A Cross-Sectional Study Examining Andrews' Analysis in Caucasian and African American Subjects

Abstract

Andrews' analysis is a commonly utilized instrument to aid in esthetic positioning of the anteroposterior position of the maxillomandibular complex; however, there is limited data regarding use in non-Caucasian subjects. The purpose of this study was to document laypersons preferences of anteroposterior position of the maxillomandibular complex in relation to Andrews' lateral profile analysis in African American (AA) and Caucasian subjects. A cross-sectional study was implemented to evaluate the esthetics of AA and Caucasian subjects. Photographs were taken and simulated with anteroposterior maxillomandibular complex positioning in varying relationships to Andrews' goal anterior line limit. A survey was then designed to select the preferred simulation of the facial profile of each subject. The independent variable was the race of the study subjects. The main outcome was the layperson's preferred lateral facial profile for each subject. The covariates included age, race, sex, education level, income, of the laypersons. A proportion test was used to decide which profile was preferred. Logistic regression analyses were conducted to assess the association between the preference and respondent demographics. P<.05 was considered significant. A total of 264 surveys were distributed, and 250 complete surveys were utilized (response rate=95%). Respondents were majority male (51.2%), aged 35-44 (37.2%), college-educated (57.2%), earning between $20,000 and $50,000 annually (44%), and identified as Caucasian (77.2%). For the female subjects, the respondents preferred+4 and+6mm anterior to goal anterior line limit with 54.2% for the Caucasian and 65.9% for the AA subjects (difference=11.7%; 95% CI:2.7 to 20.7%; P=.008). For the males, 47.4% of the respondents chose 0mm and+2mm for the AA subject, while only 24.9% preferred+2mm for the Caucasian male (difference=22.5%; 95% CI: 13.8 to 31.1%; P<.0001). Respondent demographics were not found to influence selection. The preferred facial profile as judged by laypersons differs between Caucasian and AA subjects when defined through Andrews' analysis.