Esthetic perception and economic value of orthodontic appliances by lay Brazilian adults

Abstract

OBJECTIVE: To evaluate the esthetic perception of different appliances by Brazilian lay adults and its influence in the attributed value of orthodontic treatment, considering evaluators' socioeconomic status, age and gender. METHODS: Eight different combinations of orthodontic appliances and clear tray aligners were placed in a consenting adult with pleasing smile. Standardized frontal photographs were captured and incorporated into a research album. A sample of adults (n = 252, median = 26 years old) were asked to rate each image for (1) its attractiveness on a visual analog scale and (2) the willingness to pay (WTP) for a cosmetic appliance when compared to a standard metalic appliance and a clear tray aligner. Comparisons between the appliances' attractiveness were performed using the Friedman's test and Dann's post-hoc test. Correlation between appliances' attributed value, socioeconomic status, age, gender, and esthetic perception was assessed using Spearman's correlation analysis. RESULTS: Attractiveness ratings of orthodontic appliances varied significantly in the following hierarchy: Clear aligners>sapphire brackets>self-ligating/conventional stainless steel brackets>and golden metal appliances. The correlation between WTP and esthetic perception was week. However, for individuals with better socioeconomic status and aged between 17-26 years old significantly, a significantly higher WTP was found. CONCLUSION: Clear aligners and sapphire brackets with esthetic archwire were considered better esthetic options in this sample. Nevertheless, patients were not willing to pay more money for appliances they deemed more esthetic, however, they were significantly influenced by their socioeconomic level and age.<br>OBJETIVO: avaliar a percepção de brasileiros adultos leigos para diferentes aparelhos ortodônticos e sua influência na valorização econômica do tratamento, considerando o nível socioeconômico, idade e sexo dos avaliadores. MÉTODOS: oito combinações de aparelhos ortodônticos e alinhadores foram colocadas em um adulto com bom alinhamento dentário, e fotografias frontais foram feitas para compor um álbum de imagens de pesquisa. Uma amostra de adultos (n = 252, mediana = 26 anos) classificou cada imagem por (1) atratividade, em uma escala visual analógica, e (2) disposição a pagar a mais para realizar o tratamento com um aparelho estético em relação a um aparelho metálico e em relação a um alinhador. Comparações da atratividade dos aparelhos foram realizadas utilizando-se o teste de Friedman e o post-hoc de Dann. A correlação entre a valorização econômica, nível socioeconômico, idade, sexo e percepção estética foi calculada com a análise de correlação de Spearman. RESULTADOS: a atratividade dos aparelhos ortodônticos variou significativamente, na seguinte hierarquia: alinhadores > aparelhos de safira > aparelhos metálicos tradicionais e autoligáveis > aparelhos dourados. A correlação entre a atratividade dos aparelhos e a disposição em pagar mais por eles foi fraca. Contudo, ter melhor nível socioeconômico e ...

Esthetic perception of orthodontic appliances by Brazilian children and adolescents

“…For male individuals, there was no difference in attractiveness among clear tray aligner without attachments, sapphire esthetic brackets with stainless steel archwire and traditional metallic brackets with gray elastomeric ligatures. In this sense, these results were different from Walton et al 11 and Feu et al 10 who found differences in the esthetic perception of orthodontic appliances among males and females. Males and females rated golden orthodontic brackets as less attractive.…”

“…A similar result was found in the study by Walton et al, 11 but their result was different from similar studies in adults, which found preferences for appliances with less visible metal 7 8 , 10 , 14 Group 2 gave better scores for sapphire brackets and clear aligner without attachments than Group 1, and these findings were similar to results yielded by Walton et al 11 and Oliveira et al 14 …”

“…The eight images, as described above, were randomly grouped in a grid and labeled with letters A to H (Fig 1). For more details on the methods of image acquisition and standardization, readers are referred to the study of Feu et al 10 …”

“…Those studies reveal that adult consumers value less metal showing in their brackets 7 8 Esthetic perception and economic value of orthodontic appliances among adults was investigated by Feu et al 10 who found that sex and age influence perception of orthodontic appliance attractiveness. Walton et al 11 found a statistically significant difference between sex and age, concluding that American adolescents have a significant preference for metallic brackets.…”

Contemporary esthetic nickel-titanium wires: Do they deliver the same forces?

“…For instance, in a recent study, the combination of esthetic archwires and sapphire brackets ranked second in patient preferences, only behind clear aligners. 1 Beginning in the 1970s with plastic brackets constructed from acrylic and later polycarbonate, there have been many iterations toward achieving a more esthetic or tooth colored bracket. 2 Yet, not as much interest has been focused on the esthetics of the other component of the fixed orthodontic appliance, the wire.…”