Clinical and Psychosocial Aspects of The Long Face Morphology

Abstract

Introduction: The long face morphology is a relatively common presentation in orthodontic patient populations, although the clinical and psychosocial features of this condition are still unclear.

Objectives: To investigate and compare the: (1) cephalometric features; (2) oral behaviour patterns; (3) and, oral health-related quality of life and functional limitations between long (case) and normal (control) face individuals. A longer-term objective was to establish a craniofacial database that could be used to investigate the association between vertical facial patterns and selected candidate genes. Materials and Methods: Eighty cases with a distinctively long face (mandibular plane angle greater than 2 standard deviations, or 42 degrees) and eighty controls were individually matched on age, gender, ethnicity, and treatment stage. Self-report and clinical data were collected using an online database (www.longface.ac.nz). The self-report measures included the oral behaviour checklist (OBC), the Oral Health Impact Profile (OHIP-14), and the Jaw Functional Limitation Scale (JFLS-8). Moreover, a comprehensive cephalometric analysis was carried out for each study participant. Results: The sample had a mean chronological age of 17.2 years (SD = 4.6), with the majority of the participants being female (65.0%), and of New Zealand European origin (91.3%). In comparison with controls, long face individuals were characterised by a significantly reduced posterior facial height and increased anterior facial height (P < 0.001). Nearly one-fifth of the long face sample had an anterior open-bite. In general, the long face morphology was found to consist of at least 3-4 clusters (i.e. sub-phenotypes). There were no significant differences in either the prevalence or mean number of reported oral behaviours between long and normal face individuals. Long face individuals had small but significantly higher overall and social domains scores of the OHIP-14. On the other hand, there were little differences in functional limitations scores between cases and controls (P > 0.05). Conclusions: The long face morphology is not a single clinical entity but consists of several distinct clusters that can be characterised using cephalometrics. Facial morphology is not necessarily associated with jaw function or oral behaviour patterns. Long face individuals, however, are more likely to self-report poorer oral health-related quality of life, especially with respect to social interactions.