Photogrammetric and Cephalometric Analyses of Ricketts' Esthetic Line in Malaysian Malay Adults: A Cross-sectional Study

The Open Dentistry Journal 10 Nov 2023 RESEARCH ARTICLE DOI: 10.2174/0118742106268751231010073305



To compare and correlate the Ricketts Esthetic Line measurement between photographs and lateral cephalogram. The norm for evaluating Ricketts' E-Line in the Malaysian Malay population is to be established.

Materials and Methods:

This was a cross-sectional study involving 126 pre-existing photographs and lateral cephalometric radiographs of skeletal Class I Malaysian Malay aged 19 to 40 recruited from the Orthodontic Clinic of Universiti Teknologi MARA (UiTM). Photogrammetric and cephalometric analyses of the upper and lower lips to Ricketts' E-line were performed. A paired t-test was performed to determine any statistically significant difference between the photographic and cephalometric variables. In addition, Pearson correlation was conducted to estimate the correlations between the photographic and cephalometric variables.


There was no significant difference between photographs and lateral cephalogram methods in the upper and lower lip to E-line measurement (p>0.05). For the photogrammetric analysis, the distance from the upper lip to the E-line was -0.30mm ±2.46, whereas the cephalometric analysis was -0.43mm ±2.63. The lower lip distance to the E-line for the photogrammetric analysis was 1.44mm ±2.8, whereas the cephalometric analysis was 1.24mm ±3.08. The Pearson correlation coefficient (r) for photographs and lateral cephalometric variables was close to 1 (0.914 and 0.898, respectively), indicating a robust positive correlation between the two variables.


Photographic and cephalometric analysis can be used synonymously in measuring the Ricketts E line. Malaysian Malay has a more protrusive upper and lower lip to the E-line, compared to Caucasians, and the norm for the investigated population was established.

Keywords: Aesthetic dentistry, Ricketts esthetic-line (E-line), Orthodontics, Malaysian malay's norms, Cephalometry, Facial photography.
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