Assessing the influence of lower facial profile convexity on perceived attractiveness in the orthognathic patient, clinician, and layperson
Consultant Orthodontist/Honorary Senior Lecturer, Kingston and St. George's Hospitals and St. George's Medical School, London, United Kingdom.
Oral surgery, oral medicine, oral pathology and oral radiology
09/2012; 114(3):303-11. DOI: 10.1016/j.tripleo.2011.07.031
The aim was a quantitative evaluation of how the severity of lower facial profile convexity influences perceived attractiveness.
The lower facial profile of an idealized image was altered incrementally between 14° to -16°. Images were rated on a Likert scale by orthognathic patients, laypeople, and clinicians.
Attractiveness ratings were greater for straight profiles in relation to convex/concave, with no significant difference between convex and concave profiles. Ratings decreased by 0.23 of a level for every degree increase in the convexity angle. Class II/III patients gave significantly reduced ratings of attractiveness and had greater desire for surgery than class I.
A straight profile is perceived as most attractive and greater degrees of convexity or concavity deemed progressively less attractive, but a range of 10° to -12° may be deemed acceptable; beyond these values surgical correction is desired. Patients are most critical, and clinicians are more critical than laypeople.
Available from: Eduardo Espinar-Escalona
- "- Statistical analysis: Calculation of the sample size has been made using two previous articles (20,21), where the observations analyzed were 2960 and 2100 respectively. In our study, the total amount of observations reached 3744. "
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ABSTRACT: To validate the effectiveness of the original standards of True Vertical (TV) Subnasal Line in orthognatic surgery planning. The present study evaluates the changes occurring in patients with skeletal Class II alterations programmed for orthognathic surgery with a view to improving their facial profile.
We showed a series of black profiles (composed by a first control group of subjects with normal occlusion, and another two additional groups comprised patients before -Group 2- and after orthognatic surgical correction of Class II malocclusion -Group 3-) for three groups of observers (orthodontists, surgeons and laypeople). The facial images became black silhouettes in order to determine a series of parameters (including aesthetic assessment) by means of the observers. Their observation were assessed using a 5-point Likert scale.
The sample was composed of 52 profile's subjects who were tested for a total of 72 observers. Aesthetic assessment yielded mean scores of 2.57, 1.67 and 2.46 for groups 1, 2 and 3, respectively. There was a statistically significant difference (p<0.001) between group 1 versus group 2. There were no significant differences in terms of observer assessment of aesthetics, with the exception of a wider perception range among the orthodontists. Regarding the studied profile measures, significant differences were recorded for point B' and Pg' (p<0.02) between groups 2 and 3 (i.e., pre- versus post-surgery).
The results of our study suggest the subnasale vertical and sagittal measures of the lower third of the face are decisive in facial aesthetics, and therefore also for the planning of orthognathic surgery. Consequently, these aesthetic parameters can be used as an objective tool for the planning of orthodontic treatment. Key words:Facial profile, Class II, orthognathic surgery, cephalometric analysis, facial soft tissue, subnasale vertical.
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The objective of this study was to evaluate changes in soft tissue in full-face view because of surgical correction of skeletal Class III malocclusion, using 3-dimensional (3D) laser scanning.
Twenty-seven subjects with skeletal Class III malocclusion [11 males; mean age (SD), 24.0 (5.7) years] underwent bilateral sagittal split ramus osteotomy for mandibular setback combined with Lefort I osteotomy with/without maxillary advancement. Twelve patients (group 1) had mandibular setback surgery, and the other 15 (group 2) had combination surgery. Lateral cephalograms and 3D facial scan images were assessed preoperatively and postoperatively. The facial widths upon superimposition of 3D facial images were measured in the same coordinates using a Rapidform 2006 system. Paired and independent t tests were done for statistical analysis.
The midface soft tissue broadened significantly above the cheilion plane postoperatively (P < 0.05). A larger change was observed nearer to subnasale plane, and a similar trend was seen among the horizontal planes in 1- or 2-jaw surgery groups. The widths from the exocanthion plane to the subnasale plane increased more in group 2 [mean (SD), 4.45 (2.45) mm, 8.71 (2.92) mm, and 7.62 (3.13) mm] than those in group 1 [mean (SD), 1.26 (0.97) mm, 1.84 (1.06) mm, and 1.35 (0.65) mm], and this difference was significant (P < 0.05). There was a decrease below the cheilion plane with mandibular setback between groups, but this difference was not significant.
The measurement method used here for the shape outline of the lateral parts of the face could provide quantitative data for the clinical evaluation and objective analysis of the human face in full-face view. The midface soft tissue in subjects with skeletal Class III malocclusion exhibited a greater increase in width after bimaxillary surgery procedures than mandibular setback-only surgery.
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ABSTRACT: To determine whether malocclusion influences adolescents' perception when judging their colleagues from the aspects of athletics, social and health status, leadership and academic skills.
Front view photographs of the smile of eight adolescent volunteers (non-ideal smile) were altered to create an image with aligned teeth (ideal smile). Two parallel groups were programmed with the subjects' photographs. When the image of an ideal smile of one of the subjects appeared in one of the groups, the image of the non-ideal appeared in the other. Two hundred adolescents were evaluators, half of the students being from private and half from public schools. They classified the group images indicating their social perception with respect to skills in sports, leadership, academic activities, popularity and the health conditions of each subject.
The majority of photographs of subjects with an ideal smile were evaluated as being better when compared with photographs of the non-ideal smile. The differences in the evaluations between the ideal and non-ideal smiles were significant for the perception of popularity, intelligence, leadership capability and health, differently from the performance in sports, as this aspect did not attain statistical relevance.
Malocclusion has influence on the perception of adolescents of different social levels when judging youngsters with or without malocclusion from the aspects of athletics, social and health status, leadership and academic skills.
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