Thresholds of Abnormality Perception in Facial Esthetics among Laypersons and Dental Professionals: Profile Esthetics

Abstract

Aim. To find thresholds at which laypersons and dental professionals from Jordanian population perceive abnormalities in sagittal positioning of upper and lower jaws as a major determinant to facial profile esthetics. Materials and Methods. Using photo editing software, a baseline profile image of a young male was manipulated on a 2 mm incremental basis to move each of the upper and lower jaws backward and forward relative to true vertical line (TVL) at which four variables of maxillary and mandibular retrusion and protrusion were researched. A total of 120 participants divided equally into four groups of laypersons, general dental practitioners (GDPs), orthodontists, and oral and maxillofacial surgeons (OMFSs) rated the images using an analog scale of 100 mm long. The image that showed the first statistical difference compared to the baseline was considered as a threshold of abnormality. Results. Laypersons, GDPs, and OMFSs perceived the abnormality in the maxillary retrusion at −5 mm to TVL, while orthodontists defined that at −3 mm. All dental professionals perceived the abnormality in the maxillary protrusion at +1 mm to TVL while the layperson group at +3 mm. A threshold of −7 mm mandibular retrusion to TVL was abnormally perceived by all groups. All dental professionals realized the abnormality in the mandibular protrusion at 0 mm to TVL while the laypersons at +2 mm. Conclusion. These thresholds regarding profile esthetics may contribute to the process of establishing proper orthodontic treatment planning that suits the highest facial esthetic standards.

Does Maxillary Retrusion in Skeletal Class III Malocclusion Affect the Perception of Facial Aesthetics? Evaluation of Different Groups

“…Most of the specialized categories (orthodontists, generic dentists, and maxillofacial surgeons) assessed a sagittal retrusion of the maxilla, but only orthodontists and maxillofacial surgeons recognized that the alteration of the middle facial third is an important component of the skeletal class III malocclusion. These results agree with Alrbata and colleagues who showed that orthodontists are more sensitive in perceiving maxillary retrusion than other categories [13]. Probably, orthodontists pay more attention to maxillary development to intercept a skeletal class III malocclusion already in the early stages of growth [13].…”

“…These results agree with Alrbata and colleagues who showed that orthodontists are more sensitive in perceiving maxillary retrusion than other categories [13]. Probably, orthodontists pay more attention to maxillary development to intercept a skeletal class III malocclusion already in the early stages of growth [13]. Furthermore, both orthodontists and maxillofacial surgeons had to conform their aesthetic canons with the new preferences of a more protruded facial profile; therefore, they usually focus on jaw retrusion [15].…”

“…However, in this study most of generic dentists and laypeople evaluated the mandibular advancement as the only component of the skeletal class III discrepancy. According to these results, several studies reported that an alteration in the lower facial third is more immediately perceived [13,17,18]. Johnston and colleagues showed that subjects with skeletal prognathism and vertical excess of growth are considered less attractive than subjects with normal face height, needing more efficient therapies [19].…”

“…In many cases, patients showed a facial asymmetry in addition to the sagittal discrepancy, worsening their aesthetic aspect [11]. Several authors showed significant difference in the assessment of facial perception for skeletal class III patients among dental professionals, orthodontists, oral surgeons, and laypeople [3,12,13]. Different opinions were recorded referring to facial profile, smile aesthetics, and soft tissue harmony [4,14].…”

Esthetic preferences of orthodontists, dentists, and plastic surgeons for balanced facial profiles

“…Profile esthetics might be perceived differently among various groups (especially laypeople). Some studies have implied that professionals might be biased as a result of their educational background [28], while others have stressed that laypeople might better reflect cultural influence when assessing facial attractiveness [18,37]. Nevertheless, some authors have reported general agreement among professionals and laypeople in terms of perception of facial appearance [3,32].…”