Attractiveness assessment by orthodontists and laypeople judging female profile modifications of Class II Division 1 malocclusion

Impact of orthodontic-induced facial morphology changes on aesthetic evaluation: a retrospective study

BACKGROUND

The profound influence of orthodontic treatments on facial aesthetics has been a topic of increasing interest. This study delves into the intricate interplay between orthodontic treatments, facial feature alterations, and aesthetic perceptions.

METHODS

A total of 73 patients who had undergone orthodontic treatment were included in this study. Facial photographs were taken before and after treatment. Ten orthodontists provided facial aesthetic ratings (FAR) for each patient's frontal, profile, and overall views. 48 facial landmarks were manually placed by the orthodontists and normalized using Generalized Procrustes analysis (GPA). Two types of phenotypes were derived from facial landmarks. Global facial phenotypes were then extracted using principal component analysis (PCA). Additionally, 37 clinical features related to aesthetics and orthodontics were extracted. The association between facial features and changes in FAR after orthodontic treatment was determined using these two types of phenotypes.

RESULTS

The FAR exhibited a high correlation among orthodontic experts, particularly in the profile view. The FAR increased after orthodontic treatment, especially in profile views. Extraction of premolars and orthognathic surgery were found to result in higher FAR change. For global facial phenotypes, the most noticeable changes in the frontal and profile views associated with FAR occurred in the lip area, characterized by inward retraction of the lips and slight chin protrusion in the profile view, as well as a decrease in lip height in the frontal view. The changes observed in the profile view were statistically more significant than those in the frontal view. These facial changes were consistent with the changes from orthodontic treatment. For clinical features, two profile features, namely pg.sm.hori and pg.n.ls, were found to be associated with FAR following orthodontic treatment. The highest FAR scores were achieved when pg.sm.hori was at 80° and pg.n.ls was at 8°. On the other hand, frontal clinical features had a subtle effect on FAR during orthodontic treatment.

CONCLUSIONS

This study demonstrated that orthodontic treatment improves facial aesthetics, particularly at lip aera in the profile view. Profile clinical features, such as pg.sm.hori and pg.n.ls, are essential in orthodontic treatment which could increase facial aesthetics.

Perceived Effects of Orthognathic Surgery versus Orthodontic Camouflage Treatment of Convex Facial Profile Patients

Increased facial profile convexity has a common occurrence in the population and is a primary reason for seeking orthodontic treatment. The present study aimed to compare the perceived changes in facial profile appearance between patients treated with combined orthognathic/orthodontic treatment versus only orthodontic camouflage treatment. For this reason, 18 pairs of before- and after-treatment facial profile photos per treatment group (n = 36 patients) were presented to four types of assessors (surgeons, orthodontists, patients, laypeople). Ratings were recorded on 100 mm visual analogue scales depicted in previously validated questionnaires. All rater groups identified minor positive changes in the facial profile appearance after exclusively orthodontic treatment, in contrast to substantial positive changes (14% to 18%) following combined orthodontic and orthognathic surgery. The differences between the two treatment approaches were slightly larger in the lower face and the chin than in the lips. The combined orthodontic and orthognathic surgery interventions were efficient in improving the facial appearance of patients with convex profile, whereas orthodontic treatment alone was not. Given the significant influence of facial aesthetics on various life aspects and its pivotal role in treatment demand and patient satisfaction, healthcare providers should take these findings into account when consulting adult patients with a convex facial profile.

[Aesthetic preferences of individuals when evaluating photographs of facial profiles with different sagittal and vertical growth patterns. A cross-sectional study]

Objective

To evaluate the aesthetic preferences of individuals by observing photographs of different facial profiles with different sagittal and vertical growth patterns.

Materials and Methods

Cross-sectional study that evaluated 300 students from a private university. Edited photographs of a man and a woman were used. The maxilla being moved in a vertical direction while the mandible was moved in a sagittal direction, various combinations of the photographic profile of the two individuals were created. These movements created 9 photographic profiles for the woman and the man; for intra-observer reliability, two photo profiles of both sexes were duplicated. Chi square tests and binary logistic regression were used. P<0.05.

Results

In general, the evaluated individuals mostly preferred the type 6 profile (65.7%), followed by the type 5 profile (21.7%) (slightly convex). It was found that for every year of age that an individual increases, there is a 31% greater chance of choosing one of these profiles.

Conclusions

Both sexes prefer a straight or slightly convex profile, and as age increases, individuals prefer a straight profile.

Comparing the esthetic impact of virtual mandibular advancement, bichectomy, jawline, and their combination

INTRODUCTION

The purpose of this study was to compare the effects of mandibular advancement (MA), bichectomy, jawline, and their combination on facial attractiveness. The 3-dimensional (3D) visual sculpting is a method to perform the task.

METHODS

FaceBuilder software, a Blender 2.93 LTS add-on, was used to generate a 3D head and face model of a female patient with Class II Division I malocclusion. MA, bichectomy, jawline, and combination modifications were performed on the model using a 3D virtual sculpting tab, and 4 new head models were created. Five hundred thirteen participants scored lateral and frontal views of the modified and reference models. The Mann-Whitney U, Kruskal-Wallis, and Wilcoxon tests were used for statistical analysis.

RESULTS

MA modification received the highest frontal and lateral image scores. The raters found the jawline frontal photograph to be the least attractive. Significant differences were observed between the lateral and frontal attractiveness scores in all modifications except bichectomy. The combination of 3 modifications in both frontal and lateral images received the second-lowest score.

CONCLUSIONS

Facial esthetic modifications receive different attractiveness scores in lateral or frontal evaluations. MA outperforms bichectomy and jawline augmentation in terms of improving facial attractiveness.

A CBCT Evaluation of Esthetic Preference Regarding the Perceived Facial Attractiveness of Young Korean Female Adults with a Normal Skeletal Pattern

The aim of this study was to determine the factors that affect esthetic preference regarding the perceived facial attractiveness of young Korean female adults with a normal skeletal pattern using cone-beam computed tomography (CBCT). After reorienting the CBCT images of 40 young Korean female adults, three-dimensional (3D) measurements were analyzed, and five 3D facial images were digitally constructed. A computer-based questionnaire was used to determine perceived facial attractiveness by scoring from 1 (very unattractive) to 10 (very attractive). Esthetic perception and the most influential facial view and component were examined and compared by orthodontists, general dentists, and laypeople to evaluate facial attractiveness. Compared to the unattractive group, the attractive group had significantly greater values for Pog-NB, L1SI-FH, U lip thickness, L lip-U lip, and Nasolabial angle, along with significantly lower values for U1SI-FH and Cant of U lip; the attractive group also had a more retruded U1MP (p < 0.01), L1MP (p < 0.01), U lip (p < 0.05), and L lip (p < 0.01) relative to N, as well as a more retruded U lip (p < 0.05) and L lip (p <0.001) relative to esthetic lines. Orthodontists and general dentists were more likely to consider the profile view. When evaluating facial attractiveness, orthodontists and laypeople more often focused on the lips and chin. When evaluating facial attractiveness, all evaluators showed a high esthetic preference for retroclination and retrusion of the incisors and lips, but there were some differences in how they perceived facial attractiveness. Therefore, the ultimate perception of facial attractiveness needs to be based on the esthetic perceptions of laypeople.