Older adults' facial characteristics compared to young adults' in correlation with edentulism: a cross sectional study.

Background: Facial ageing is a result of superficial wrinkling combined with changes to the underlying soft tissues and skeleton. The influence of tooth loss, as a geriatric characteristic, on facial appearance is still poorly explained. The aim was to evaluate the facial characteristics of older adults, correlate these characteristics with the dentition and make comparisons with young adults using a non-invasive 3D methodology.

Methods: 90 participants older than 65 years, classified into 3 subgroups (edentulous, partially edentulous, toothed) and 30 young adults were evaluated. Their faces were scanned with an optical Artec 3D-scanner. Cephalometric analyses were made using the RapidForm computer program. An independent t-test and ANOVA were used for the comparisons. Pairwise, post-hoc tests were applied with respect to the significant differences (P < 0.05).

Results: The faces of older adults are wider and longer because of the longer middle facial height. Older adults also have a longer upper lip, a larger nose, a smaller nasolabial angle (due to the nasal ptosis), narrower upper- and lower-lip vermilions and larger facial and lower-facial-height angles, resulting in a flat facial profile. The facial changes due to ageing are the most pronounced in the edentulous. In comparison with the toothed, they have a smaller facial height due to the smaller lower facial height, larger nasolabial angle, smaller mouth width, shorter upper lip and narrower lip vermilions. Their profile is flatter and their lips are more retruded.

Conclusions: The proportions of the whole face are changed in older adults and they are the most expressed when this is combined with tooth loss.