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Zhang Y, Wang X, Xu X, Feng S, Xia L. The Use of Eye-Tracking Technology in Dento-Maxillofacial Esthetics: A Systematic Review. J Craniofac Surg 2024; 35:e329-e333. [PMID: 38376176 DOI: 10.1097/scs.0000000000010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 02/21/2024] Open
Abstract
The use of eye-tracking technology in dental esthetics has gained popularity over the past decade because of its ability to assess observers' visual preferences in an objective manner. The goal of this study was to provide a comprehensive review of eye-tracking studies in dentistry, which could provide a reference for the rational and effective application of eye-tracking technology by dentists in the future. A comprehensive search of articles on eye tracking, published from January 1946 to June 2023, was conducted across several databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The major criterion for inclusion was that the study evaluated the use of eye-tracking technology in the field of dentistry. Two independent reviewers screened the eligible studies. A total of 67 articles were identified, 41 of which met our inclusion criteria. The most common application of eye tracking was the assessment of perceptions of changes in specific dental conditions among different classes of observers. Overall differences between groups (different classes of observers, different types of conditions) among different areas or regions of interest were analyzed. This systematic review demonstrated the utility of eye-tracking technology as a quantifiable objective assessment and emerging research tool for evaluating outcomes in several domains of dentistry.
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Affiliation(s)
- Yimeng Zhang
- Department of Practical Teaching, School of Architecture and Art, North China University of Technology
| | - Xiaobo Wang
- Department of Urban Planning and Landscape, School of Architecture and Art, North China University of Technology
| | - Xi Xu
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College. Beijing, P.R. China
| | - Shi Feng
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College. Beijing, P.R. China
| | - Long Xia
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College. Beijing, P.R. China
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Wang E, Tran JT, Chapa EM, Cody R, Greives MR, Nguyen PD. Correlation of Orthognathic Surgical Movements to Perception of Facial Appearance in Patients With Cleft Lip and Palate. J Craniofac Surg 2024; 35:1205-1208. [PMID: 38738880 DOI: 10.1097/scs.0000000000010251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/16/2024] [Indexed: 05/14/2024] Open
Abstract
STUDY DESIGN Cephalometric scans were compared before and after surgery to assess the degree of correction. Correlations between skeletal movements and survey outcomes were determined using multivariate regression analysis. OBJECTIVE This study aims to identify relationships between subjective observer-reported improvements in esthetics and emotional appearance with specific surgical movements. METHODS Ten patients at a single tertiary institution (average age: 18.1 ± 0.8), 9 males and 1 female, underwent orthognathic repair and had comprehensive cephalometric records. Standardized anterior posterior and lateral pre and postoperative photographs of patients were included in a survey to clinicians to assess noncognitive domains on a Likert Scale (1-10). CLEFT-Q was administered to gauge patient satisfaction in categories of appearance, speech, and quality of life. RESULTS Per clinicians, multiple domains increased including facial attractiveness (4.1 ± 0.7 versus 7.3 ± 0.7, P < 0.001), friendliness (4.5 ± 0.4 versus 7.3 ± 0.5, P < 0.001), confidence (4.1 ± 0.4 versus 7.1 ± 0.4, P < 0.001), and recommendation for surgery decreased (8.9 ± 0.1 versus 3.6 ± 0.5, P < 0.001). Speech distress decreased with increased SNA and convexity, whereas Psychological and Social scores decreased with an increased ANB. Functional eating and drinking scores increased with maxillary depth. CONCLUSIONS Orthognathic surgery improves many noncognitive domains in patients with cleft lip and palate as assessed by both patients and clinicians on all aspects of facial attractiveness and perception. These findings demonstrate objective bases of skeletal adjustments for perceived improvements in facial appearance and emotion.
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Affiliation(s)
- Ellen Wang
- Division of Plastic Surgery, Department of Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School and Children's Memorial Hermann Hospital
| | - Joseph T Tran
- Division of Plastic Surgery, Department of Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School and Children's Memorial Hermann Hospital
| | - Elysa M Chapa
- Division of Plastic Surgery, Department of Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School and Children's Memorial Hermann Hospital
| | - Ryan Cody
- Department of Plastic Surgery and Orthodontics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Matthew R Greives
- Division of Plastic Surgery, Department of Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School and Children's Memorial Hermann Hospital
| | - Phuong D Nguyen
- Department of Pediatric Plastic Surgery, Children's Hospital Colorado
- Department of Surgery, Division of Plastic Surgery, University of Colorado, Aurora, CO
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Atiyeh B, Emsieh S, Hakim C, Chalhoub R, Habal M. A Narrative Review of Eye-Tracking Assessment of Esthetic Endpoints in Plastic, Reconstructive, and Craniofacial Surgery. J Craniofac Surg 2023; 34:2137-2141. [PMID: 37590000 DOI: 10.1097/scs.0000000000009578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/31/2023] [Indexed: 08/18/2023] Open
Abstract
ABSTRACT Reporting of esthetic outcomes in plastic surgery relies classically on ill-defined endpoints and subjective measures very often from the patients' and/or providers' perspectives that are notoriously characterized by subjectivity and questionable solid scientific validation. With the recent trend of increasing demand for all types of esthetic medical and surgical interventions, there is an urgent need for reliable and objective outcome measures to quantitate esthetic outcomes and determine the efficacy of these interventions. The current review is intended to analyze available evidence regarding advantages as well as limitations of eye-tracking (ET) technology in objectively documenting esthetic outcomes of plastic, reconstructive, and craniofacial interventions. Although gaze pattern analysis is gaining more attention, ET data should be interpreted with caution; how a specific visual stimulus directly influences one's sense of esthetics is still not clear. Furthermore, despite its great potentials, it is still too early to confirm or deny ET usefulness. Nevertheless, patient-reported outcomes being most indicative of an esthetic intervention success, measurement of patients' satisfaction by ET technology could offer a major breakthrough in objective assessment of esthetic outcomes that need further in-depth investigation. EVIDENCE LEVEL Level III.
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Affiliation(s)
- Bishara Atiyeh
- American University of Beirut Medical Center, Beirut, Lebanon
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Wang H, Nicklaus K, Jewett E, Rehani E, Chen TA, Engelmann J, Bordes MC, Chopra D, Reece GP, Lee ZH, Markey MK. Assessing saliency models of observers' visual attention on acquired facial differences. J Med Imaging (Bellingham) 2023; 10:S11908. [PMID: 37091297 PMCID: PMC10118307 DOI: 10.1117/1.jmi.10.s1.s11908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/03/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose Saliency models that predict observers' visual attention to facial differences could enable psychosocial interventions to help patients and their families anticipate staring behaviors. The purpose of this study was to assess the ability of existing saliency models to predict observers' visual attention to acquired facial differences arising from head and neck cancer and its treatment. Approach Saliency maps predicted by graph-based visual saliency (GBVS), an artificial neural network (ANN), and a face-specific model were compared to observer fixation maps generated from eye-tracking of lay observers presented with clinical facial photographs of patients with a visible or functional impairment manifesting in the head and neck region. We used a linear mixed-effects model to investigate observer and stimulus factors associated with the saliency models' accuracy. Results The GBVS model predicted many irrelevant regions (e.g., shirt collars) as being salient. The ANN model underestimated observers' attention to facial differences relative to the central region of the face. Compared with GBVS and ANN, the face-specific saliency model was more accurate on this task; however, the face-specific model underestimated the saliency of deviations from the typical structure of human faces. The linear mixed-effects model revealed that the location of the facial difference (midface versus periphery) was significantly associated with saliency model performance. Model performance was also significantly impacted by interobserver variability. Conclusions Existing saliency models are not adequate for predicting observers' visual attention to facial differences. Extensions of face-specific saliency models are needed to accurately predict the saliency of acquired facial differences arising from head and neck cancer and its treatment.
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Affiliation(s)
- Haoqi Wang
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Krista Nicklaus
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Eloise Jewett
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Eeshaan Rehani
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Tzuan A. Chen
- University of Houston, HEALTH Research Institute, Houston, Texas, United States
- University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, Texas, United States
| | - Jeff Engelmann
- Rogers Behavioral Health, Oconomowoc, Wisconsin, United States
| | - Mary Catherine Bordes
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Deepti Chopra
- The University of Texas MD Anderson Cancer Center, Department of Psychiatry, Houston, Texas, United States
| | - Gregory P. Reece
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Z-Hye Lee
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Mia K. Markey
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
- The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Houston, Texas, United States
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Roy T, Steinbacher DM. Perception of the Nose and Lower Face Before and After Orthognathic Surgery in Subjects with Dentomaxillofacial Deformities: An Eye-Tracking Study. Aesthetic Plast Surg 2022; 46:1738-1740. [PMID: 35831753 DOI: 10.1007/s00266-022-02982-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Tulsi Roy
- Plastic and Reconstructive Surgery, Oral and Maxillofacial Surgery, Yale University New Haven Health, 330 Cedar St, New Haven, CT, 06519, USA
| | - Derek M Steinbacher
- Plastic and Reconstructive Surgery, Oral and Maxillofacial Surgery, Yale University New Haven Health, 330 Cedar St, New Haven, CT, 06519, USA.
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