A Metric Analysis Of The Facial Profile*WILLIAM D. BOWKER, D.D.S., h1.S. andHOWARD V. MEREDITH, Ph.D.Iowa City, ZozuaThis investigation pertains to theintegumental profile of the face inchildhood. It describes a quantitativemethod for depicting the facial pro-file and presents a number of find-ings from application of the method.The integumental profile is meas-ured with respect to a line passingthrough nasion and pogonion. Dis-tances perpendicular to this line aremeasured, these distances terminatinganteriorly at selected points on thefacial profile. Supplementary dataare obtained to determine (a) posi-tional relations among the measuresperpendicular to the nasion-pogo-nion-line, and (b) the angular re-lation of the nasion-pogonion line toa cranial-base line.The measures are obtained fromnorma lateralis radiographs of thehead taken on North American whitechildren. Each of 26 girls and 22 boysare studied at two postnatal ages nineyears apart.STATEMENT of OBJECTIVESSpecific aims of the study were:1. To devise a metric method fordescribing the integumental profile ofthe face and to investigate reliabilitiesfor various facets of the method.2. To investigate age, sex, and indi-vidual differences in the integumentalprofile of the face. Basic in the reali-zation of this objective were compu-tations of univariant statistics for (a)measurements of the integumental* Supported in part by a resea.rch grant,D-217, from the National Institnte for Den-tal Research, of the National Institutes ofHealth, Public Hezlth Service.profile at ages 5 and 14 years, and (b)changes in the integumental profilebetween ages 5 and 14 years.3. To study associations betweencomponents of the integumental pro-file. This entailed determining bivari-ant statistics for different aspects of theprofile at ages 5 and 14 years, givingparticular attention to (a) size at age5 years in relation to change between5 and 14 years, and (b) association be-tween age changes in different profilecomponents.PERTINENT LITERATUREThe literature pertaining to facialsize and form was examined in an ef-fort to locate previous research onthe integumental profile of the face.Search was made for methodologicproposals and reported findings onchildren and adolescents.Five relevant publications werefound, two2' presenting methods ofdescribing the facial profile, onelodealing with age and sex differencesfor height and depth measures of theprofile, and reporting findingson change with age in the angle be-tween a facial-height line and acranial-base line.E1sasser3 constructed a facial ortho-meter that provided a reference axisanterior to the profile and at rightangles to the Frankfort plane. Directmeasurements were proposed (a) fromthe axis posteriorly to three points onthe integumental profile, i.e., pointsestimated to lie in the same horizon-tal planes as nasion, subnasale and po-gonion, also (b) along the axis fromthe estimated level of nasion to sub-149 I50 Bowker July, 1959nasalc and to the lowest point onthc intcgunicntal chin.A method 01 studying thc facial pro-file on tzo) m(i loteinlrs radiographswas dcvclopcd by H~rstonc.~ Thisproposal calls for the dctcrniination ofseries 01 angles (a) bctwccn pails otlincs drawn to sclcctctl points alongthc intcgiiniental profilc and (b) bc-tween lincs along the profile paircdwith a linc passing through thc nil-tcrior and postcrior nasal spincs.Pclton antl Elsasser,10 utilizing theElsasser ortlionictcr, dcrivcd two mcas-ures each of the forward and down-ward growth of the integumental pro-file. They amassed and analysctl datafor thcse incasiircs on 3,676 whitenialcs and 3,153 white femalcs bc-tween 5 and 25 ycars of age.Bjork' and Landcc, cach studyingnialcs only, dctcrmincd the angle bc-twcen a facial-height line and acranial-base line at differcnt agcs scp-aratcd by approximateiy ninc ycars.'The means of Bjork are bascd oncross-sectional data, those of Landclargely on longitudinal data. Landestudied 20 boys at age 3 ycars antl32 boys at age 12 years; Bjork's sam-plcs numbered 322 at age 12 yearsand 281 in young adulthood.'Tlic Elsasscr and Riirstonc publi-cations arc citcd for their mcthodolo-gic relevance. Findings from the in-vestigations of Pclton and Elsasser,Lande, and Rjork are pcrtincnt forlater comparison with findings frointhc present study.SUBJECTSThe subjects were 48 American-bornwhite children, 26 girls and 22 boys.All were normal, healthy children par-ticipating in a longitudinal researchprogram at the State University ofIowa.' The children were enrolledfor study on the basis of willingness tocooperate and the likelihood of con-tinued residence in the vicinitv. Thevwere not selcctcd on the basis of facialcharacteristics or orthodontic necds.Ninety-six per cent of the subjectshad at least two grandparents ofnorthwest European descent. For 56pcr cent of tlie subjccts, all four grand-parents were of northwest Europeanancestry.Seventy per cent of the fathers heldprofessional or major managerial 1'0-sitions. Over 20 pcr cent were in theminor managerial, commercial orskilled trade groups, and the remain-der were employed at semiskilled oc-cupations.SOURCE of DATA'llic source of all data was nominIntel-nlis radiographs of thc hcad,drawn from the files of the FacialGrowth Study.+ In this Study ratlio-graphs of every subject are taken onor near each birth anniversary, nntlat semiannual intervals up to 12 yearsThose subjccts includcd in thc prcs-cnt investigation were requircd to sat-isfy the following criteria:1. Radiographs on file at ages 5 antl14 years, each showing good soft tissucdcfinition...c ^-^VI nsc.2. Molar tceth in occlusion.3. Lips in contact, or nearly so. I'hclattcr was accepted when, from cx-ainination of serial radiographs, slightlip separation was considercd thc nor-mal position for the child.LANDMARKS and hrEA5UREhf ENTSOsseous landmarks used in detcr-mining the referencc and cranial-basclines were:1. Nasion, defincd as thc most an-terior point of the frontonasal su-t~re.~'This nroernni. known ns tlie Facial Growth Study,'is kder the joint direction of E. H. Hixon, Departinent of Orthodontics, and H... I ~~-- , V. Meredith, Child Welfare Research Station. Vol. 29. No. 3 Facial Profile 1512. Pogonion, defined as the mostanterior point of the mandible foundby means of a rule movcd at rightangles to the niandibular3. Tuberculum, defined as thc inostsuperior point of the anterior out-line of sella turcica before the out-line turns and continues forward.12A line from nasion to pogonion wasdrawn on each radiograph. Using arule inovccl at right angles to this re-ference line, five pairs of points weremarked with a ncedle prolx. 'l'heposterior point of cach pair was onthe nasion-pogonion line and the ari-terior point of cach pair on the in-tegumental profile. The levels forplacement of these points werefound by locating:1. The minimum distance frointhe nasion-pogonion line to the in-tegumental concavity at the root ofthe nose.2. The distance from the nasion-pogonion line to the tip of the nosc.3. The minimum distance froin tilcnasion-pogonion line to thc concavityof the upper lip.4. The minimum distance from thenasion-pogonion line to the labioment-al groove.ll5. The distance from the nasion-pogonion line to the most forwardpoint of the convexity of the integu-mental chin.These landmarks were used in ob-taining two series of Iincar meas-urements. The first series rcpresent-ed anteroposterior distances betweeneach pair of points (see Figure 1).The second series represented dis-tances along the nasion-pogonionline; from nasion to the first level,between the first and second levels,and so forth.The measurements were obtaincddirectly on the marked radiographsby use of a steel tape calibrated inmillimeters. All readings were takenwith the aid of a magnifying glass andFig. 1 1lluxtr:ttioii of tlw nietliotl rise(l foriii(~trie:illy tlrwribiiig tlie f:ic.i:il prc~filc.estimated to the nearest 0.1 mn~. 'l'liccalibration of the tape was chcckctlfor accuracy against a standard scale.A cranial-base line, drawn throughnasion and tuberculum sella, formedan acute anglc with the nasion-pogo-nion line. 'I'his angle was mcasurctlon cach radiograph by nicans of ;Icalibratctl drxfting machine with awrnier scale. All angles werc nir:is-urctl to the ncarcst miniitc.RELIABILITY OF DATATwo problems pertaining to tlie re-liability of the data were investigatrd.Both were studied on the 26 femalesubjects and dealt with distances fromthe nasion-pogonion line to the fa-cial profile.The first problem considered theagrcement of two measurers, workingindependently, in determining :hedistances between the pricked anteriorlandmarks on the integumental pro-file and the pricked posterior land-marks on the nasion-pogonion line.Each distance was measured to thenearest 0.1 mm, and all five distanceswere dcterrnined at ages 5 years and14 years. The extent to which a rec-ord obtained by measurer A differedfrom the corresponding record obtain-ed by measurer R was determined. 152 Bowker July, 1959Over the entire series, this gave 260difference values. The standard de-viation for these values was 0.10 mm,and the standard error of measurement0.07 mm.'The foregoing analysis treats onephase of the dependability of the data,i.e., chance variation in measuring be-tween the points registered on the ra-diographs. Additional chance varia-tion is associated with positioning thesubject, radiographic processing, draw-ing the nasion-pogonion line, and reg-istering the measurement landmarks.For the study of these sources of un-reliability, the desirable materialswould be several independently ob-tained radiographs for each subjectrepresenting the same age. Since onlysingle radiographs were available fora given age, it was necessary to em-ploy a substitute procedure.For each subject, single radiographswere on file at semiannual ages from4.5 years to 11.5 years, and at annualages from 12 years on. It was decidedto investigate reliability using pairsof radiographs taken at a specified ageand six months later. Two growthstages were selected, 5.0-5.5 years and11.0-11.5 years. The 26 female sub-jects were studied at both stages.Each radiograph was dealt with byfollowing the same series of stcps aswere projected for deriving the basicdata to be used in the study. Thesesteps have been described to thepoint of independent measurement ofthe five dimensions from the nasion-pogonion line to the facial profile.When the two records for a dimen-sion differed by no more than 0.2mm, their mean was employed. Whenthe difference between the two rec-ords was 0.3 mm or more, two addi-tional measurements were taken, themost divergent of the four was dis-carded, and the mean of those remain-ing was employed. The compositevalues for each dimension were cor-rected for radiographic en1argement.lAnalysis by age-levcl and specificdimension gave the reliability esti-mates presented in Table I. Each cor-relation coefficient depicts the asso-ciation between corresponding meas-urements of a facial dimension cle-rived from two radiographs taken sixmonths apart. It will be seen thateight of the tcn T'S are 0.9 or higher.FINDINGSThe findings of the study will bepresented under foyr captions: profiledistances measured perpendicular tothe nasion-pogonion line, profile dis-tances measured along the nasion-po-gonion line, angular relationship ofTable IReliability estimates for fire dimensionsproposed in metrically describing theintegumental profile of the faceDimension r5.0-5.5 yearsr11.0-11.5 yearsNasion-pogonion line to :Root of nose .............................. .92*Concavity of upper lip ..................... .90Labiomental groove ........................ .85Convexity of chin ......................... .72Tip of nose ............................... .93.91*.98.9G.93.9F* In each instance, N=26 female subjects. Vol. 29. No. 3Facial Profile153Table I1Central tendency :ind v:iri:ibility valurs (inni) for fivi.t1ist:inres from the nasion-pogonion line to tliii fac.i::l profilc.Level of Age 6 years Age 14 ymrs1)iniension Sex S 3Ie:111 S.D. 31ran S.D.Root of Girls ti.3 0.8 ti.0 0.8nose Boys 2'" 6.6 0.7 7.1 0.8Tip of Girls OG 23.8 1.G 33.9 2.9Concavity of Girls ?ti 14.6 2.1 16.3 2.0upper lip Boys '7 -- ' 14.7 I .ti 17.5 2.3groove Boys 02 9.5 I .8 9.5 1 .YConvexit.y of Girls 26 11.3 I .3 12.3 1.4cliin R0p . . -- 11.4 I ..? 12.4 1 .(inose Boys "O+" 24.6 2.1 32.0 33Lnbion1ent:il Girls 26 9.7 I .6 9.9 1.7* For samples of this size, the range of :I distribution :ipproxini:itc.s the S.1). (Ht:ind:ir(Ideviation) multiplied hy 3.8.** Two radiographs did not include the tip of the nose :it ngc 14 years.the nasion-pogonion linc to a cranial-base line, and selected illustrationsof individual differences in facial pro-file.The basic values for distances alongthe nasion-pogonion line were derivedby the same measurement and adjust-ment procedures as those for the dis-tances perpendicular to the nasion-po-gonion line.On no radiograph did two indc-pendent measures of the pogonion-nasion-tuberculum angle differ bymore than 0.3 degree. Values for an-alysis were obtained by averagingeach pair of these measures. Anglesrequire no correction for radiographicen1a1-gernent.I~Profile distnnce mensirred perpendi-ctilnr to the nasion-pogonion line.Table I1 displays central tendency andvariability values for five distancesfrom the nasion-pogonion line to thefacial profile. Separate analyses areshown for children of each sex at ages5 years and 14 years. The statistics ofthis table support the following find-ings:1. Mean distances perpendicular tothe nasion-pogonion linc arc (a)shorter to the root of thc nose thanto the labiomental groovc, and (b)shorter to thc most antcrior point ofthe convcxity of the intcgumcntalchin than to the most posterior pointof the concavity of the upper lip.2. At 5 years of age, both sexescombined, thc obtained means for per-pendicular distances from the nasion-pogonion line to the integumentalprofile are 6.4 mm at the root ofthc nose, 9.6 mm at thc labiomentalgroove, 11.3 mm at the convexity ofthe chin, 14.6 mm at the concavityof the upper lip, and 24.1 mm at thetip of the nose.3. All of the differences betweencorresponding means for the two sexesare under 1.0 mm at 5 years of age,and under 1.5 mm at 14 years of age.In no instance does a sex differencein standard deviation exceed 0.6 mm.At age 5 years, for none of the fivedimensions is there a statistically signi-ficant difference between the distribu-tions on girls and boys. At age 14years, the only statistically significantdifference is that between the means I54 Bowker July, 1959for distance from the nasion-pogonionline to the root of the nose (t = 2.0) .*In several instances, the statisticspresented in Table I1 suggest an in-crease in central tendency and/orvariability with age. By pooling thedata for the two sexes, larger N'swere obtained for testing the dependa-bility of age changes. Changes in cen-tral tendency significant at the 1 percent level of confidence7 are found forthe distances from the nasion-pogo-nion line to the root of the nose, thetip of the nose, the concavity of theupper lip, and the convexity of thechin. The only dimensions for whichthe magnitude of the increase he-tween ages 5 and 14 years exceeds1.0 mm are those from the nasion-po-gonion line to the deepest concavityof the upper lip (2.3 mm) and fromthe nasion-pogonion line to the tip ofthe nose (7.3 mm) . The latter dimen-sion stands alone in yielding a statist-ically significant difference in variab-ility with age.*Since the same sample was studiedat ages 5 and 14 years, the data of thissection could be utilized to investigatethe following relationships: (a) as-sociation between the magnitude of agiven dimension at 5 years and thechange in this dimension over the per-iod 5 to 14 years, and (b) associationbetween the change in a given dimen-sion over the period 5 to 14 years andthe change in another dimension dur-ing the same period of childhood.Correlation coefficients symbolizingboth types of relationship are assem-bled in Table 111. Inspection of thistable shows:1. For none of the five dimensionsis there a strong association betweensize at age 5 years and change in size(luring the ensuing nine-year period.The obtained T'S all lie between zeroand 0.4 Size-change concomitance islow positive for the distance from thetip of the nose to the nasion-pogonionlinc, and low negative for the distancesfrom the root of the nose to the nas-ion-pogonion line and from the mostforward point on the convexity of theintegumental chin to the nasion-pog-onion line.2. Over the age interval 5-14 years,the amount of change at one level ofthe facial profile is not highly relatedto that at other levels. Moderate pos-itive associations (r's between 0.4 and0.7) are found for (a) change at thelevel of the tip of the nose with thatat the level of deepcst concavity of theupper lip, (b) change at the level ofthe labiomental groove with that atthe level of the anteriormost projec-tion of the integumental chin, and(c) change at the level of deepest con-cavity of the upper lip with that atthe level of the labiomental groove.Profile distances measured along thenasion-pogonion line. Measures alongthe nasion-pogonion line were obtain--ed for the distance from nasion to thelevel of the integumental root of thenose; the distances between profilelevels 1 and 2, 2 and 3, 3 and 4, 4 and5; and the distance from nasion topogonion. These measures were sub-grouped according to age, sex and di-mension, then analyzed for centraltendency and variability. The resultsare arranged in Table IV. Represent-ative findings are:1. The mean distance along thenasion-pogonion line from nasion toa perpendicular passing through theroot of the integumental nose is great-er in early childhood than during ad-olescence. For both sexes combined,the obtained means are 3.2 mm at age5 ycars and 2.0 mm at age 14 years.An appropiate significance test,? bysupporting rejection of the null hy-pothesis at the 1 per cent confidencelevel, allows the inference of a de-crease in this dimension with age. Vol. 29, No. 3Facial Profile155Table I11Relationships among magnitude and inrrement dah for fire measures from the nasion-pogonion line to the integumental profile of the faceMeasure N ?' P*Size at age 5 ?/cars with cltalige 5-14 yearsRoot of nose ............................ -0.30 0.03Tip of nose ............................. 46 0.36 0.03Concavity of upper lip .................... 48 0.017 ...Labiomental groove ...................... 48 -0.18 ...Convexity of chin ....................... 48 -0 31 3.0348**Change 5-14 yeaw at different lewlsRoot of nose: ............................ 46Tip of nose: ............................. 46Tip of nose: ............................. 46concavity of upper lip : ................... 48Tip of noseConcavity of upper lipLabiomental grooveLabiomental groove0.17i ...0.67 0.010.1 6 ...0.43 0.01Labiomental groove : .............Convexity of chinConvexity of chinTip of nose: .............................48 0.67 0.0110 0.25 ...* Probability that the population T is zero.** Children of both sexes. Table IVCentral tendency and variability values (nm) for six distances along the nasion-pogonion lineAge 5 yearsAge 14 yearsMeasurement Sex N Mean S.D. Mean S.D.Nasion to Girls 26 2.8 2.3 1.9 1.6level 1* Boys 22 3.7 1.8 2.1 2.4Level 1 to Girls 26 27.2 2.6 36.9 2.8level 2 Boys 20x1 27.6 3.1 39.1 4.5Level 2 to Girls 26 12.5 1.7 17.3 2.0level 3 Boys 20+" 12.6 1.9 18.0 2.1Level 3 to Girls 26 29.8 3.4 31.4 3.9level 4 Boys 22 31.0 3.0 32.9 3.0Level 4 to Girls 26 7.4 1.8 10.2 2.5level 5 Boys 22 8.6 1.9 11.6 2.3Xasion to Girls 26 86.7 4.5 10.5.5 5.7pogonion Boys 22 90.4 4.4 111.0 6.5* The successive levels represent (1) root of the integumental nose, (2) tip of the nose,(3) most posterior point on the concavity of the upper lip, (4) labiomental groove, and(5) most anterior point of the integumental chin.**Two radiographs did not include the tip of the nose at age 14 years. 156 Bowker July, 19592. At age 5 years, mean distancesbetween the successive lines drawnperpendicular to the nasion-pogonionline are, for the two sexes pooled, 27.4mm, 12.5 mm, 30.4 mm and 8.0 mm.1 lie comparable means at age 14 yearsare higher by 10.6 nini, 5.1 nim, 1.7mm and 2.9 mm, respectively. For eachof these vertical distances a statistical-ly dependable change with age may beposited, z.e., the hypothesis of nochange is untenable at the 1 per centconfidence level.3. The mean vertical distance be-tween the root and tip of the integii-mental nose is about 3.0 nim shorterat age 5 years than the mean verticaldistance betwccn the deepest concavityof the upper lip and the labiomentalgroove. .it agc 14 years the formcrdistance (levels 1 to 2) exceeds thelatter (levels 3 to 4) by more than 5.0mni. It follows that for thc age period5 to 14 ycars there is much greatervertical increase in the nasal region ofthe integumental profile than in thelabial region.4. The mean distance from nasionto pogonion is greater for boys thangirls. A sex difference significant at thc1 per cent level of confidence is foundat each aqe. With two exceptions, theothcr differences between correspond-ing means on boys and girls are notdependable statistically; significance atthe 5 per cent level is found for dis-tance from the labiomental groove tothe most forward point on the integ-umental chin at age 5 years, and forr-distance from the root to the tip ofthe integumental nose at age 14 yeais.5. Combining data on both sexes,the mean distance along the nasion-pogonion line froin a perpendicularpassing through the root ot the noseto a pcrpendicular passing throughthe anteriormost point of convexityof the integumental chin is 78.1 mniat age 5 years and 98.4 min at age 14years. The portion of this verticaldimension lying above the perpendi-cular passing through the point otdeepest concavity of the upper lipincreases from 51 pcr cent at the earl-ier age to 56 per cent at the later age.This relative increase harmonizes withfindings by Meredith, Knott and Hix-on8 on changcs during childhood inthc nasal and subnasal components ofskeletal face height.Angzilnr relntionship of the nnsion-pogonion line to n rinninl bnse line.Table V presents central tcndency andvariability statistics derived froin mea-sures of the acutc angle formed ondrawing straight lines on each radio-graph from pogonion to nasion andfrom nasion to tubcrculum sella. It isLou n d:1. The mcans obtaincd at age 14ycars are larger than thosc obtained atagc 5 years by 3.7 deqrees and 3.5 dc-Crees on girls and boys, respectively.For both sexes combined, it is possibleto reject at the 1 per cent level thehypothesis that the angle does not dif-fer at the two ages.2. At each age, the mcan obtained Table VCentral tendency and variability values (degrees)for the acute angle pogonion-nasion-tuberculumSexAge 5 yearsAge 14 yearsN Mean S.D. Mean S.D.Girls . . . . . . .. . . . . . . . . . . . . . 26 76.4 2.8 80.1 4.2Boys ..................... 22 78.4 4.0 81.9 3.7 Vol. 29, No, 3 Facial Profile 157on girls is smaller than that obtainedon boys. At 5 years a dependable dif-ference is tenable at the 5 per centlevel; at 14 years the null hypothesiscannot be rejected.3. Pooling the data for a given ageon both sexes, the obtained means forthe angle are 77.4 degrees at age 5years and 81.0 degrees at age 14 years.It follows that in the 48 childrenstudied the mean increase in pogo-nion - nasion - tuberculum angle be-tween 5 and 14 ycars of age is 3.6 de-grees.Comparative reference to radio-graphic studies by Landee and Bjorklis relevant. Lande measured the acuteangle formed by drawing lines fromgnathion to nasion and from nasion tothe center of sella turcica; Bjork mea-sured the acute angle betwccn linesfrom pogonion to nasion and nasion tothe center of sella turcica. Thc subjectsfor both investigations were boys.Lande reports means at ages 3 yearsand 12 ycars; Bjork rcports means atage 12 ycars and in early adulthood.In each study, the mcan at the olderage is 2.8 degrees higher than that atthe younger age. Gcnerali~ing, find-ings from Lande, Ejork, and the pres-ent study show that over thc yearsfrom early childhood to carly adult-hood there is an increase with age inthe acute angle bctween two linesfrom the region of sella turcica tonasion and from nasion to the regionof the anterior margin of the mandi-ble.Returning to anteroposterior di-mensions, it will be recalled that be-tween 5 and 14 years of age the dis-tance from the nasion-pogonion lineto the tip of the nose is found to in-crease much more than the distancefrom the nasion-pogonion line to themost forward point on the integu-mental chin (See Table VI, rows 2and 5). When account is taken of theage change in the pogonion-nasion-tuberculum angle, what may be in-ferred regarding the forward develop-ment of the integumental profile inthe lower nasal and chin regions? Ifthe angular incrcasc v;ere diu: en-tirely to the movement of pogonion,there would be little c'ifferencc inamount of forward development of tlicprofile at these two levels. However, itappears unlikely that this extremeassumption with regard to pogonionholds; some downward movement ofnasion (See Table 6, row 6) and/orupward movement of tuberculumsella'? probably occurs. Pelton andEl~a~~er~~, using a reference line atright angles to the Frankfort horizon-tal and in contact with the integu-mental profile near nasion, found thatduring childhood and addesccncs theaverage North American white boyand girl is characterized by slightlymore forward developirierit ol the in-tegumental profile in the rcgion ofsubnasale than in the region of pogo-nion.Selected illtistrotions of indi?iidirnldifferences iii facinl pl-ofile. To thisiuncture, individual variation in thedifferent measures obtained has beendenoted numerically in terms of thestandard deviation and the Pearson rcoefficient of correlation. In the pres-ent section, three pairs of profiles areplaced in iuxtaposition for the pur-pose of providing pictorial examplesof individual variation.Part A of Figure 2 presents the fa-cial profiles of two children (h4 2, F12) 5 years of age. These childrenwere selected to illustrate the rangefound for the minimum distance fromthe nasion-pogonion line to the deep-est point of the concavity of the upperlip. The child showing the larger cri-terion measure (F 12) is aboi~e aver-ageX in distance from the nasion po-gonion line to the tip of the nose, 158Table VIJuly, 1959Central tendeney and variability values (mm) representing change in twelve incisures of the fiieial profile over the age period from 3 to 14 years Girls: S = `761\Ieasnrmient 3le;in S.D. Nenn S.D.Boys: s = 22Anteroposterior :Level 1' ........ 0.G 9.5 0.G 1.7 7.5"" 2.2 ............... 1.8 1.4 2.8 1.7 ............. 0.2 1.3 0.0 1 ..iLevel 5 ....................... 1.0 1.1 1.0 1.2Vertical :Nasion to level 1 .............. -0.9 1.8 -1.G 2.iLevel 1 to level 2 .............. 9.7 2.4 11.5** 3.7Level 2 to level 3 ............... 4.8 2.0 .i,4S;; 2.2Level 3 to level 4 .............. 1.G 3.0 1 .o 3.6Level 4 to level 6 .............. 2.8 2.0 3.0 2.qNasion to pogonion ............ 1S.8 2.8 20.G 5.2Angle :Pogonio~~-iiasi~n-tuberculuni .... 3.7 3.1 3..i2.7" See first footnote below Table IV.3- = 20*Saboue average in distance from nasionto pogonion, average in distance fromthe nasion-pogonion line to the an-teriormost projection of the chin con-vexity, below average in distance fromthe nasion-pogonion line to the labio-mental groove, and below average inpogonion-nasion-tuberculum angle.Portrayed in part B of Figure 2 arethe facial profiles of two children (F15, F 38) 14 years of age. Those pro-files illustrate the range found for thedistance from the nasion-pogonionline to the most forward extension ofthe integumental chin. The child withthe smaller criterion measure (F 38) is* As used throughout this section, "aboveavera.ge" denotes that the child falls morethan one standard deviation above the meanof the sex-specific distribution for the vari-able specified. "Below average" implies" more than one standard deviation beloivthe mean."below auerage in distances from thenasion-pogonion line to the labiomen-tal groove, the deepest point of theconcavity of the upper lip, and theanteriormost point on the convexityof the integumental chin. In pogo-nion-nasion-tuberculum angle, verti-cal distance from the root to the tip ofthe nose, and the remaining distancesfrom the nasion-pogonion line to thefacial profile this girl closely approxi-mates the ar~erage. These findings andthose in the preceding paragraph wereobtained by referring the measure-ments on individual children to theappropriate group statistics presentedin Tables 11, IV and V.In part C of Figure 2, facial pro-files are displayed for the same child(hl 38) at ages 5 and 14 years. Of thesubjects included in the study, thisboy exhibits the greatest change in Vol. 29, No. 3Facial Profile159Fig. 4 Selected illustrations of individunl differences in integui1ient:il profile of the facc.distance from the nasion-pogonilmline to the tip of thc nose. His incre-ment is almost 60 per cent greatsrthan the.mean increment for boys. Inother measures the age changes of thisboy are below auel-age for vertical dis-tance from the tip of the nose to thedeepest point of the concavity of thcupper lip, auerage for distance fromthe nasion-pogonion line to the root ofthe nose, and aboue average for dis-tance from the nasion-pogonion lineto the labiomental groove, distancefrom the nasion-pogonion line to themost forward point on the chin, andvertical distancc froin the root to thetip of the nose. The group statistics towhich the age changes on M 38 werereferred are assembled in thc right-hand columns of Table VI.ton and the integumental profile. Areference axis is drawn through na-sion and pogonion, and from this axisthe profile is studiecl horizontally,vertically and with respect to a cra-nial-base line.Later sections of thc paper reportfindings obtained on 48 North Ameri-can white children each studied at 5and 14 years of age. Profile variationis investigated for twelve separatemeasures, with analyses being madefor size at age 5 years, change betwcen5 and 14 years, and size at agc 14years. Associations between aspects ofthe integumental profile are studiedand individual differences in facialprofile illustrated.W-510 East HallSUMMARYEarly sections of this paper presentREFERENCES.. .quantiiative procedure for describing 1. Bjork, A. : The Face in Profile. Scenskthe integumcntal profile of the face Tnndlakare-Z'irlskrift, 40: No. 5B, 1947.and discuss the Of data 2. Bnrstone, C. J.: The Integumentalamassed through its use. The proce- Profile. Am. J. Ortho., 44: 1-25. 1958...,dure necessitates norinn lateralis ra- 3. Elsasser, W. A.: Studies of Dentofacial Morphology: 1. A Simple Instrument for Appraising Variations. Anglediographs of the head showing gooddefinition of the anterior facial skele-Ortho., 21: 163-171, 1951. BowkerJuly, 19594.D.6.7.8.Guilford, J. P. : FuntZantental Statisticsin Psyeliology and Education. NcGraw-Hill Book Co., New York, 1950.lirognian, W. BI. and Sassouni, V.: ASyllabus in Roe~ztgcnograp7~'lc Ceplialo-nictry. Center Research Child Growth,Philadelphia, 1957.Lande, 11. J.: Growth Beh;ivior of the~-I~IIII:III Uony Facial Profile :ts Re-vealed by Serial Cephalometric Iioeiit-geiiologj. Angle Ortko., 22 : 78-90,1952.Lindquist, E. F. : Statistical Aiialysisin Etlucathn Iteseaieh. Houghtoii Mif-fliii Co., Boston, 1940.Meredith, H. V., Knott, V. B., ?.ndIiixoii. E. H.: Relation of the Xasal:ind Subnas:il Components of Facial1.1-ight in Childhood. Am. J. O~Ylto., 44:285-294, 1958.9.10.11.12.13.Sewnian, I . J., and Meredith, H. V.:Individual Growth in Skeletal BigoiiialDiameter During the Childhood PeriodFrom 5 to 11 Years of Age. Ani. J.Anat., 99: 157-187, 1936.Pelton, IV. J., aiid Elsasser, W. A.:Studies of Dentofacial Morphology :IV. Profile Changes Among 6,829 WhiteIndividuals According to Sex and Age.Angle Ortho., 25: 199-207, 1955.Sicher, H. : Oral Anatoniy. C. V. MosbyCo., St. Louis, 1952.Silverman, F. S. : Roentgen Stand:irdsfor Size of the Pituitary Fossa fromInfancy through Adolescence. Awt. J.Eoent., Ead. Tlier. and Nuc. Mea., 78:4.51-460, 1957.Thurow, R. C. : Cephaloinetric Methodsin Research ;ind Private Practice.AlLgle Ortho., 21: 104.116, 1951.