Evaluation of facial esthetics in long-faced white Brazilian middle school students

Vertical Dentofacial Skeletal Divergency Is Not Linked with Oral Health-Related Quality of Life

The aim of this study is to assess how vertical skeletal malocclusion affects oral health-related quality of life (OHRQoL) among a sample of individuals comprising adolescents, young adults, and adults seeking orthodontic treatment. From January 2019 to March 2020, participants were consecutively enrolled. The assessment of OHRQoL involved measurement using the oral health impact profile (OHIP-14). Lateral cephalograms were performed to measure the vertical skeletal divergency with four cephalometric measurements. Descriptive and inferential statistical analyses were performed. The Mann-Whitney test was applied to compare OHRQoL scores according to the vertical dimension category. The mean age of the participants ranged between 30.3 ± 14.9 and 29.9 ± 14.4 and there was a majority of female participants, between 64.1% and 65.9%. There were no statistically significant differences observed between hyperdivergent and normodivergent groups in either the total score or any domain of the OHIP-14 questionnaire. Individuals with hyperdivergent facial morphology did not show a reduced OHRQoL compared with a normodivergent facial type.

Cephalometric determinants of facial attractiveness: A quadratic correlation study

INTRODUCTION

This research aimed to determine the nonlinear correlation between lateral cephalometric measurements and facial attractiveness, evaluated in the frontal and profile views. A quadratic correlation was studied, in which the vertex of the function indicates the cephalometric value corresponding to the maximum attractiveness.

METHODS

Frontal and profile facial attractiveness of 60 patients with Class I (n = 20), Class II (n = 20), or Class III malocclusion (n = 20) aged 18-35 years without previous orthodontic treatment was evaluated by 14 laypersons (7 men and 7 women) with a visual analog scale. Soft- and hard-tissue measurements were collected on lateral cephalometric radiographs. Pearson and nonlinear quadratic correlations between the attractiveness of the face and cephalometric measurements were calculated. Maximum attractiveness values (MxAt) were determined for the significant cephalometric variables.

RESULTS

Significant quadratic correlations were found between frontal facial attractiveness and the following variables: Ls-SnPog' (r = 0.45; MxAt = 3.1 mm), Li-SnPog' (r = 0.41; MxAt = 3.8 mm), the ANB angle (r = 0.42; MxAt = 0.2°) and MPA (r = 0.51; MxAt = 31.9°). Profile attractiveness correlated nonlinearly with Ls-SnPog' (r = 0.42; MxAt = 3.2 mm), Li-SnPog' (r = 0.41; MxAt = 3.9 mm) and MPA (r = 0.46; MxAt = 32.4°).

CONCLUSIONS

Significant quadratic correlations were found between facial attractiveness and cephalometric measurements, which were stronger than linear correlations. The maximum attractiveness points indicated a tendency for laypeople to consider a more protrusive lower lip and an ANB angle lower than the norm as the most attractive.

Can smile influence the lower anterior vertical facial height on frontal view in an adult Asian female subject? A cross-sectional study

Objectives:

Smile is a universal phenomenon, the effect of which is not discovered on the lower anterior facial height (LAFH). The objective of this study was to determine the influence of smile on different LAFH in frontal view as assessed by different panels of raters using visual analog scale (VAS) in a female subject.

Material and Methods:

The frontal photographs (at rest and on smile) were taken at natural head position of a female subject aged 28 years old after taking informed consent. LAFH of the photographs was modified using a Photoshop software (Adobe Systems, San Jose, Calif.). Sixty raters equally divided into orthodontic residents, general dentists, and laypersons were given a VAS to make subjective assessments of facial attractiveness of the modified photographs. Comparison of raters’ scores was done using Kruskal–Wallis and Mann–Whitney U-tests. Wilcoxon Signed-Rank test was used to compare the esthetic scores of the subject at rest and with smile.

Results:

The mean age of the all raters was comparable (early adulthood). All raters preferred normal or slightly shorter LAFH in both postures, that is, at smile and rest. Similarly, all raters disliked long face modifications. On comparing smile and rest photographs at various LAFH, we found less VAS scores for smile. Gender of raters played no role in difference of VAS scores.

Conclusion:

All the panels of rater found normal LAFH to be the most attractive; however, the panels disliked long face modifications on both smile and at rest. Smile had no positive influence on the VAS scores as assumed so the effect of “Smiloflage” must be investigated further to understand it properly.

Effect of orthodontic maxillary posterior en masse intrusion anchored with miniplates on maxillary sinuses volume. Retrospective CBCT study

OBJECTIVE

To evaluate, by means of cone beam computed tomography (CBCT), the volume change of maxillary sinuses in patients that underwent orthodontic maxillary posterior en masse intrusion anchored with miniplates.

MATERIALS AND METHODS

The sample consisted of pretreatment (T1) and posttreatment (T2) CBCT scans obtained from 14 patients (4 male and 10 female), with a mean age of 32.4 years, that underwent orthodontic maxillary posterior en masse intrusion anchored with miniplates in the zygomatic crest. The mean treatment duration was 20 months and the mean intrusion movement was 2.4 mm. Maxillary sinus volume was measured by means of the software ITK SNAP (version 3.8.0) in T1 and T2 CBCT scans. The changes in sinuses volume were calculated by T1-T2 values. Data were analyzed statistically with Wilcoxon test at 5% of level of significance and the method error was analyzed with Wilcoxon test, intraclass correlation and Dahlberg's formula.

RESULTS

The mean difference (T1-T2) was -242.85 mm³ (p = 0.396) for the right sinus and -32.5 mm³ (p = 0.875) for the left sinus. A slight increase in the volume of the sinuses was shown although these results were not statistically significant.

CONCLUSION

The orthodontic maxillary posterior en masse intrusion anchored with miniplates did not influence significantly the maxillary sinus volume.

Influence of incisor inclination and anterior vertical facial height on facial attractiveness in an adult Asian male

INTRODUCTION

Balanced facial proportions and hard tissue relationships are important factors in facial attractiveness. The objective of this study was to determine the most pleasing maxillary incisal inclination (MII) on the lateral profile and the impact of various lower anterior facial height (LAFH) ratios (at rest and with a smile) on facial attractiveness.

METHODS

This cross-sectional study was performed with 66 raters equally divided into 3 panels: general dentists (GD), orthodontic residents (OR), and laypersons (LP). Lateral profile view photographs of an Asian man were modified using Photoshop software (Adobe Systems, San Jose, Calif) to show altered MII and LAFH ratios at rest and when smiling. Subjective evaluations of facial attractiveness were performed by raters using a visual analog scale. Kruskal-Wallis test was used to compare esthetic scores among raters, and the Mann-Whitney U test was applied to compare ES between groups.

RESULTS

Kruskal-Wallis test showed significant differences in esthetic scores among raters for -10° (P = 0.028) and -15° MII (P = 0.030). Similarly, significant differences were found in ES for 8% LAFH ratio (P = 0.022), and 4% LAFH ratio (P = 0.035) at rest. Mann-Whitney U test showed significant differences between raters for -10° and -15° MII and between 8% and 4% LAFH ratio at rest.

CONCLUSIONS

All groups rated -5° inclinations to be most attractive. General dentists and orthodontic residents found normal LAFH to be the most attractive, whereas long facial height was less attractive with smile. In addition, smile had a camouflaging effect on LAFH.

Perceptions of orthodontists, laypersons, and patients regarding buccal corridors and facial types

INTRODUCTION

The space on each side of the mouth, between the commissure of the mouth and the buccal surface of the last visible tooth, is called the buccal corridor. The size of the buccal corridor can affect perceptions of facial esthetics. We analyzed the perceptions of orthodontists, laypersons, and orthodontic patients regarding the size of buccal corridors in people with brachyfacial, mesofacial, and dolichofacial types.

METHODS

Photographs of 1 male and 1 female model were modified digitally into brachyfacial, mesofacial, and dolichofacial types. Each facial type was further modified to create 5 sizes of buccal corridors. Orthodontists, adult orthodontic patients, and laypersons were invited to rate the photographs.

RESULTS

Orthodontists rated lower than the other groups of raters when they evaluated the female model with the buccal corridors of 20% (P <0.05). Laypersons could not distinguish the changes of the buccal corridors when evaluating the male model with brachyfacial and mesofacial (P >0.05). Orthodontic patients rated significantly higher than the orthodontists and the laypersons when evaluating the dolichofacial type of both models (P <0.05).

CONCLUSIONS

Orthodontists are more sensitive to the buccal corridors than are orthodontic patients and laypersons. It is only necessary to consider eliminating the patient's buccal corridors when the buccal corridor area ratio is over 15%.

The influence of incisor inclination and anterior vertical facial height on facial attractiveness in an Asian woman

INTRODUCTION

Orthodontic treatment can help improve facial attractiveness through the modification of factors affecting the soft tissue profile. The objectives of this study were to determine the impact of different maxillary incisal inclinations and lower anterior facial heights (at rest and with a smile) on the facial attractiveness of an Asian woman, as perceived by different panels of raters using visual analog scale (VAS) scores.

METHODS

A cross-sectional study was performed with 66 raters equally divided into 3 panels that consisted of general dentists, orthodontic residents, and laypersons. Raters assessed modified photographs of a subject with various incisor inclinations and lower anterior facial height/total anterior facial height (LAFH/TAFH) on lateral profile view. Modifications were made using Photoshop software (Adobe, San Jose, Calif). Subjective evaluations of facial attractiveness were performed by raters using VAS. Kruskal-Wallis test was used to compare VAS scores among raters. Mann-Whitney U test was applied to compare VAS scores between groups.

RESULTS

Significant differences in VAS scores were found among raters for -10° (P = 0.004) and -15° (P = 0.021) incisal inclinations. Significant differences were found in VAS scores for -8% LAFH/TAFH (P = 0.044) and 4% LAFH/TAFH with smile (P = 0.002).

CONCLUSIONS

Professionals preferred normal incisal inclinations to be the most attractive. General dentists found reduced facial height to be unattractive. Orthodontic residents and laypersons considered increased LAFH/TAFH to be most unattractive. Smile had a negative impact on VAS scores at extreme anterior facial height modifications.