Holdway's analysis

1. HOLDAWAY’S ANALYSIS Ajeesha N air

2. INTRODUCTION Reed . A.Holdaway In 1983

3. Variables and Norms FACIAL ANGLE NOSE PROMINENCE SUPERIOR SULCUS DEPTH SOFT TISSUE SUBNASALE TO H LINE SKELETAL PROFILE CONVEXITY BASIC UPPER LIP THICKNES UPPER LIP STRAIN MEASUREMENT H ANGLE LOWER LIP TO H LINE INFERIOR SULCUS TO H LINE SOFT TISSUE CHIN THICKNESS

4. Lines used : H line or harmony line S oft tissue facial line Hard tissue facial plane Sella-nasion line Frankfort horizontal plane Line drawn at right angle to FH plane down tangent to the vermilion border of upper lip

5. LINES USED

6. SOFT TISSUE FACIAL ANGLE Between FH plane and soft tissue facial plane. Normal 91 +/- 7. Prognathic or retrognathic

7. NOSE PROMINENCE Nose tip to the line perpendicular to FH and running tangent to upper lip. 14-24 mm

8. SUPERIOR SULCUS DEPTH Perpendicular to FH and tangent to vermilion border of upper lip. 3mm 1-4mm acceptable

9. soft tissue subnasale to H line Ideal is 5mm 3-7mm is normal Short thin lips-3mm Long thicker lips-7mm

10. Skeletal profile convexity From point A to hard tissue facial plane (Na- Pog ). Varies with H angle

11. Basic upper lip thickness Upper lip thickness is measured horizontally from a point 3 mm below point A to outer border of upper lip. Avg value - 15 mm Amount of lip strain or incompetency

12. Upper lip strain measurement Vermilion border of upper lip to the most anterior portion of central incisor 13-14 mm

13. H angle Between soft tissue facial plane and harmony line. Ideal 10 degree 7-15 degrees. Measures upper lip prominence or retrognathism of the Soft tissue chin

14. H angle and skeletal convexity

15. Lower lip to H line H line to most prominent point on lower lip 0- 0.5 mm ideal -1 to + 2mm acceptable. <-1mm lingually positioned lower anteriors >2mm denture is protrusive

16. Inferior sulcus to H line is measured from the deepest point in the curvature between the Lower lip and the chin and the H-line AVG VALUE- 5 mm

17. Soft tissue chin thickness Soft tissue thickness is measured from hard tissue Pogonion to soft tissue Pogonion . AVG VALUE- 10 TO 12 mm

18. ACCORDING TO HOLDAWAY A PERFECT PROFILE SHOULD HAVE ANB - 2 degrees H-LINE ANGLE - 7 to 8 degrees LOWER LIP should touch the H line H-LINE should bisec t S curve between Pronasale and Subnasale TIP OF THE NOSE - Should be 9mm anterior to H -line T here should be no lip tension on closure

19. Analysis

20. Normal Patient value Inference St facial angle 91+/-7 83 Slightly Retrusive lower jaw Nose prominence 14-24 mm 17 normal Superior sulcus depth 1-4 mm 2 Normal Soft tissue subnasale to h ine 5+-2 mm 7 Normal Skeletal profile convexity 0 mm 3 Convex profile Upperlip thickness 15mm 20mm Increased

21. Normal Patient value Inference Upper lip strain 13-14 mm 14 No lip strain H angle 7-14 22 Protrusive upperlip or retrusive chin Lower lip to H line -1- 2 mm 2.5 slightly protrusive Inferior sulcus to H line 5 mm 5 Normal Soft tissue chin thickness 10-12 mm 13 Slightly increased

22. conclusion A soft tisue chin nicely positioned in the facial profile No serioius skeletal convexity H angle with in the convexity A definite lip curl of 4-6 mm Lower lip n h line or within 1 mm of it Lower lip form and sulcus depth harmonious with upper lip

23. REFERENCES A soft tissue cephalometric analysis and its use in orthodontic treatment planning.Part 1 :Reed A Hold away Orthodontic cephalometry ; Athanasios E Athanasiou

24. THANK YOU