Mandibular advancement analysis among orthodontists, lay people and patients in class II malocclusion subjects. A three‐dimensional imaging study

Abstract

Objective: To evaluate the acceptance of orthodontists, laypeople and the patient when progressive mandibular advancements are performed in class II subjects with mandibular retrognathism.Setting and sample: 3D images were obtained by an optical surface scanning of fifteen individuals (12 males and three females, mean age of 23 years and 8 months) with mandibular retrognathism in three mandibular positions: maximum intercuspation (MIC) and progressive mandibular advancement of 2 and 4 mm. Methods:The images (n = 45) were evaluated through a scale by two groups of panellist, 20 orthodontists, 20 laypeople and by the patients themselves (n = 15). The participants evaluated and rated each video and give scores between 0 and 10, according to their perception of facial harmony. MANOVA for repeated measures was used for intra-and intergroup differences and to evaluate the patients' self-perception.Results: Laypeople reported better face acceptance than orthodontists in MIC and progressive mandibular advancement of 2 and 4 mm (P < .0001). 80% of the patients evaluated their own face as pleasant in MIC. Around half of them did not note significant difference following mandibular advancement of 2 mm as compared with MIC and even two-third attributed lower scores when the mandible was advanced 4 mm. Conclusion:A high variability was observed among all groups of raters. Patient´s opinion should be taken into account when mandibular advancement of 4 mm or more is planned. This study suggests that a thorough discussion of facial changes resulting from mandibular advancement should be carried out among professionals, parents and patients.

Effects of the mandibular protraction appliance FLF on the face: morphometric analysis

“…Perhaps the absence of a significant effect on the face is an advantage, at least from the point of view of patients who, according to recent research (Espinosa et al,2021), assessed their face and were satisfied with it without the impact of treatment.…”