# Anthropometric vs. Dental Variables of the Ageing Face: A Clinical Study
## 2 Materials and Methods
### Data Collection  
The AUTH School of Denistry Committee for Research Ethics approved the study protocol (No. 23/02.02.2017). After assessing their orthopantomographic X-rays, one hundred eighty randomly selected dentate individuals were called to participate in the study. A thorough extra- and intraoral clinical examination was carried out. Fifty-eight adults met the inclusion criteria and signed the informed consent document. Sex, height, weight, and body mass index were recorded. During the intraoral examination, the following data were recorded: periodontal disease index (PDI), anterior-posterior overlap (overjet and overbite), angle class, and the number of FTUs. Digital two-dimensional photography was utilised for the collection of facial anthropometric measurements. This method was chosen due to its frequent application in everyday clinical practice, ease of use, efficiency, and low cost [27; 28; 29]. The armamentarium included a DSLR Canon 1200D digital camera, along with a Canon EF 100 mm f/2.8 Macro USM lens (Canon U.S.A. Inc., Melvill, New York, USA), a camera tripod (Polaroid Corp., Minnetonka, MN, USA), two flashlights, a \"monolight\" and a \"soft-box\", which were fixed on tripods ([PERSON]\({}^{\circled{R}}\), Shenzhen, China), a black background, a fixed standing base, a measuring tape, a weight scale, calibration stickers, a computer (Lenovo Ideapad Flex 14 Notebook, Lenovo Technology B.V.--Greece Branch, Marousi, Athens, Greece), a dental examination set, and photography equipment [30]. The photographs were obtained with the participants in a standing position, with the head in a natural head posture and a mandibular physiologic rest position. For both full-face frontal and lateral views, three standardised photographs were obtained. The distance between the participant's face and the camera was 160 cm. The camera was adjusted to the participant's height (eye level), utilising a mounted spirit level for standardisation. Subsequently, five intraoral photographs were taken of each participant. Vitruvian trisection was used to define facial thirds, while the middle and lower thirds were studied. The middle third of the face is defined between the soft tissue points glabella (G') and subnasale (Sn). The lower third of the face is defined between the soft tissue points subnasale (Sn) and soft tissue menton (Me') [31; 32]. Figure 1 is an illustrative sketch which better demonstrates facial thirds and facial points that were registered in our study (Figure 1). To accurately capture the face in a photograph, a make-up pencil was used to mark relevant anatomical points that were prominent or palpable but not visible in the picture. Furthermore, a standardized sticker was provided to adjust the image (Figure 2). Anthropometric measurements are a reliable tool for analysing facial aesthetics, although a universal protocol has yet to be established. However, specific measurements have been widely implemented in numerous studies as a standard practice [29; 33; 34]. The anthropometric parameters explored in the present study were the facial index, the vertical facial percentage of the middle third of the face to the lower third of the face (based on the Virtuvian trisection), the mouth width, the distance between the nose and mouth, the pupil-to-orbital point height, the height of the lower lid, the Frankfurt plane inclination, the nasolabial angle, the Po-N-A angle (portion-nasion point A angle), the Po-N-B angle (portion-nasion point B angle), the ANB angle (point A-nasion point B angle), and the distance between the upper lip and E-line, as well as the distance between the lower lip and E-line (Ricketts' esthetic line). A digital analysis of the measurements was performed using the software ImageJ, which is available for use without permission [35]. Figure 1: Landmarks: (**a**) frontal and (**b**) lateral views.