Assessment of facial soft-tissue profiles based on lateral photographs versus three-dimensional face scans

Bewertung des Gesichtsweichteilprofils anhand seitlicher Fotografien vs. 3-D-Scans

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The purpose of this study was to compare two-dimensional (2D) lateral photographs versus three-dimensional (3D) face scans in analyzing facial profiles using Schwarz’s concept of the jaw profile field (JPF) in its original 2D and in a modified 3D version. In addition, the distribution of the facial profile types described by Schwarz were examined.

Materials and methods

Of 75 adult volunteers recruited specifically for this study, we obtained both photographs (Nikon D 300S; Nikon, Düsseldorf, Germany) and scans (FaceSCAN3D Scientific Photolab 60 Hz; 3D-Shape, Erlangen, Germany) in a standardized setting. Four raters analyzed the pertinent measurements using image analysis software (Onyx Ceph 3; Image Instruments, Chemnitz, Germany). Statistical analysis was conducted using the R suite environment (v. 3.2.1; R Foundation for Statistical Computing, Vienna, Austria).


Intraobserver reliability was substantial for two raters (κ = 0.61–0.8), moderate for one (κ = 0.41–0.60), and almost perfect for one (κ = 0.81–1.00). As for interobserver reliability, we observed moderate agreement between the two basic technologies tested, but internal agreement was only moderate even within the 2D view modes (average κ = 0.51) versus almost perfect within the 3D view modes (κ = 0.84–0.94). Forward-slanting anteface was clearly the most common (43.27%) and straight retroface the least common (0.3%) diagnosis. Only a minority of patients (18.38% of women and 16.15% of men) had straight as opposed to slanting profiles.


Given our findings of acceptable agreement between 3D scanning and 2D lateral photography, in combination with almost perfect internal agreement between different 3D view modes, it appears useful to adapt Schwarz’s method of facial profile assessment for clinical use in 3D virtual environments.



Zweck dieser Studie war der Vergleich zweidimensionaler lateraler Fotografien mit dreidimensionalen Aufnahmen anhand der Profilanalyse nach Schwarz und einer modifizierten 3-D-Version. Zusätzlich sollte die Häufigkeitsverteilung der von Schwarz beschriebenen Diagnosen untersucht werden.

Material und Methodik

Von 75 erwachsenen Probanden wurden dreidimensionale (FaceSCAN3D Scientific Photolab 60 Hz; 3D-Shape, Erlangen, Deutschland) und zweidimensionale laterale faziale Fotos (Nikon D 300S; Nikon, Düsseldorf, Deutschland) unter standardisierten Bedingungen angefertigt. Die Auswertung erfolgte durch 4 Untersucher in Doppelmessung mit der Software Onyx Ceph 3 (Image Instruments, Chemnitz, Deutschland). Die statistische Auswertung wurde mithilfe des Programmpakets R, Version 3.2.1 (R Foundation for Statistical Computing, Wien, Österreich) durchgeführt.


Die Intraobserver-Reliabilität stellte sich bei 2 der 4 Untersucher als substanziell (κ = 0,61–0,8) und bei jeweils einem als moderat (κ = 0,41–0,60) bzw. als fast perfekt (κ = 0,81–1,00) dar. Hinsichtlich der Interobserver-Reliabilität ergab sich zwischen den untersuchten Verfahren eine moderate Übereinstimmung. Allerdings war auch die Übereinstimmung innerhalb des 2-D-Verfahrens nur moderat (durchschnittliches κ = 0,51), während sie sich innerhalb des 3-D-Verfahrens als fast perfekt darstellte (κ = 0,84–0,94). Die mit Abstand häufigste Diagnose war das nach vorne schiefe Vorgesicht (43,27%), das gerade Rückgesicht dagegen die seltenste Diagnose (0,3%). Gerade Profile fanden sich gegenüber schiefen Profilen in der Minderzahl (♀ 18,38%, ♂ 16,15%).


Der Grad der Übereinstimmung zwischen der lateralen Fotografie und dem dreidimensionalen Verfahren sowie die annähernd perfekte Übereinstimmung innerhalb des 3-D-Verfahrens sprechen für einen klinischen Einsatz dieser Analyse am dreidimensionalen Modell.

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The authors would like to thank all those directly involved in this study as well as 3D-Shape GmbH (Erlangen, Germany) and Image Instruments GmbH (Chemnitz, Germany) for technical advice.

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Correspondence to Martin Fink.

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M. Fink, U. Hirschfelder, V. Hirschinger, M. Schmid, C. Spitzl, A. Detterbeck and E. Hofmann state that there are no conflicts of interest. All procedures on human subjects were performed in accordance with national law and with the 1975 Declaration of Helsinki (as revised) after obtaining approval by the institutional review board (ethics commission). All participants gave their written informed consent. Any of them whose identity may be disclosed by pictures or other details mentioned in the text have consented to such disclosure in writing.

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Dr. med. dent. Martin Fink.

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Fink, M., Hirschfelder, U., Hirschinger, V. et al. Assessment of facial soft-tissue profiles based on lateral photographs versus three-dimensional face scans. J Orofac Orthop 78, 70–76 (2017) doi:10.1007/s00056-016-0055-z

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  • Jaw profile field
  • Orthodontic diagnostics
  • Soft-tissue analysis
  • 3D diagnostics
  • Photographic analysis


  • Kieferprofilfeld
  • Kieferorthopädische Diagnostik
  • Weichteilanalyse
  • 3-D-Diagnostik
  • Fotoanalyse