Original Article

A coupled-lines system to determine the anteroposterior position of

maxillary central incisors for smiling profile esthetics
Bin Lia; Xiang Xiangb; Gao Huangc; Peiqi Wangd; Chaoran Xuee; Xianglong Hanf; Ding Baif; Hui Xug

ABSTRACT

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Objectives: To develop a coupled-lines system to determine the anteroposterior position of
maxillary central incisors (U1) for smiling profile esthetics.
Materials and Methods: Thirty Asian females with ordinary and good facial harmony were selected
as the study sample and the control sample, respectively. Three-dimensional facial images and
458- and 908-angled profiles were collected. The anteroposterior relationships between U1 and
upper- and mid-facial soft tissue landmarks were measured. By morphing photos of the study
sample, two artificial images were created to represent the well-balanced 458- and 908-angled
profiles and were further processed with combined variations of soft tissue subnasale (SSn)–
Glabella and the mid-point of facial axial points of the bilateral central incisor (mFA)–SSn distances.
Esthetic assessments were performed on these images by layperson (n ¼ 94) and orthodontist (n ¼
94) raters.
Results: Both upper- and mid-facial soft tissue landmarks were indispensable in assessing
anteroposterior positions of U1 for well-balanced smiling profiles. As assessed in 458- and 908-
angled profiles, the most esthetically sensitive parameters were mFA-Glabella and mFA-SSn
distances. A coupled-lines system was constructed, comprising the Glabella and SSn vertical lines.
In smiling profiles with optimal esthetics, the mFA point was at 2 to 5 mm posterior to the Glabella
vertical and concomitantly 4 to 7 mm posterior to the SSn vertical, as perceived by orthodontists.
Laypersons gave a wider range for mFA-Glabella distances, at 2 to 6 mm.
Conclusions: The coupled-lines system could serve as a reliable reference for determining
esthetically optimal anteroposterior positions of U1 for female facial profiles. (Angle Orthod.
2023;93:447–457.)
KEY WORDS: Smile esthetics; Facial profile; Maxillary central incisor; Soft tissue

a
MDS Candidate, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases; and Department of
Orthodontics, West China Hospital of Stomatology; Sichuan University, Chengdu, China.
b
Associate Professor, School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan,
China.
c
Associate Professor, Department of Automation, Tsinghua University, Beijing, China.
d
PhD Candidate, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases; and Department of
Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
e
Research Assistant, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases; and Department
of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
f
Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases; and Department of
Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
g
Associate Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases; and Department
of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Corresponding author: Dr Hui Xu, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases;
Department of Orthodontics, West China Hospital of Stomatology, Sichuan University; 14#, 3rd, Section of Renmin South Road,
Chengdu 610041, China (e-mail: [email protected])
Accepted: December 2022. Submitted: July 2022.
Published Online: February 21, 2023
Ó 2023 by The EH Angle Education and Research Foundation, Inc.

DOI: 10.2319/073022-529.1 447 Angle Orthodontist, Vol 93, No 4, 2023

448 LI, XIANG, HUANG, WANG, XUE, HAN, BAI, XU

INTRODUCTION Sample Selection

Positioning of the maxillary central incisors (U1) in The study sample consisted of 30 Asian females
the anteroposterior dimension is crucial to achieving (age ¼ 23.4 6 2.6 years) selected from university
optimal dentofacial esthetics.1–6 Numerous studies4–9 students in the School of Arts. The inclusion criteria
have been dedicated to determining the ideal or were attractive appearance in smiling profile, with well-
norms for assessing the positions and labiolingual aligned and no missing teeth in the upper canine-to-
inclinations of U1. The U1 position was assessed canine segment. The control sample comprised 30
relative to the forehead for full-facial harmony.7–9 Asian females (age ¼ 24.1 6 2.2 years, pretreatment)
However, problems were encountered when clinicians randomly selected from university students with pleas-
universally used these norms as treatment goals for ing smiling profiles as neither inclusion nor exclusion

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different faces. The esthetically optimal anteroposte- criteria. With the forehead and U1 fully visible, each
rior relationship between U1 and the forehead subject was instructed to display a posed smile in
remains controversial. natural head position for 3D facial image (3dMDFlex;
An important implication was that it might be 3dMD, Atlanta, Ga) and 908- and 458-angled two-
interethnically inapplicable or even intraethnically dimensional (2D) photo acquisition. The attractiveness
unreliable to use the forehead as the sole reference of the photos in the study sample and the control
with which to assess U1 positions for faces with sample were rated in a survey by 100 laypersons (50
morphologic diversity. Facial structures other than the females and 50 males, age ¼ 26.1 6 2.4 years) using a
forehead might still impact dentofacial harmony in 0–10-point visual analog scale (VAS, 0 representing
profile views. Second, it might be unreliable to evaluate ‘‘least attractive’’ and 10 representing ‘‘most attrac-
anteroposterior U1 positions based merely on 908- tive’’).
angled profile views; 458-angled views should be
considered with the same attention as 908-angled Measurements
profile views in smile analysis.7,8 However, evidence is In the 3D facial images, measurements were made
currently lacking on assessments of anteroposterior U1 (Table 1; Figures 2 and 3) by one investigator with
positions on 458-angled facial views. Geomagic wrap software (2017 version, 3D System,
Soft tissue subnasale (SSn) was proposed as a Morrisville, NC, USA).
reliable midfacial landmark for assessing lip and chin
position.9 Remarkable interethnic and interindividual Digital Image Processing
variation was found in midfacial prominence in
esthetically pleasing profiles.10–12 Thus, the ideal The 908- and 458-angled 2D photos in the study
position for lower-facial soft tissue should be shifted sample were merged into one artificial image for
anteroposteriorly in pace with SSn variation rather each perspective (framed in green in Figure 4,
than staying at a constant relationship with the presented in Figure 5) by averaging and morphing
forehead. It remains unknown whether and how the using FantaMorph software (5.6.2 Deluxe, Abrosoft
U1 relates to midfacial landmarks for smile esthetics. Co, Beijing, China). In the 908-angled profile image,
Incorporating the forehead and midfacial soft tissue the U1 crown labial surface tangent was parallel to
landmarks into the reference system by which the U1 the true vertical at an ideal inclination, as previously
positions are assessed might help develop more suggested.13 These two images were used as the
reliable and applicable guidelines for treating faces original images for photographic modification using
Adobe Photoshop (CC2018; Adobe Systems Inc,
with diverse morphology. Therefore, this study was
San Jose, Calif).
conducted to assess the anteroposterior position of
For the 908-angled profile views, image modification
U1 based on 908- and 458-angled facial profiles using
was designed based on the combination of two
a three-dimensional (3D) facial analysis. The hypoth-
independent variables, ubnasale (SSn)–Glabella
esis was that U1 position should harmonize with both
(SSn-Glabella) and mid-point of facial axial points of
upper- and midfacial soft tissue for smiling profile
the bilateral central incisor (mFA)–SSn distances, each
esthetics.
varying in 1.0-mm increments (Figure 4).
A total of 30 artificial images were created (series 1,
MATERIALS AND METHODS
Figure 4A). For each profile image in series 1, a
This study was approved by the Ethics Committee of corresponding 458-angled view was created (series 2,
West China Hospital of Stomatology, Sichuan Univer- Figure 4B) based on the mathematical correlation of
sity Hospital. The workflow of this study is shown in the measurements in the right-angled and 458-angled
Figure 1. views (Figure 2B). For the 458-angled views, SSn-

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Figure 1. Workflow of the study.

Glabella and mFA-SSn distances varied in 0.7-mm randomized order, a third evaluation was performed by
increments. Within each series, the images were 30 of the raters 2 weeks after the second assessment
arranged in a randomized order for esthetic assess- to determine intraobserver reliability.
ment.
Statistics
Esthetic Assessment
Data analysis was conducted using GraphPad
Based on a standard deviation of a 14% VAS Prism and SPSS. Differences in measurements
difference, as determined in a pilot study, for a power of between the study and control samples were detected
90% and a significance level of .05, a sample size of 84 by an independent t-test. Correlations between
raters was required. A group of orthodontists (n ¼ 94; forehead inclinations and measurements of distances
47 females, 47 males; age ¼ 28.9 6 2.3 years; were detected by the Pearson correlation coefficient.
professional experience of 3.0 6 1.8 years) and Intraobserver reliability of esthetic evaluations was
laypersons (n ¼ 94; 47 females, 47 males; age ¼ determined by intraclass correlation coefficient (ICC).
25.5 6 2.1 years) were recruited as raters to evaluate The effect of gender or group of the raters on esthetic
the attractiveness of each image using a 0–10-point assessment was evaluated by two-way analysis of
VAS (0 indicating ‘‘least attractive,’’ 10 representing variance. Differences in esthetic assessments be-
‘‘most attractive’’). The two series of images were tween images within series were detected by Sidak’s
evaluated separately, and evaluations were repeated multiple comparisons. The level of significance was
after 1 week. Using images arranged in a newly set at .05.

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450 LI, XIANG, HUANG, WANG, XUE, HAN, BAI, XU

Table 1. Facial and Dental Landmarks, Reference Lines, and Measurements

Landmarks
Tr: soft tissue trichion
Su: superion, the most superior aspect of the forehead with angular or rounded contour
Gl: soft tissue glabella
FFA: the midpoint of the clinical forehead (between superion and glabella for foreheads with angular or rounded contours or between
trichion and glabella for foreheads with flat contour)
SSn: soft tissue subnasal point
mFA: first locate the facial axial (FA) points of the left and right central incisors, then draw a line segment between these two points; the
mFA point is the mid-point of this line segment. In the profile view, the mFA point is frequently located in the same place as the FA point
Reference lines
FFA vertical: the vertical line through the FFA point

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Gl vertical: the vertical line through the GI point
SSn vertical: the vertical line through the SSn point
GALL: the goal anterior limit line (GALL) is the FFA vertical when the forehead inclination is less than or equal to 78. For every degree the
forehead inclination is more than 78, the GALL is modified into a line parallel to and 0.6 mm anterior to the FFA vertical, but never
beyond the glabella
All of the above lines were perpendicular to the true horizontal
Measurements
Distances: the horizontal distances from the mFA point to the FFA vertical (mFA-FFA), to the GALL (mFA-GALL), to the Gl vertical (mFA-
Glabella), and to the SSn vertical (mFA-SSn); the horizontal distances from the SSn point to the Gl vertical (SSn-Glabella)
Forehead inclination: first construct a line connecting the glabella to the uppermost point of the clinical forehead (trichion point for
foreheads with flat contour, superion point for foreheads with rounded or angular contours). Forehead inclination was defined as the
angle between this line and FFA vertical

Figure 2. Landmarks and reference lines. (A) A 3D facial image example of the subjects of the study sample (shown in 458- and 908-angled
views). (B) Mathematical correlations of the measurements of distances in the 458- and 908-angled views. Distance ‘‘a’’: the SSn-Glabella
horizontal distance in the 908-angled profile view. Distance ‘‘b’’: the 908-angled profile rotated 458 to the front with the SSn-Glabella distance
marked. Distance ‘‘c’’: the SSn-Glabella horizontal distance in the 458-angled facial view. The value of distance ‘‘a’’ equals distance ‘‘b,’’ and the
value of distance ‘‘c’’ is approximately 0.7 3 distance ‘‘a.’’

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Figure 3. The anteroposterior relationship of U1 to the upper- and midfacial soft tissue landmarks in profile views. The anteroposterior positions of
the U1 relative to facial landmarks were measured as mFA-FFA, mFA-GALL, mFA-Glabella, and mFA-SSn horizontal distances in 908-angled
smiling profiles of the study (A) and control (B) (B) and in 458-angled views of the study (D) and control (E) samples. The anteroposterior positions
of SSn relative to Glabella were measured as SSn-Glabella distances in the 908-angled (C) or 458-angled (F) views. Data are presented as
individual scatter points. A positive value is assigned when the mFA point of U1 was anterior to the reference line or when the SSn point was
anterior to Glabella.

RESULTS limit line (GALL), mFA–midpoint of the clinical forehead

(FFA), mFA-Glabella, and mFA-SSn distances be-
Interindividual Consistency and Esthetic tween samples (Figure 3; Table 2). For the 908-angled
Sensitivity of mFA-Glabella and mFA-SSn profile views of the study sample, the distributions of
Distances in Determining U1 Positions mFA-Glabella and mFA-SSn distances had narrower
ranges and smaller standard deviations than did those
The esthetic superiority of the study sample com-
of the mFA-GALL and mFA-FFA distances. In the 458-
pared to the control sample was validated by the
angled views, the values of mFA-Glabella and mFA-
survey, in which all photos of the study sample were SSn distances of the study sample were distributed
given significantly higher scores than were photos with smaller standard deviations than were noted with
within the control sample (P , .05, study vs control: the control sample. These results suggested mFA-
average score ¼ 8.46 vs 5.31), with consistency Glabella and mFA-SSn distances to be esthetic-
between genders of the raters (P . .05). Significant essential parameters in determining facial harmony
differences (P , .05) were found in mFA–goal anterior for female profiles.

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Figure 4. Variable assignments and image processing. Image modifications of the 908-angled (A, images of series 1) and 458-angled (B, images
of series 2) smiling profiles were based on the combination of two independent variables: SSn-Glabella (a) and mFA-SSn distance (b). A positive
value is when the SSn point was anterior to the Glabella or mFA point. The original images are framed in green.

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453

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Figure 4. Continued
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Figure 5. Esthetic assessments for the smiling profiles. Images of the 908-angled (A) and 458-angled (B) profiles representing Asian females with
well-balanced facial features. A table was constructed to show the esthetic ratings for each image with specific variable assignments, for the 908-
angled (C, series 1) or 458-angled (D, series 2) facial views rated by each group of raters. With the number of images and the esthetic grade
marked, each dot carries a color that reflected the level of the esthetic score. S-G indicates SSn-Glabella; F-S, mFA-SSn; F-G, and mFA-Glabella
distances measured in 908-angled profiles. S-G (458) indicates SSn-Glabella; F-S(458), mFA-SSn; and F-G(458), mFA-Glabella distances
measured in 458-angled profiles. A positive value occurs when the mFA point of the central incisor is posterior to the Glabella or SSn vertical or
when the Glabella is posterior to the SSn point.

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Table 2. Descriptive Statistics of the Measurements, Shown as SSn, indicating that relying solely on either one of the
Mean 6 Standard Deviation (SD) and Interquartile Range (IQR), for two measurements would not necessarily lead to good
the Study Sample and Control Samplea
facial esthetics (Figure 5). Optimal esthetics in a 908-
Study Sample, mm Control Sample, mm angled profile were achieved when the mFA-Glabella
Mean 6 SD IQR Mean 6 SD IQR was 1 to 7 mm and, concomitantly, when the mFA-SSn
908-angled views was 4 to 7 mm, as perceived by laypersons. The
mFA-GALL 4.48 6 1.87 1.61 0.70 6 2.65 3.62 esthetic range narrowed to 2 to 5 mm for mFA-
mFA-FFA 1.35 6 2.10 2.22 1.74 6 2.89 4.02 Glabella, while staying unchanged for mFA-SSn, as
mFA-Glabella 4.97 6 1.54 1.10 1.25 6 2.64 3.55
mFA-SSn 6.31 6 0.96 1.23 2.96 6 1.94 2.50
perceived by orthodontists. Having an mFA-SSn of
forehead inclination, 8 13.10 6 2.06 2.55 12.79 6 3.01 3.17 more than 8 mm would significantly compromise (P ,

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458-angled views .05) smiling profile esthetics, as rated by both
mFA-Glabella 3.51 6 1.09 0.78 0.88 6 1.85 2.48 orthodontists and laypersons.
mFA-SSn 4.46 6 0.68 0.87 2.07 6 1.35 1.82
a
See Table 1 for view definitions. Smiling Facial Esthetics Perceived Differently in
458-Angled Views than in 908-Angled Profile Views
Perceived smiling facial esthetics in 458-angled
Forehead Inclination Correlated Weakly with views followed a similar trend to that in 908-angled
Anteroposterior Spatial Relations of the mFA Point views, with minor but noteworthy differences (Figure
to Upper- and Midfacial Landmarks 5C compared with 5D). Having an mFA-Glabella of
There was no significant difference in forehead less than 0.7 mm led to significantly compromised
inclination (P . .05) between the control and study smile esthetics (P , .05) at a 458-angled facial view.
samples. The forehead inclination did not significantly In contrast, the negative effect on smile esthetics was
correlate (P . .05; r  0.28) with mFA-GALL, mFA- less sensitively perceived in the 458-angled view than
Glabella, or mFA-SSn distances in the profiles of the in the 908-angled view when the mFA-SSn was 5.6
control and study samples. There were weak correla- mm and, concomitantly, the mFA-Glabella was 2.8 to
tions (P , .05; r ¼ 0.38) between forehead inclination 4.2 mm. Having an mFA-Glabella of more than 4.9
and mFA-FFA distance for the study sample and mm at a 458-angled view compromised smile esthet-
moderate (P , .05; r ¼ 0.52) correlations for the control ics as much as perceived in the 908-angled profile
sample. These results suggested that forehead incli- views.
nation had no significant effect on spatial harmony of
anteroposterior positions of U1 with Glabella and SSn Determining Esthetically Optimal Anteroposterior
point. U1 Position Using a Coupled-Lines System
The two sets of esthetic ranges for parameters in
Smile Esthetics Determined by Coupled 908- and 458-angled profile views could be incorpo-
Parameters of the mFA-Glabella and mFA-SSn rated into one, as assessed in 908-angled profiles,
Distances based on the mathematic correlations (Figure 2B). In
Excellent intraobserver reliability was demonstrated view of that, by combining upper- and midfacial
for orthodontists (ICC, 0.761–0.856) and laypersons reference frames and incorporating the esthetic
(ICC, 0.754–0.849). There was no significant differ- considerations for 458- and 908-angled facial profiles,
ence (P . .05) between esthetic assessments by a coupled-lines system (Figure 6) was developed to
males and females. The orthodontists and laypersons help determine the anteroposterior U1 position for
differed significantly (P , .05). According to the smiling profile esthetics. For clinical use, two refer-
esthetic assessments, the 30 images of each series ence lines were constructed, first on the photo of a
were divided into three grades: ‘‘attractive’’ (grade ‘‘a’’), 908-angled smiling profile, the Glabella vertical and
‘‘neutral’’ (grade ‘‘n’’), and ‘‘unattractive’’ (grade ‘‘u’’), the SSn vertical, with two scales attached posteriorly
according to Sidak’s multiple comparisons (Figure 5). to these two lines. Carried on these scales were two
Each image in grade ‘‘a’’ had a significantly higher (P , bands indicating the esthetic ranges for mFA-Glabella
.05) score than did all of the images in grade ‘‘u’’. (2 to 6 mm for laypersons and 2 to 5 mm for
Images in grade ‘‘n’’ had scores that were neither orthodontists) and mFA-SSn (4 to 7 mm) distances,
significantly lower than the images in grade ‘‘a’’ nor respectively. Second, the overlapping area of the blue
higher than the images in grade ‘‘u.’’ (or green) and the yellow bands (Figure 6) was
There were different grades of esthetics (P , .05) for identified. This area (red) indicated the esthetic goal
images with the same mFA-Glabella but varying mFA- for positioning the FA point of the U1.

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Figure 6. The coupled-lines system for determining the anteroposterior position of the U1 for smile esthetics. The coupled-lines system was
constructed by two coupled scales indicating the horizontal distances posterior to the Glabella vertical (scale G), and to the SSn vertical (scale S),
respectively. The bands marked on the scales indicate the esthetic ranges (blue: laypersons’ judgments; green: orthodontists’ judgments; yellow:
judged consistently by laypersons and orthodontists). The overlapping area (red) is the esthetic goal for U1 positions. Examples are shown in the
cases in which the SSn point was slightly posterior (A), slightly anterior (B), or remarkably anterior (C) to the Glabella vertical.

DISCUSSION esthetic ranges of mFA-Glabella and mFA-SSn (no

overlapping area). Failing to identify an esthetically
In facial profiles of Asian females with pleasing
optimal U1 position in these cases might indicate a
appearances, the anteroposterior positions of U1 were
compromised skeletal relationship. Interestingly, the
not on or around GALL, as proposed by Andrews.14
acceptable range of 2 to 5 mm for the SSn-Glabella
They were as far as 5 mm posterior to this line, with a
variation range as wide as 8 mm. The definition of distances, indicated by the coupled scales based on
GALL was developed based on a strong correlation the laypersons’ judgments, was just where the mid- to
between forehead inclinations and FA-FFA distances upper-facial relationship varied in profiles of the study
observed in attractive Caucasian profiles.14 The weak sample of Asian females. This range narrowed to 1 to
correlation between forehead inclinations and mFA- 5 mm, as perceived by orthodontists. In this sense, the
FFA distances observed in this study sample might coupled-lines system could serve as an indicator of the
indicate that GALL is not applicable for determining the acceptability of the maxilla position.
esthetically pleasing incisor position for an Asian face. In this study, the dental-facial discrepancies were
The findings revealed a wide range of SSn-Glabella perceived differently in 458-angled views than they
distances in the facial profiles of the study sample. were in 908-angled views, especially when the subject
Considering the esthetic sensitivity of the anteroposte- had excessively protrusive or retrusive teeth.7,8 The
rior relations between SSn and lower facial soft difference in perceived esthetics between 458- and 908-
tissue,11 the great individual variability in SSn positions angled views might have resulted from different
emphasized the importance of incorporating midfacial perceivability of anteroposterior disharmony between
landmarks into the reference system when evaluating the incisors and the face. There was also a possibility
U1 positions. By using photos of natural individuals, that the 458-angled views revealed some disharmony
with each possessing unique facial features and in the perioral region (eg, canine-to-lip spatial rela-
digitally modified images with variables controlled, it tions),8 which was imperceivable when viewed from the
was revealed that both mFA-Glabella and mFA-SSn 908-angled profile. These phenomena suggest the
distances were esthetically sensitive in determining U1 necessity of incorporating the 458-angled facial views
positions. in pre- and posttreatment recording, assessment, and
It is noteworthy that having an SSn point more than 2 planning.
mm posterior or more than 5 mm anterior to the Considering sexual dimorphism15 and interethnic
Glabella vertical would lead to total separation of the differences,10–12 the reference ranges suggested by

Angle Orthodontist, Vol 93, No 4, 2023

COUPLED-LINE SYSTEM FOR SMILING PROFILE ESTHETICS 457

this study should not be used as a universal guideline 5. Pasukdee P, Cheng JHC, Chen DS. Smile preferences of
across diverse ethnic populations. Nevertheless, the orthodontists, general dentists, patients, and the general
coupled-lines system brought forward a new perspec- public in three-quarter and lateral views. Am J Orthod
Dentofacial Orthop. 2021;159:311–320.
tive that both upper- and midfacial soft tissue land-
6. Cho SW, Byun SH, Yi S, et al. Sagittal relationship between
marks should be incorporated into the reference the maxillary central incisors and the forehead in digital twins
system for U1 positioning. By using coupled parame- of Korean adult females. J Pers Med. 2021;11:203.
ters, this reference system could be more applicable 7. Yang X, Yi Y, Yang S, et al. Role of sagittal and oblique
and reliable for faces with diverse morphology, even smiling profiles in evaluating facial esthetics. J Craniofac
among patients of the same ethnic background. Surg. 2015;26:532–536.
8. Tian Y, Huang G, Xiang X, et al. The lower bow-shaped
curve as a novel reference frame to determine the lateral

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CONCLUSIONS
limit of the maxillary anterior arch for smile esthetics. Am J
 The esthetically optimal anteroposterior position of Orthod Dentofacial Orthop. 2022;161:544–553.
the U1 was determined by being in harmony with the 9. Spradley FL, Jacobs JD, Crowe DP. Assessment of the
upper- and midfacial soft tissue landmarks, among anteroposterior soft-tissue contour of the lower facial third in
the ideal young adult. Am J Orthod Dentofacial Orthop.
which the most esthetically sensitive were the
1981;79:316–325.
Glabella and SSn point for Asian females. 10. Scavone H, Zahn-Silva W, do Valle-Corotti K, Nahas A. Soft
 The coupled-lines system could help determine the tissue profile in white Brazilian adults with normal occlusions
anteroposterior position of the U1 for an esthetic and well-balanced faces. Angle Orthod. 2008;78:58–63.
smiling profile. 11. Hwang H, Kim W, McNamara J. Ethnic differences in the soft
tissue profile of Korean and European-American adults with
normal occlusions and well-balanced faces. Angle Orthod.
ACKNOWLEDGMENT 2002;72:72–80.
This work was supported by the Research and Develop 12. Bravo-Hammett S, Nucci L, Christou T, Aristizabal JF, Kau
Program of West China Hospital of Stomatology (grants CH. 3D analysis of facial morphology of a Colombian
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Angle Orthodontist, Vol 93, No 4, 2023