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UPPER DENTAL AND MAXILLARY PROTRUSIONS. 811

the other features of the changeable area, instead of comparing it,
as we should do, to the more stable or unchangeable features of the
physiognomy.
In examining the physiognomy of a patient, the head should be in
an upright position, on a line with that of the observer, and the face
studied from dilferent angles while in repose and in action.
While looking at the profile in repose the most important thing to
determine is the relative position of the chin with the forehead, malar
prominences, and bridge of the nose. If its position is harmonious
with the unchangeable area and the lower lip is well posed, it indicates
that the operation of facial contouring should be performed—if any-
where—upon the upper jaw and teeth. For if the first and second seg-
ments are abnormally protruded it will cause a chin to appear retruded
that is perfectly harmonious in its relations to the principal features of the
face. (See Fig. 847.) Again, a retruded or contruded upper arch with
a depression of those features wliich are supported by the upper maxillae
will cause a perfectly posed lower jaw and chin to appear protruded or
prognathous ; as instanced by the cases illustrated in sections I. and IV.
in which the facial effect, before treatment, was that of protruded lower
jaw, but which were perfectly corrected by an anterior movement of
the upper incisors and intermaxillary processes.

ni. Upper Dental and Maxillary Protrusions.
Figs. 847 and 848 w411 serve to illustrate the class of facial de-
formities known as abnormal upper protrusions, and the advantage of
retruding the upper anterior teeth and surrounding process.

Fk;. S47.

In Fig. 847 M'ide interdental spaces between the upper teeth per-
mitted the reduction without extracting. In Fig. 848 the upper first
bicuspids were extracted.