Global facial soft tissue thicknesses for craniofacial identification (2023): a review of 140 years of data since Welcker's first study

This year (2023) marks 140 years since the first publication of a facial soft tissue thickness (FSTT) study. Since 1883, a total of 139 studies have been published, collectively tallying > 220,000 tissue thickness measurements of > 19,500 adults. In just the last 5-years, 33 FSTT studies have been conducted. Herein, we add these data (plus an additional 20 studies) to the 2018 T-Table to provide an update of > 81,000 new datapoints to the global tallied facial soft tissue depths table. In contrast to the original 2008 T-Table, some notable changes are as follows: increased FSTTs by 3 mm at infra second molar (ecm2-iM2'), 2.5 mm at gonion (go-go'), 2 mm at mid-ramus (mr-mr'), and 1.5 mm at zygion (zy-zy'). Rolling grand means indicate that stable values have been attained for all nine median FSTT landmarks, while six out of nine bilateral landmarks continue to show ongoing fluctuations, indicating further data collection at these landmarks holds value. When used as point estimators for individuals with known values across 24 landmarks (i.e., C-Table data), the updated grand means produce slightly less estimation error than the 2018 T-Table means (3.5 mm versus 3.6 mm, respectively). Future efforts to produce less noisy datasets (i.e., reduce measurement and sampling errors as much as possible between studies) would be useful.

The relationship between biological parameters and facial soft tissue thickness measured by ultrasound and its forensic implications

Facial soft tissue thickness (FSTT) data are currently widely used in forensic and medical science. In the forensic sciences, they form the basis for craniofacial reconstruction and identification methods. Since there are few FSTT data in the Slovak population, this study aims to enrich the data in well-defined age categories, taking into account differences between sexes and body mass index (BMI). The sample consisted of 127 participants aged 17 to 86 years from Slovakia. In addition to biological sex and age information, stature and body weight were recorded to calculate BMI. Subsequently, 17 facial anthropometric landmarks were used to measure FSTT using a noninvasive General Electric LOGIQe R7 ultrasound device. The mean values of FSTT were greater in the mouth region in males and in the zygomatic and eye regions in females. Differences between males and females, regardless of sex and BMI, were significant only at two landmarks. When BMI and age were taken into account, there were differences in 12 of 17 landmarks. Linear regression results showed the strongest correlation of most landmarks with BMI, followed by age and sex. When the FSTT was estimated in association with sex/age/BMI, landmarks in the zygomatic, mandibular, and frontal regions were the best regressors. The results of the present study demonstrate that B-mode ultrasound measurements of FSTT can be used in facial reconstruction as a function of BMI, age, and sex of the subject. Furthermore, the present regression equations can help practitioners in the forensic/medical field to calculate individual tissue thickness.

Do facial soft tissue thicknesses change after surgeries correcting dental malocclusions? An intra- and inter-patient statistical analysis on soft-tissue thicknesses in BSSO + LFI surgeries

OBJECTIVES

The aim of this study was to analyse changes in facial soft tissue thickness (FSTT) after corrective surgeries for dental malocclusion. The correlation between body mass index (BMI) and sex of patients and their FSTT before undergoing surgery was analysed.

MATERIALS AND METHODS

Cone beam computed tomography of seventeen patients that underwent Le Fort I osteotomy in combination with bilateral sagittal split osteotomy were collected. Hard and soft tissue landmarks were selected basing on the interventions. FSTT were computed, and measurements from pre- to post-operative were compared. The relationship between FSTT, sex, and BMI was investigated.

RESULTS

Considering the comparison between pre- and post-operative measurements, any significant difference emerged (p > .05). The Pearson's correlation coefficient computed between BMI and the FSTT (pre-operative) showed a correlation in normal-weight patients; the region-specific analysis highlighted a stronger correlation for specific landmarks. Higher median values emerged for women than for men; the subset-based analysis showed that women presented higher values in the malar region, while men presented higher values in the nasal region.

CONCLUSIONS

The considered surgeries did not affect the FSTT of the patients; differences related to BMI and sex were found. A collection of FSTT mean values was provided for twenty landmarks of pre- and post-operative of female and male subjects.

CLINICAL RELEVANCE

This exploratory analysis gave insights on the behaviour of STT after maxillofacial surgeries that can be applied in the development of predictive methodologies for soft tissue displacements and to study modifications in the facial aspect of the patients.

The facial soft tissue thickness related facial reconstruction by ultrasonographic imaging: A review

The facial soft tissue thickness is crucial for facial reconstruction. Ultrasound is one method to evaluate facial thickness. There are two main modes of ultrasound that can be used for measurement: A-mode and B-mode. Because of its advantage, B-mode is frequently used in many recent studies. The factors that contribute to the varying results of facial soft tissue thickness are classified as method error and biological factors. The following factors should be considered when designing a study: subject type, subject posture and facial expression, ultrasound machine, ultrasound mode, transducer type, frequency, gel type and application, transducer orientation, landmark selection, and thickness measurement. According to the results of previous research, the main biological factors that likely affected facial thickness are sex, age, body mass index, and ancestry. However, there is still insufficient evidence to conclude how the thickness differs among various methods of measurement and which method produces the best results for facial reconstruction. Future ultrasonographic imaging research associated with facial thickness should determine the accuracy of the facial reconstruction to compare with other techniques and evaluate the gold standard of the facial reconstruction. Furthermore, the standardized landmarks and ultrasonographic imaging of each landmark should be clarified for consistency across the populations.

The development and testing of Thai facial soft tissue thickness data in three-dimensional computerized forensic facial reconstruction

Forensic facial reconstruction is a useful tool to assist the public in recognizing human remains, leading to positive forensic investigation outcomes. To reproduce a virtual face, facial soft tissue thickness is one of the major guidelines to reach the accuracy and reliability for three-dimensional computerized facial reconstruction, a method that is making a significant contribution to improving forensic investigation and identification. This study aimed to develop a facial soft tissue thickness dataset for a Thai population, and test its reliability in the context of facial reconstruction. Three-dimensional facial reconstruction was conducted on four skulls (2 males and 2 females, with ages ranging between 51 to 60 years). Two main tools of three-dimensional computer animation and modeling software-Blender and Autodesk Maya-were used to rebuild the three-dimensional virtual face. The three-dimensional coordinate (x, y, z) cutaneous landmarks on the mesh templates were aligned homologous to the facial soft tissue thickness markers on the three-dimensional skull model. The final three-dimensional virtual face was compared to the target frontal photograph using face pool comparison. Four three-dimensional virtual faces were matched at low to moderate levels, ranging from 30% to 70% accuracy. These results demonstrate that the facial soft tissue thickness database of a Thai population applied in this study could be useful for three-dimensional computerized facial reconstruction purposes.

Establishment of a finite element model based on craniofacial soft tissue thickness measurements and stress analysis of medical goggles

In this study, an accurate finite element (FE) stress analysis of head-mounted products for Chinese users was performed. Using craniofacial computed tomography scans of 280 Chinese individuals, the total soft tissue thickness and thickness of the fat and muscle layers for 41 landmarks were measured. The data were used to construct FE head models (FEH). An FE stress test was conducted to analyse the wearing of medical goggles using two FE models based on one-layer (FEH 1) and three-layer (FEH 3) soft tissue material parameters. When compared with the experimental results, the modelling results for FEH 3 were more realistic than those for FEH 1. Wearing medical goggles led to stress concentration over five landmark areas, A: upper medial forehead, B: temporal, C: zygion, D: infraorbital fossa and E: rhinion, of which B, C and D caused the most discomfort during long-term goggle wear. Practitioner summary: A precise FE head model can reflect the complex contact pressure of a head-related product. Two FE models based on one- and three-layer soft tissue material parameters were established and tested separately with medical goggles. The model can be used to improve the comfort of head-related products. Abbreviations: FE: finite element; FEH: FE head models; FEH 1: FE models based on one-layer; FEH 3: FE models based on three-layer; VR: virtual reality; AR: augmented reality; 3D: three-dimensional; WSU: Wayne State University; WSUBIM: Wayne State University Brain Injury Model; CT: computed tomography; MRI: magnetic resonance imaging; CFSTT: craniofacial soft tissue thickness; FSR: force sensing resistor; NURBS: non-uniform rational basis spline; SPSS: statistical product and service solutions; STL: stereolithography; STP: standard for the exchange of product model data; BDF: glyph bitmap distribution format; EEG: electroencephalogram.

Age- and Sex-Related Measurements of Total Craniofacial Soft Tissue Thickness and Fat in a Central Chinese Population

ABSTRACT

In this study, data related to the total soft tissue thickness and fat layer thickness of 41 anatomical landmarks were extracted from the craniofacial computerized tomography data of 280 Chinese individuals (160 males and 120 females). The measurements were assessed according to the following factors: a. sex, b. age, and c. sex × age. Descriptive statistics and a differential analysis were carried out in each group to analyze both the total soft tissue thickness and fat layer thickness. The results showed the following. 1. The results showed that the greater the total thickness of the soft tissue, the thicker the fat layer. 2. The thicknesses of the head and face soft tissues are strongly affected by sex. The total thickness of all landmark points in the men, except for the zygomatic points, was on average greater than that in the women. In contrast to the total thickness, the fat layer, except for the point of rhinion, in the women was larger than that in the men. 3. In the comparison of the 4 age groups, most feature points did not show an evident increasing or decreasing trend with age in the total thickness of the soft tissue. However, regarding the thickness of fat, the thickness at the other points, except for the feature infraorbital fossa point, decreased with age. 4. In the analysis of the sex × age group, no statistically significant differences were found at any landmark points. This paper is significant for facial reconstruction and cosmetic surgery in the Chinese population.