Correlation between objective evaluation and subjective evaluation of facial profile in skeletal Type II females

Abstract

Objectives: The objective of this study was to find the cephalometric measurements that correlate with the visual perception. Materials and Methods: A total of 250 lateral cephalograms of patients from the year 2016 to 2018 were hand traced and analyzed. Thirty-six hard- and soft-tissue measurements were obtained from the lateral cephalometric analysis. Silhouettes obtained from cephalometric films were rated by 10 orthodontists based on their level of convexity. For each sample, the rating of visual perception was correlated with all the cephalometric (hard and soft) measurements. Results: ANB, AF-BF, L1-NB (mm), overjet, anterior maxillary alveolar height, posterior maxillary alveolar height, lower lip to E plane, and H angle were positively correlated with the visual perception. On the contrary, Pg. to N perpendicular and Pg. to NB (mm) were negatively correlated with the visual perception. However, the measurements in the vertical dimensions did not have any significant correlations with visual perception. H angle showed a higher correlation with visual perception than the nasolabial angle, facial contour angle, and lower lip to E plane. Conclusion: The agreement between objective cephalometric measurements and subjective visual perception was less than expected. In general, only 27% of the cephalometric measurements had a significant correlation with visual perception. Therefore, orthodontic treatment planning based solely on cephalometric analysis can result in unsatisfactory treatment outcomes. An inclusion of subjective measures such as visual perception in orthodontic diagnosis and treatment planning is necessary.

Establishing H Angle Hard Tissue and H Angle Soft Tissue Norms in Skeletal Class I Malay Adult Females and the Correlation between the H Angles and Visual Perception of Laypersons

“…Furthermore, the wide range of intraexaminer reliability, including one negative value, suggests that the judgments on facial profile of the same layperson tend to be variable and subjective at different occasions, although the same profile feature was evaluated. Our result contrasts with that of Lersinghanart et al (2020) 22 and Choki et al (2021) 29 who reported good correlation between H angles and visual perception. These differences can be explained in part by the difference in our study sample being recruited, in which laypersons were selected instead of orthodontic postgraduate students 22 and orthodontic specialists 29 who had orthodontic knowledge.…”

“…This finding was in agreement with Lersinghanart et al (2020), 22 ALBarakati and Bindayel (2012), 27 and Panezai et al (2021) 28 who reported that the mean values of the H angles were 15.27, 15.16, and 15.05 degrees, respectively. However, our mean H angle value was different with Choki et al (2021) 29 and Noviaranny et al (2022), 30 with a mean value of 20 and 10 degrees, respectively. H angle soft tissue is influenced by the thickness and position of the lips and the nose.…”

“…Thick upper lip corresponds to a larger H angle soft tissue and since the Malay population mostly have thicker upper lips, the H angle soft tissue is therefore larger compared with the Caucasians. 30 A study by Cezairli (2017) In this study, H angle soft tissue has a very strong correlation with H angle hard tissue, and this concurred with the result by Choki et al (2021). 29 It was claimed that certain soft tissue structures have a tight association with hard tissue.…”

“…In this study, the mean value for H angle hard tissue was 11.64 degrees which was in agreement with Lersinghanart et al (2020) 22 at 11.13 degrees, but different from the finding by Choki et al (2021) 29 at 16.39 degrees, although Thailand females were the subjects in both studies. Lersinghanart et al (2020) recruited skeletal Class I Thailand female patients with a mean ANB value of 3.39 degrees which was similar to the mean ANB value in our study.…”

“…In this study, H angle soft tissue has a very strong correlation with H angle hard tissue, and this concurred with the result by Choki et al (2021). 29 It was claimed that certain soft tissue structures have a tight association with hard tissue. 33 For instance, the vertical changes of the upper lip could be due to a horizontal change in prosthion (the most inferior anterior point on the maxillary alveolar process between the central incisors) and the position of upper incisors.…”