Cone-Beam Computed Tomography-Based Anatomic Mapping of Maxillofacial Foramina: Development of a Novel Proportional Guide for Facial Aesthetic Procedures

Abstract

Objective: Anatomic safety and aesthetic harmony are of critical importance in facial aesthetics and surgical procedures. This study aims to evaluate whether the distance ratios among the supraorbital, infraorbital, and mental foramina conform to the golden ratio (φ = 1.618). Methods: In this retrospective study, cone-beam computed tomography (CBCT) scans of 88 patients aged 18 to 33 years (42 males and 46 females) were analyzed. The distances between the supraorbital foramen/notch (SOF), infraorbital foramen (IOF), and mental foramen (MF) (SOF-IOF, IOFMF, and SOF-MF) were measured bilaterally. The conformity of the SOF-MF/SOF-IOF ratio to the golden ratio (1.618) was statistically assessed using (SPSS version 26.0; IBM Corp., Armonk, NY). Results: In our study, the distance between SOF and IOF was 45.40 ± 2.81 mm on the right side and 45.47 ± 3.11 mm on the left side. In addition, the distance between IOF and MF was 66.01 ± 5.01 mm on the right side and 65.21 ± 5.14 mm on the left side. The SOF-MF/SOF-IOF ratio was 1.522 on the right side and 1.418 on the left side in men; in women, it was 1.400 on the right side and 1.402 on the left side. In addition, the overall average was 1.459 on the right side and 1.440 on the left side. All measurements showed a significant difference compared with the golden ratio (1.618) (P < 0.05). Conclusion: This study provides morphometric data on distance ratios between the supraorbital, infraorbital, and mental foramina, which may serve as a reference for anatomic planning and localization of neurovascular structures in aesthetic and surgical procedures. The findings suggest that these proportional relationships could contribute to safer, more predictable facial interventions; however, larger-scale studies are required to validate these ratios across diverse ethnic groups and populations.