue cephalometric analysis and its use in orthodontic treatment planning. Part I. Amer. J. Orthodont. dentofacial Orthop. 98, 8, cï., s Jacobson, A.: Radiographic Cephalometry, From Basics to Videoimaging. Berlin, Chicago: Quintessence, Rakosi, T.: Cephalometric Radiography. London, Wolfe Medical Publications, 98.. Turley, P. K.; Auger, T. A.: The female soft tissue profile as presented in fashion magazines during the 900s: A photographic analysis. Int. J. Adult Orthodont. Orthognath. Surg. 999,, cï., s Sutter Jr., R. E.; Turley, P. K.: Soft tissue evaluation of contemporary Caucasian and African American female facial profiles. Angle Orthodont.998, 68, cï. 6, s Yehezkel, S.; Turley, P. K.: Changes in the African American female profile as depicted in fashion magazines during the 0th century. Amer. J. Orthodont. dentofacial Orthop. 00, 5, cï., s Czarnecki, S. T.; Nanda,R. S.; Currier, G. F.: Perceptions of a balance facial profile. Amer. J. Orthodont. dentofacial Orthop. 99, 0, cï., s Werli, T.; Matis, R.; Hedelin, G.; Rothea-Gouillard, C.: Aesthetic assessment of soft tissue profile by visual art students. Revue Orth. Dento Faciale 00, 7, s Sergl, H. G.; Zentner, A.; Krause, G.: An experimental study of the esthetic effect of facial profiles. J. Orofac. Orthop./Fortschr.Kieferorthop. 998, 59, cï., s

11 rocïnõâk7 0. Foster, E. J.: Profile preferences among diversified groups. Angle Orthodont. 97,, cï., s. -0. Cit. in: Czarnecki, S. T.; Nanda, R. S.; Currier, G. F.: Perceptions of a balance facial profile. Amer. J. Orthodont. dentofacial Orthop. 99, 0, cï., s Schlosser, J. B.; Preston, C. B.; Lampasso, J.: The effects of computer-aided anteroposterior maxillary incisor movement on ratings of facial attractiveness. Amer. J. Orthodont. dentofacial Orthop. 005, 7, cï., s. 7-. MUDr.KaterÏina UtõÂkalova Klinika zubnõâho leâ karïstvõâ LF UP Palacke ho, Olomouc Altis Group, spol. s r. o. ±vyâhradnõâ zastoupenõâ pro CÏ eskou republiku a Slovensko RaÂdi bychom VaÂs pozvali na pokracïovaânõâ dvoudennõâho kurzu Prof. Dr. Bjorn U. Zachrissona DDS, MSD, PhD., Norsko TermõÂn: 7.±8. listopadu 008 MõÂsto konaânõâ kurzu: ANDEL'S HOTEL PRAGUE (StroupezÏnickeÂho, Praha 5) TeÂmata kurzu:. PrÏestavba alveolaârnõâch tkaânõâ a kosti ortodontickyâm posunem zubu pro zlepsïenõâ estetiky implantaâtu. LeÂcÏebny plaân a kefalometrie - skeletaâlnõâ analyâza a analyâza meïkkyâch tkaânõâ. VyuzÏitõ VTO.. DuÊ lezïiteâ aspekty dlouhodobeâ stability vyâsledkuê ortodontickeâ leâcïby.. Extrakce jednoho dolnõâho rïezaâku v ortodoncii. 5. Klinicke novinky u fixnõâch lepenyâch retianeruê. 6. Lepenõ na atypickeâ povrchy (porcelaân, amalgaâm, zlato, kompozitum atd.) v klinickeâ praxi - nesrovnalosti mezi laboratornõâmi a klinickyâmi fakty. 7. SpolupraÂce s estetickou stomatologiõâ a uzavõâraânõâ mezer u pacientuê s chybeï jõâcõâmi hornõâmi lateraâlnõâmi rïezaâky. ÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐ PrÏipravujeme v CÏ eskeâ republice v roce Praha, hotel ILF ± jednodennõâ kurz TeÂma: Kotevnõ mikrosïrouby ± teorie a praxe PrÏednaÂsÏejõÂcõÂ: MUDr. Ivo Marek, doc. MUDr. Martin Starosta, Ph.D. Altis Group, s. r. o., 7. listopadu 5, BrÏeclav, provozovna: Husova 5, BrÏeclav Tel./fax: 59 5, Petra Karafova , Marie PõÂsarÏõÂkova ± Zelena linka: Slovakia Altis Group, s. r. o., K. SÏmidkeho /0, 9 08 TrencÏõÂn, mobil: , tel./fax: ,

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