Esthetic perception of facial profile changes after extraction and nonextraction Class II treatment

Abstract

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.

Attractive perception of profile class II patients treated with extractions versus dentoalveolar mandibular advancement devices

“…In both studies 18,19 results are similar to ours: Class II Treatment had positive effect in both cases.…”

“…For Rocha et al 19 the orthodontic treatment of Class II division 1 malocclusion both with extraction of maxillary first premolars and with the Forsus appliance had positive effects on facial profile esthetics. This was evaluated by both lay examiners and orthodontists, who assigned greater scores to the posttreatment profile.…”

Soft tissue profile changes during treatment of patients with class II malocclusion

“…The lower lip is the adjacent esthetic subunit to the chin, and its features play an important role in determining facial esthetics in the lower third of the face [27]. As such, the prominence of the lower lip may influence the perception of chin prominence and thus the overall management plan in terms of camouflage vs orthognathic surgery and extraction vs non-extraction decisions [21,28,29].…”

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“…Also, in a relevant way, the patient complained about the dental inclinations and gingival recessions. Although the premolar extractions in Class II patients represent a subject widely discussed by orthodontists, 19,20 it was opted for the combination of orthognathic surgery associated with premolar extractions, due to the fact that the mandibular advancement does not cause damage to the facial profile. In addition, orthodontic movement is favored due to the transient osteopenia caused by surgery, characterized by the reduction of bone density after a surgical procedure in a given region, which supposedly facilitates the orthodontic mechanics and width closure 10,11,13 .…”