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Bravo Vallejo G, Alcaraz Ros GDD, Peloso RM, Gambardela-Tkacz CM, Cotrin P, Freitas KMS, de Freitas MR. Long-term profile attractiveness of patients with Class I and II malocclusion treated with and without extractions: A 35-year follow-up. Am J Orthod Dentofacial Orthop 2024; 165:513-519. [PMID: 38231168 DOI: 10.1016/j.ajodo.2023.11.009] [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: 06/01/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 01/18/2024]
Abstract
INTRODUCTION The objective of this study was to compare the profile attractiveness in subjects treated with and without extractions after the long-term 35-year follow-up, according to laypeople, dentists, and orthodontists. METHODS A total of 40 patients with Class I and II malocclusion were divided into 2 groups, according to the treatment protocol: extraction (E) group, extractions of 4 premolars (n = 24), with mean pretreatment (T1), posttreatment (T2), and long-term posttreatment (T3) ages of 13.13, 15.50 and 49.56 years, respectively. The mean treatment time (T2 - T1) was 2.37 years, and the long-term follow-up (T3 - T2) was 34.19. Nonextraction (NE) group (n = 16), with mean ages at T1, T2, and T3 of 13.21, 15.07, and 50.32 years, respectively. The mean (T2 - T1) was 1.86 years, and the (T3 - T2) was 35.25 years. Lateral cephalograms were used to perform profile facial silhouettes, and an online evaluation was performed by 72 laypeople, 63 dentists, and 65 orthodontists, rating the attractiveness from 1 (least attractive) to 10 (most attractive). The intragroup comparison was performed with the repeated measures analysis of variance and Tukey tests. Intergroup comparison was performed with t tests, 1-way analysis of variance, and Tukey tests. RESULTS The E group had a longer treatment time than that of the NE group. In the pretreatment, posttreatment, and long-term posttreatment stages, the E and NE groups showed similar profile attractiveness. Laypersons and dentists were more critical than orthodontists. CONCLUSIONS At long-term posttreatment follow-up, profile attractiveness was similar in patients treated with and without extractions.
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Affiliation(s)
- Gabriel Bravo Vallejo
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
| | | | - Renan Morais Peloso
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Paula Cotrin
- Department of Orthodontics, Ingá University Center UNINGÁ, Maringá, Paraná, Brazil
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Fangueiro DG, Garib DG, Conti ACDCF, Largura L. Evaluation of facial pleasantness in patients with complete and unilateral cleft lip and palate rehabilitated and submitted to orofacial harmonization. Dental Press J Orthod 2024; 29:e2423115. [PMID: 38567921 PMCID: PMC10983844 DOI: 10.1590/2177-6709.29.1.e2423115.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 01/30/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE The objective of the present prospective case control study was to evaluate the facial pleasantness of patients with complete and unilateral cleft lip and palate at the end of interdisciplinary rehabilitation, submitted to facial fillers based on hyaluronic acid. METHODS The study group consisted of 18 individuals with complete unilateral cleft lip and palate, aged between 18 and 40 years (mean age 29 years) of both sexes. The patients presented a concave profile with mild to moderate maxillary deficiency, with completed orthodontic treatment and conducted by means of dentoalveolar compensations without orthognathic surgery. Participants underwent facial filling procedures with hyaluronic acid (HA) in the midface, inserted by a single operator. Standard photographs in frontal norm at rest, right profile at rest, and left profile at rest were obtained from each patient at the following operative times: (T1) pre-filler and (T2) and one-month post-filler. The photographs in T1 and T2 were randomly placed on a page of a virtual album. A 5-point Likert scale was used to assess facial pleasantness. The photographs were evaluated by two groups of evaluators consisting of 18 individuals with cleft lip and palate (CLPG=18) and 18 orthodontists with experience in the treatment of clefts (OG=18). For comparison between phases T1 and T2, and between evaluators with orofacial clefts and orthodontists, the Wilcoxon test was used (p<0,05). RESULTS People with cleft lip and palate rated their face as more pleasant after the midface filling procedure. In the perception of the orthodontists, on the other hand, the facial pleasantness remained similar after the facial filling procedure. CONCLUSIONS The filling of the middle third of the face in patients with cleft lip and palate treated without orthognathic surgery increased the pleasantness of the face in the opinion of laypeople with cleft lip and palate.
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Affiliation(s)
- Daniel Giaretta Fangueiro
- Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais (Bauru/SP, Brazil)
- Universidade do Sagrado Coração, Faculdade de Odontologia (Bauru/SP, Brazil)
| | - Daniela Gamba Garib
- Universidade de São Paulo, Faculdade de Odontologia de Bauru (Bauru/SP, Brazil)
| | - Ana Cláudia de Castro Ferreira Conti
- Universidade do Sagrado Coração, Faculdade de Odontologia (Bauru/SP, Brazil)
- Universidade Norte do Paraná, Faculdade de Odontologia (Londrina/PR, Brazil)
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Saab FJ, de Freitas DS, Cotrin P, Oliveira RC, Valarelli FP, de Oliveira RCG, Salmeron S, Pinzan Vercelino CRM, Freitas KMS. Comparison of Gingival Recession of Mandibular Incisors of Class III Patients Immediately after Compensatory or Surgical Orthodontic Treatment. Eur J Dent 2023; 17:1089-1096. [PMID: 36574782 PMCID: PMC10756781 DOI: 10.1055/s-0042-1758068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE This study aimed to compare gingival recession in mandibular anterior teeth in patients with Class III malocclusion, immediately after compensatory or surgical orthodontic treatment. MATERIALS AND METHODS The sample consisted of 40 patients with Class III malocclusion, divided into two groups: Group 1 (compensatory), 20 patients treated with compensatory orthodontics, with a mean initial age of 20.26 years (standard deviation [SD] . = 7.44), mean final age of 23.07 years (SD = 7.32), and mean treatment time of 2.81 years (SD =0.84). Group 2 (surgical), who undergone orthodontic-surgical treatment, with a mean initial age of 23.08 years (SD =5.48), mean final age of 25.43 years (SD =5.12), and mean treatment time of 2.35 years (SD =1.56). Intraoral photographs taken before and after removal of the fixed orthodontic appliance were used to measure the gingival recession, from the cervical of the mandibular incisors from the most cervical point of the gingival margin to the cementoenamel junction. In the initial and final cephalograms, the position of the mandibular incisors was measured. The intergroup comparison was performed using the independent t-test. RESULTS The results showed that there was no statistically significant difference in the gingival recession at the beginning, at the end, and of changes with treatment between the compensatory and surgical groups. CONCLUSION It was concluded that the compensatory and surgical orthodontic treatments for Class III malocclusion showed similar results regarding the gingival recession of the mandibular incisors.
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Affiliation(s)
- Fábio Jorge Saab
- Orthodontic Graduate Student, Ingá University Center UNINGÁ, Maringá, Brazil
| | | | - Paula Cotrin
- Department of Orthodontics, Ingá University Center UNINGÁ, Maringá, Brazil
| | | | | | | | - Samira Salmeron
- Department of Periodontics, Ingá University Center UNINGÁ, Maringá, Brazil
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An English Flipped Classroom Teaching Model Based on Big Data Analysis. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:7391258. [PMID: 36093496 PMCID: PMC9452939 DOI: 10.1155/2022/7391258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/21/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022]
Abstract
In order to improve the defect that the quality of English flipped classroom teaching cannot be quantitatively evaluated, an English flipped classroom teaching model based on big data learning analysis is proposed. In the English flipped classroom teaching mode, which applies the flipped classroom teaching mode, the classroom teaching links are changed, the preview feedback, joint answer and question between teachers and students, classroom teaching, and teachers’ questions are taken as the key links of classroom teaching, and the teacher education and school management system are improved, so as to complete the reform of English flipped classroom teaching mode. The convolution neural network is used to extract the evaluation text features, mine the association rules of massive evaluation text data through the Apriori algorithm, determine the evaluation index of English flipped classroom teaching quality, and complete the evaluation of English flipped classroom teaching quality by using the decision tree method in big data analysis. The experimental results show that the proposed method can quantitatively evaluate the quality of English flipped classroom teaching by using the evaluation text, and the evaluation accuracy and recall rate are higher than 98%, which can realize the objective evaluation of English flipped classroom teaching quality.
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Kouskoura T, Ochsner T, Verna C, Pandis N, Kanavakis G. The effect of orthodontic treatment on facial attractiveness: a systematic review and meta-analysis. Eur J Orthod 2022; 44:636-649. [PMID: 35984326 DOI: 10.1093/ejo/cjac034] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Facial and smile attractiveness are significant motivating factor for patients to seek orthodontic treatment. Although there is a general belief that orthodontic treatment improves facial appearance, this has yet not been systematically evaluated. OBJECTIVE The objective of this study was to assess the current evidence on the effect of orthodontic treatment on facial attractiveness. SEARCH METHODS Systematic and unrestricted search of nine databases were performed up to January 2022. SELECTION CRITERIA Studies evaluating facial attractiveness before and after orthodontic treatment. DATA COLLECTION AND ANALYSIS Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality, and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomized studies and with RoB-2 for randomized controlled trials (RCTs). Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were performed. RESULTS Twenty studies were included in data synthesis; three randomized controlled clinical trials and 17 non-randomized clinical studies of retrospective or prospective design. One of the RCTs was found to have low risk of bias, one presented some concerns and the third showed a high risk of bias. All non-randomized studies showed either unclear or high risk of bias. Data syntheses showed that orthodontic treatment improved facial attractiveness ratings by 9% when compared with untreated controls (MD: 9.05/95% CI: 4.71; 13.39). A combination of orthodontics and orthognathic surgery also showed a positive effect of 5.5% (MD: 5.51/95% CI: 1.55; 9.47) when compared with orthodontic treatment alone. There was no difference in effect between extraction and non-extraction treatments (MD: -0.89/ 95% CI: -8.72; 6.94) or between different types of Class II correctors (MD: 2.21/95% CI: -16.51; 20.93). LIMITATIONS With the exception of two RCTs, included studies were of unclear or low quality. CONCLUSIONS Orthodontic treatment has a clinically weak effect on facial attractiveness when compared to no treatment. The same is true when a combined orthodontic/surgical treatment is compared to orthodontics alone. REGISTRATION PROSPERO #: CRD42020169904.
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Affiliation(s)
- Thaleia Kouskoura
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Switzerland
| | - Tatjana Ochsner
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Switzerland
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.,Private Practice, Corfu, Greece
| | - Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Switzerland.,Department of Orthodontics and Dentofacial Orthopedics, Tufts University School of Dental Medicine, Boston, MA, USA
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Management of Class III Extraction with the Miniscrew-Supported Orthodontic Pseudo-Ankylosis (MSOPA) Using Direct Tads. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The aim of the present study is to represent the orthodontic treatment of a young patient with a skeletal Class III malocclusion(Wits Appraisal −9 mm), in which the extractions of the first lower premolars were performed to obtain a class III camouflage using direct temporary anchorage devices (TADs). The patient reported a history of three years of orthodontic treatment at another clinic and the radiographic evaluation revealed an important impairment of the upper root incisors. A treatment was performed with a fixed appliance in the upper and lower arches using an archwire sequence of 0.16 CuNiTi, 19 × 25 CuNiTi, 19 × 25 SS and was carried out in 18 months. Post-treatment records of our patient show a control of facial esthetics from the frontal and lateral perspectives, with a harmonious soft-tissue profile. A Class I canine was achieved and her overbite and overjet were normalized by retracting the mandibular anterior teeth and carrying out a bodily mesialization of the posterior sector into the extraction space. In conclusion, the “pseudoankylosis system” used in this case allowed the desired result to be achieved with minimal change to the lower incisal inclination and without overloading the anterior upper and lower sectors, thus reducing the risk of further root resorption and patient compliance.
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Reis GM, de Freitas DS, Oliveira RC, de Oliveira RCG, Pinzan-Vercelino CRM, Freitas KMS, Valarelli FP. Smile attractiveness in class III patients after orthodontic camouflage or orthognathic surgery. Clin Oral Investig 2021; 25:6791-6797. [PMID: 33959816 DOI: 10.1007/s00784-021-03966-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The study's objective was to compare the smile attractiveness in patients with class III malocclusion treated with orthodontic camouflage or orthognathic surgery. MATERIAL AND METHODS The sample consisted of 30 patients with class III malocclusion treated without extractions divided into two groups, according to the treatment performed: G1, orthodontic camouflage, consisting of 15 patients (9 female; 6 male) with mean initial age of 21.26 years (SD = 7.39) and mean final age of 24.52 years (SD = 7.10). The mean treatment time was 3.26 years (SD = 1.50). G2, ortho-surgical, consisting of 15 patients (8 females; 7 males), with mean initial age of 23.12 years (SD=7.37), mean final age of 25.82 years (SD = 7.14) and mean treatment time of 2.71 years (SD = 0.90). The smile attractiveness was evaluated in black and white photographs of posed smiles taken before and after treatment, with a numerical rating scale from 1 to 10, with 1 being the least attractive and 10 the greatest smile attractiveness. The smiles were evaluated in a questionnaire by 111 participants, 67 orthodontists (mean age 41.31 years, SD = 9.44) and 44 laypeople (mean age 41.41 years, SD = 14.38). Intergroup comparison was performed with independent t test. RESULTS There was a significant improvement in the smile attractiveness with both camouflage and ortho-surgical treatments. The smile attractiveness was similar between the camouflage and surgical groups at the beginning. There was a significantly greater improvement in smile attractiveness with treatment in the surgical group than in the camouflage group, and at the end of treatment, the surgical group showed greater smile attractiveness than the camouflage group. Orthodontists considered the smiles more attractive both at the beginning and the end of treatment when compared to the assessment made by laypeople. CONCLUSION The ortho-surgical treatment promoted a greater improvement in the smile attractiveness, and at the final stage, a greater smile attractiveness than the orthodontic camouflage. CLINICAL RELEVANCE Smile attractiveness is an important characteristic of the final result of orthodontic treatment. Knowing which treatment protocol will provide a better improvement and outcome regarding smile esthetics is essential.
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Affiliation(s)
- Gabriela Martins Reis
- Department of Orthodontics, Ingá University Center Uningá, Rod PR 317, Maringá, PR, 6114 -87035-510, Brazil
| | | | - Renata Cristina Oliveira
- Department of Orthodontics, Ingá University Center Uningá, Rod PR 317, Maringá, PR, 6114 -87035-510, Brazil
| | | | | | | | - Fabricio Pinelli Valarelli
- Department of Orthodontics, Ingá University Center Uningá, Rod PR 317, Maringá, PR, 6114 -87035-510, Brazil
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Pozza OA, Cançado RH, Valarelli FP, Freitas KMS, Oliveira RC, Oliveira RCGD. Attractiveness of the facial profile: comparison of Class II patients treated with Twin Force® or intermaxillary elastics. Dental Press J Orthod 2021; 26:e212014. [PMID: 34669827 PMCID: PMC8529958 DOI: 10.1590/2177-6709.26.5.e212014.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022] Open
Abstract
Objective: To compare the facial profile attractiveness of Class II patients treated with Twin Force® or intermaxillary elastics. Methods: Sample comprised 47 Class II patients divided into two groups: G1) TWIN FORCE - 25 patients treated with fixed appliances and Twin Force® fixed functional appliance (mean initial age was 17.91 ± 7.13 years, mean final age was 20.45 ± 7.18 years, and mean treatment time was 2.53 ± 0.83 years); G2) ELASTICS - 22 patients treated with fixed appliances and Class II intermaxillary elastics (mean initial age was 15.87 ± 5.64 years, mean final age was 18.63 ± 5.79 years and mean treatment time was 2.75 ± 0.60 years). Lateral cephalograms from pretreatment and posttreatment were used. Cephalometric variables were measured and silhouettes of facial profile were constructed and evaluated by 48 laypeople and 63 orthodontists, rating the attractiveness from 0 (most unattractive profile) to 10 (most attractive profile). Intergroup comparisons were performed with Mann-Whitney and independent t-tests. Results: At pretreatment, facial profile of the Twin Force® group was less attractive than the Elastics group. Treatment with Twin Force® or Class II elastics resulted in similar facial profile attractiveness, but the facial convexity was more reduced in the Twin Force® group. Orthodontists were more critical than laypeople. Conclusions: Treatment with Twin Force® or Class II elastics produced similar facial profile attractiveness at posttreatment. Profile attractiveness was reduced with treatment in the elastic group, and improved in the Twin Force® group. Facial convexity was more reduced with treatment in the Twin Force® group.
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Affiliation(s)
- Otávio Augusto Pozza
- Centro Universitário Ingá - Uningá, Departamento de Ortodontia (Maringá/PR, Brazil)
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Combined Orthodontic and Surgical Management for Treatment of Severe Class III Malocclusion with Anterior and Posterior Crossbites. Case Rep Dent 2021; 2021:5579077. [PMID: 34258077 PMCID: PMC8257345 DOI: 10.1155/2021/5579077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022] Open
Abstract
Severe class III malocclusion can be a great challenge, especially in adult patients. This case report describes an adult patient with severe skeletal class III malocclusion and with an obvious maxillary deficiency and mandibular excess causing both anterior and posterior crossbites in addition to a shift in the upper and lower midlines to the left concerning the facial midline. This was complicated by compensatory mechanisms such as the proclination of upper incisors and retroclination of lower incisors. Decompensation of the upper and lower arches was performed combined with upper arch expansion to relieve crowding in the upper arch and correct the posterior crossbite. This was followed by double jaw surgeries, including Le Fort I osteotomy in the maxilla and bilateral sagittal split osteotomy (BSSO) in the mandible. Orthodontic finishing procedures were then used to correct any other dental discrepancies. Remarkable esthetic and functional results were achieved with high patient satisfaction.
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Comparison of Profile Attractiveness between Class III Orthodontic Camouflage and Predictive Tracing of Orthognathic Surgery. Int J Dent 2020; 2020:7083940. [PMID: 32963533 PMCID: PMC7492899 DOI: 10.1155/2020/7083940] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/07/2020] [Accepted: 08/25/2020] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of this study was to compare the profile attractiveness between orthodontic camouflage of the Class III malocclusion and the predictive tracing simulating orthognathic surgery evaluated by dentists and laypeople. Settings and sample population. The sample consisted of 21 patients (9 male; 12 female) with Class III malocclusion treated with orthodontic camouflage and Class III intermaxillary elastics. Material and Methods. The mean initial age of the patients was 24.38 years (SD 3.32), and the mean ANB angle was −1.91° (SD 0.83°). Patients presented skeletal Class III and normal growth patterns. Initial and final lateral cephalograms of each patient were used. The initial cephalogram was used to perform the treatment simulation of orthognathic surgery, and its silhouette was compared to the silhouette obtained from the final cephalogram after Class III orthodontic camouflage. A subjective analysis of profile attractiveness was performed by 47 laypeople and 60 dentists, with scores from 1 (less attractive) to 10 (most attractive). Mann–Whitney tests were used to compare profile attractiveness between the orthodontic treatment and the predictive tracing groups and between dentists and laypeople. Results The predictive tracing of orthognathic surgery showed to be statistically significantly more attractive (mean score 4.57, SD 2.47) than that of the Class III camouflage orthodontic treatment (mean score 4.22, SD 2.40), with a mean numerical but significant difference of 0.35 (SD 2.01) (P < 0.001). Laypeople were more critical than dentists in evaluating profile attractiveness, but numerical difference between the groups was also small. Conclusion The profile silhouette of predictive tracing simulating orthognathic surgery showed to be more attractive than that of Class III camouflage orthodontic treatment; however, differences were small but statistically significant. Laypeople showed to be more critical than dentists.
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