Facial Profile Photographs Research Articles

Genetic and environmental contributions to the development of soft tissue facial profile: a twin study.

This study aimed to determine the relative contribution of genetic and environmental factors in the phenotypic variation of the soft tissue facial profile during the mixed dentition and the permanent dentition stages. In this retrospective cohort study, standardized facial profile photographs of 139 twin pairs (55 monozygotic and 84 dizygotic) were obtained from archival records at the Adelaide Dental School. Photographic analysis used 12 angular and 14 linear facial profile measurements from the mixed dentition (7-11 years) to the permanent dentition (12-17 years) stages. A genetic analysis was performed using a univariate structural equation model adhering to the normal assumptions of a twin model. In the mixed dentition stage, the additive genetic (A) and unique environment (E) model, AE model, was the most parsimonious in explaining the observed phenotypic variance for all 26 facial traits with the narrow-sense heritability estimates ranging between 0.38 and 0.79. In the permanent dentition, the AE model was the most parsimonious for 20 out of 26 traits, however, the variance of six traits, particularly those in the lower third of the face, was best explained by the shared environmental and unique environmental factors. This study exclusively included twins of European ancestry. The soft tissue facial profile demonstrated dynamic genetic and environmental influences with a greater additive genetic influence during the mixed dentition and the early stages of the permanent dentition. However, there was evidence of increasing environmental influence in the lower third of the face during the early stages of the permanent dentition.

Accuracy of Facial Soft Tissue Measurements Using Photographic Analysis Method

Background and Aim Facial photograph is an essential diagnostic aid having great importance in diagnosis and treatment planning in Orthodontics and is absolutely hazard free. In this era of paradigm shift where soft tissue is of much significance facial photographs are an excellent aid in appraising facial balance type and harmony of external features. The aim of this study was to determine the accuracy of intra examiner and inter examiner landmark identification and measurement by photographic analysis on standardized photographs of patients using a custom-made software.Methods Fifty individuals including both males and females were included in the study. Their frontal and profile facial photographs were taken using a standardized method. The photographs were stored in TIFF Tag Image File Format and uploaded in the custom-made software for analysis. Two examiners with similar experience were selected for marking the landmarks and performing the analysis. Analysis was done initially T0 and after 24 hrs T24. Both intra and inter examiner reliability was checked using ICC. The data were entered in Excel sheet and subjected to statistical analysis. Data were analyzed using SPSS Statistical Package for Social Sciences 25.0 version IBM Chicago. Inter-examiner and intra-examiner correlation was assessed using intra-class correlation coefficient.Results In frontal linear measurements all correlations of inter and intra examiner readings initial reading T0 amp after 24 hrs T24 the parameters Sn-Me Sn-St St-Me Tr-Me ChR-ChL showed significant correlation Plt0.05 whereas parameter Tr-N showed non-significant correlation Pgt0.05. In profile angular measurements all correlations of inter and intra examiner readings T0 amp T24 the angular parameters N-Pn-Cm N-PnN-Pog Li-B-Pog G-N-Nd N-Pn-Pog showed significant correlation Plt0.05 whereas parameter Cm-Sn-Ls showed non-significant correlation Pgt0.05.Conclusion The present study revealed a high accuracy of landmarks and measurements when done on standardized photographs with photographic analysis using customized software. Except Nasolabial angle Cm-Sn-Ls in angular parameters and Tr-N in linear parameters which showed the most variability in terms of reliability and reproducibility and were also statistically non significant.

Establishing standards for Yonsei point in a White South African population for the treatment of gummy smile.

The purpose of this study is to establish the efficacy of Yonsei point in the treatment of a gummy smile in a White South African population. The accurate surface anatomy criteria in relation to the underlying musculature for the administration of Botulinum toxin injections in the treatment of gummy smile was determined. Nineteen (10 males and 9 females) cadavers were selected for facial dissection. Facial profile photographs were taken before and after dissection. The before and after photographs were overlayed to determine where the pin positions should be on the dissected cadaver to determine the Yonsei point. The levator labii superioris (LLS), LLS alaeque nasi (LLSAN), zygomaticus minor, and zygomaticus major muscles were measured using a protractor and ruler, which accounted for the manual measurements. Digital measurements were measured by importing dissected images into ImageJ. Circles with a 2 cm diameter (1 cm radius) were constructed to determine whether the Yonsei point could successfully influence muscles fibers. Digital and manual measurements show comparable results with high correlation and reliability. Results showed that the White South African population had narrower facial musculature angles as compared with the Korean population. Based on the selected sample, the Yonsei point is an ineffective injection site for the successful treatment of gummy smile in a White South African population.

Predicting the sagittal skeletal pattern using dental cast and facial profile photographs in children aged 9 to 14 years.

To quantify prediction of sagittal skeletal pattern using anteroposterior dental relationships on dental casts and facial profile photograph. The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from December 2016 to July 2017, and comprised orthodontic patients of either gender aged 9-14 years who attended the outpatient dental clinic. The sagittal skeletal relationship assessed on cephalometric radiographs was compared with anteroposterior dental and facial measurements on their dental cast and facial profile photographs. A prediction model was developed using multiple linear regression. The applicability of the prediction model was checked on an independent sample. Data was analysed using STATA 12. Of the 76 patients, about two-third (n=47) were females. The overall median age was 12.3 years (inter-quartile range: 1.8), with majority (60.5%) aged 12-14 years. The proportion of Class I, II and III malocclusion was 25 (32.9%), 50 (65.8%) and 1 (1.3%) respectively. Highest percentage of variability 47.4% in ANB angle was determined by the soft tissue ANB angle. 54.9% of the variability in the ANB angle could be explained by overjet, soft tissue ANB' angle, lower lip to E-line distance, Class II incisor relationship, history of malocclusion and thumb sucking, interaction terms between Class II incisor relationship and history of malocclusion, and history of thumb sucking and soft tissue ANB' angle. Sagittal skeletal relationship in an individual can be predicted with moderate accuracy using the prediction equation incorporating dental and facial variables along with history of malocclusion and thumb-sucking without potentially harmful exposure to cephalometric radiographs.

Soft Tissue Treatment Goals for Orthodontic Patients- A Photogrammetric Analysis of Facial Profile for Soft Tissue Norms and Gender Variations in Young Adults, Hyderabad, India

Introduction: An average face is always more aesthetic than an atypical face, so setting soft tissue treatment goals for male and female orthodontic patients required local norms, like average measurements of local aesthetically pleasing profile is more important than adopting universal norms. Aim: To obtain angular and average measurements of softtissue facial profiles for males and females in young adults of Hyderabad, India. Materials and Methods: The cross-sectional study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics, Government Dental College and Hospital, Hyderabad, India, from the December 2007 to January 2010. The study included 104 aesthetically pleasing individuals between the age group of 16 years to 25 years (42 male and 62 female) selected by Orthodontists and laypersons, facial profile photographs were taken with standardized photographic set up with camera using 100 mm macrolens. Photographs were traced and 12 angular measurements were taken. Descriptive statistical analysis was done using software MATLAB (Matrix Laboratory) mean, maximum, minimum value, standard deviation and confidence intervals were calculated. Student’s t-test was done to determine sexual dimorphism, and p-value ≤0.05 was considered statistically significant. Results: Total of 104 subjects (42 male subjects; mean age :21.4 years and 62 female subjects; mean age: 19.6 years) were analysed. There was a statistically (p-value <0.05) significant sexual dimorphism in seven of the angular measurements were noted. The nasofrontal (females-141o ±4.8o , males-137.86o ±5.2o ), nasal angle (females -84.4±9o , males-80.7o ±6.9o ), vertical nasal (males-32.08o ±3.3o , females-28.33o ±3.636o ), nasal dorsal angle (males-180.19o ±7.112o , females-174.43o ±6.648o ), cervicomental angle (females-98.41o ±5.4o , males-95.7o ±5.1o ), angle of facial convexity (females-173.2o ±4.4o , males-169.6o ±54.8o ), and angle of total facial convexity (females-149o ±4.6o , males144.4o ±5.2o ), showed sexual dimorphism. In the present study, large variability was observed with the nasolabial (p-value=0.314), and mentolabial (p-value=0.798) angles. Conclusion: Successful orthodontic treatment is mainly measured by patient appraisal only, this can be obtained by giving the locally more aesthetically pleasing facial profile to the patient, setting soft tissue facial profile treatment goals to native individuals is far more important than following universal norms in the total benefit of the patients.

Comparative assessment of cephalometric with its analogous photographic variables.

Objective:The purpose of this study was to evaluate the accuracy of photographic measurements and compare it with its analogous cephalometric variables.Materials and Methods:Lateral cephalograms and standardized facial profile photographs were obtained from a sample of 120 subjects (92 females, 28 males; age 12–22 years with mean age of 17.5 years). A total of 4 linear and 7 angular measurements along with 3 ratios analogous to one another were measured on both. Descriptive statistics for all measurements were computed. Pearson's correlation coefficients were computed between analogous measurements, and regression analysis was done for each variable measured on the photograph to accurately predict the cephalometric variable.Results:The reliability of the standardized photographic technique was satisfactory. Most photographic measurements showed highly significant correlations (P < 0.001) with cephalometric variables. Among all measurements used, the A'N'B' angle was the most effective in explaining the variability of its analogous cephalometric (r2= 0.35). The Frankfort-mandibular plane angle' angle showed best results for vertical assessment (r2= 0.81) along with anterior face height (AFH) and lower anterior facial height (r2= 0.859) and ratio lower posterior facial height/AFH (r2= 0.702).Conclusions:Although we cannot rule out lateral cephalogram as the primary record in orthodontics, photographic assessment can always be used through proper standardization, as an alternative diagnostic aid, and also for large-scale epidemiological purposes and places with unavailability of cephalostat.

What do black patients expect from orthodontic treatment? The aesthetic perception of facial profile between orthodontists and black laypersons.

ABSTRACTObjective: To evaluate the influence of anteroposterior position of the soft tissue on facial attractiveness in black people, and compare the perception of aesthetics and satisfaction between orthodontists and black laypersons. Methods: The sample was composed of 69 orthodontists and 69 laypersons of black ethnicity (n=138). Facial profile photographs of two black volunteers, a man and a woman, were digitally manipulated to change the position of the lips and chin, by making gradual changes of 4mm in relation to the true vertical line, simulating advance or retrusion of the soft tissues by -2, -6, -10, +2, +6, +10mm, totalling six images per sex. The photographs were classified by the research participants using a visual analogue scale (VAS), from 0 (unpleasant) to 100 (pleasant). The results were analyzed by generalized linear model and by the Fisher’s exact test, considering the level of significance of 5%. Results: The orthodontists and black laypersons considered straight profiles the most pleasant. The two groups classified the male profile as being more unpleasant in comparison with the female facial profile, which was concave. When evaluating all the images together, the image most indicated as being the most pleasant, once again, was the one with the straight profile, for both sexes. Conclusion: The influence of orthodontists’ and laypersons’ aesthetic perception on evaluating the facial profile of blacks was similar. The straight profile was classified as the most pleasant and the concave, as the most unpleasant.

A machine learning approach to determine the prognosis of patients with Class III malocclusion

The conundrum of determining how to treat a patient with Class III malocclusion is significant, creating a burden on the patient and challenging the orthodontist. The objective of this study was to employ a statistical prediction model derived from our previous cephalometric data on 5 predominant subtypes of skeletal Class III malocclusion to test the hypothesis that Class III subtypes are associated with treatment modalities (eg, surgical vs nonsurgical) and treatment outcome. Pretreatment lateral cephalometric records of 148 patients were digitized for 67 cephalometric variables, and measurements were applied to a mathematical equation to assign a Class III subtype. Subjects were assigned to either a surgical or nonsurgical group depending on the treatment received. Treatment outcome was determined by facial profile and clinical photographs. Log binomial models were used for statistical analysis. Subtype 1 (mandibular prognathic) patients were 3.5×more likely to undergo orthognathic surgery than subtypes 2/3 (maxillary deficient) and 5.3×more likely than 4/5 (combination). Subtype 1 patients were also 1.5×more likely to experience treatment failure than subtypes 2/3 (maxillary deficient) and 4/5 (combination). This assessment of a systematic method to characterize patients with Class III malocclusion into subtypes revealed that subtype 1 (mandibular prognathic) showed a likelihood to undergo orthognathic surgery while subtypes 2/3 experienced significantly lower treatment failure (in response to orthodontics alone). Further refinement of the equation may yield a reliable prediction model for earlier identification of surgical patientsand also provide predictive power of Class III treatment outcomes.

Profile shape variation and sexual dimorphism amongst middle-aged Northern Europeans.

To explore profile shape variation in a large population of middle-aged individuals and investigate features of sexual dimorphism. Facial profile photographs of 1776 individuals (964 females and 812 males; 46 years old), members of the Northern Finland Birth Cohort 1966 (NFBC1966), were uploaded and digitized with Viewbox software. Profile shape was defined with 47 landmarks (4 fixed and 43 sliding semi-landmarks). Digitized images were reoriented and scaled with Procrustes Superimposition, and shape variation was determined with a Principal Component Analysis. More than 90 per cent of profile shape variation was explained by Principal Components (PC) 1-9. PC1, explaining the largest amount of variation (33.1 per cent) described changes in facial convexity, slope of the forehead, lip, and chin protuberance. PC2 (23.1 per cent variation) was more related to vertical changes of the lower facial third and PC3 (11 per cent variation) primarily described changes in lip protrusion and nasal projection. Shape analysis showed a significant difference between the average female and the average male profile shape (P < 0.001); however, this was not evident upon visual observation. The shape variable most associated with sex was PC3 (η 2 = 0.245; P < 0.001), which described changes in lip prominence and in projection of the dorsal nasal surface. An additional discriminant analysis showed that profile shape predicted sex in 76 per cent of males and 79.6 per cent of females. There is significant sexual dimorphism in facial profile among middle-aged adults. Profile shape variation was associated to changes in lip protrusion, nasal protuberance, and chin projection.

Esthetic evaluation of profile photographs showing various sagittal and vertical patterns

The purpose of this study was to determine the esthetic preferences of people at different levels of society and also to determine whether this preference is affected by sex, age, education level, social status, geographic region, and individual profile factors. Facial profile photographs of 1 man and 1 woman, each having a profile designated as ideal (the ideal profile), were digitized. The sagittal and vertical dimensions of these photographs were modified, and 9 variations of each profile picture were obtained using different combinations of alterations. The photographs were scored by 373 participants. For the analysis, Mann-Whitney U and Kruskal Wallis-H tests were used in the comparison of the scores. The ideal profile was the most preferred in both sexes, whereas the least preferred was a severe Class III malocclusion with a reduced vertical dimension of 8mm. In general, esthetics decreased as it moved away from the ideal profile in a sagittal or vertical direction. Some factors from among those sampled (sex, age, education, social status, geographic region, and personal profile) affected esthetic preference, whereas others did not.

Self-perception of facial esthetics by patients with different profiles compared with assessments of orthodontists and lay people

This study evaluated the perception of facial esthetics of patients with different profiles as assessed by orthodontists, lay people, and patients. The sample comprised 120 patients (81 females, 39 males; mean age, 26.3years) selected from private practices at the onset of orthodontic treatment. The patients were divided into 3 groups of 40 according to the type of facial profile. The groups were composed of straight, concave, and convex profiles, on the basis of the facial convexity angle (G.Sn.Pog') measured on the initial cephalometric tracings. Patients analyzed only their frontal (smiling and at rest) and profile facial photographs and evaluated the pleasantness of these images on a 5-point Likert scale. A group of 30 orthodontists and 30 lay people also evaluated the patients' facial pleasantness, using the same scale. Factorialanalysis of variance (convexity and sex) was used to evaluate the differences between the convexities, and analysis of variance mixed model (type of evaluator and sex) to compare the 3 categories of evaluators, using the aligned rank transform technique. The correlation between the convexity angle and facial pleasantness was assessed by the Spearman correlation coefficient. Patients and lay people assigned higher pleasantness scores than orthodontists, with statistically significant differences for all evaluations, except for the frontal analysis of the convex group. The correlation coefficients regarding profile convexity and facial pleasantness were negative, indicating a tendency that more convex or concave facial profiles received lower pleasantness scores; however, this correlation was only significant in the evaluation of profile photographs by orthodontists. Patients with different profiles were scored with acceptable faces by lay people and patients themselves. Orthodontists' perceptions were different; they attributed lower pleasantness scores. Discrepant profiles affect facial esthetics in the profile view when judged by orthodontists.

Comparision of profile macro-estethic perception among orthodontists, dentistry students, orthodontic patients and surgical orthodontic patients.

BackgroundThe patient’s needs should guide the orthodontist in choosing the most appropriate therapy. The purpose of the present survey was to compare the esthetic perception of the facial profile by orthodontists (O), dentistry students (DS), orthodontic patients (OP) and surgical-orthodontic patients (SOP) and to evaluate the influence of gender, age and level of study. Material and MethodsA facial profile photograph of a young female was taken and twelve modified images were made, altering the position of the jaws in protrusion and in retrusion. Two hundred caucasian examiners, divided into four groups (O, DS, OP, SOP), were selected. Each examiner was asked to complete the questionnaire with an approval rating from 1 to 10. An ordinary least square OLS model was applied. Significant levels were set at P ≤ 0.05. ResultsAll examiners considered a straight profile or a slight retrusion of the maxilla as the most attractive profile. Slight discrepancies (up to 2 mm) in jaw protrusion were barely perceived by patients. Mandibular retrusion (2 and 4 mm) was one of the least appreciated condition by all examiners. Surgical-orthodontic patients assigned lower ratings compared to orthodontic patients. Female subjects assigned lower ratings than males. Patients with secondary school education assigned higher statistically significant values compared to other levels of study. The lowest values were attributed by the sample of age > = 17 years. ConclusionsThe choice of the most appropriate therapy is based not only on a correct diagnosis, but on the evaluation of esthetic and psychological aspects. Key words:Estethic, profile, orthodontic, surgical orthodontic patients.

Glabellar vertical line as a reference goal for anteroposterior maxillary position

ABSTRACTObjective: The aim of this study was to evaluate the use of glabellar vertical line (GVL) as the anteroposterior maxillary position goal. Methods: A cross-sectional study was conducted assessing 129 participants (20.21 ± 1.99 years): 67 women (20.16 ± 1.99 years), and 62 males (20.26 ± 2.06 years). The facial profile photographs were taken with a posed smile in natural head position. The linear distance from the most facial convexity of the upper central incisor (FA) to the goal anterior-limit line (GALL) and also from FA to GVL were measured and compared. Wilcoxon signed-ranks test was applied. To determine the correlation between the distances, Spearman’s correlation coefficient was used. Simple and multiple linear regression were also performed. Results: The GALL-GVL separation was 0.54 ± 1.14 mm (95%CI: 0.34-0.74). A strong correlation between FA-GALL and FA-GVL distances (Spearman’s rho=0.983 [95%CI: 0.976-0.988], p< 0.01) was identified. The FA-GVL distance explains almost all the total variation of FA-GALL (R2=95.84%, p< 0.01). The FA-GALL distance can be predicted by using the formula: FA-GALL=0.5+0.9*(FA-GVL). Conclusion: These findings suggest that GVL could be used as an easier-to-use treatment goal to determine the maxillary anteroposterior position, compared to GALL, to improve facial harmony profile goals in cases where the maxillary incisors are properly positioned anteroposteriorly.

Influence of overjet and overbite on soft tissue profile in mature adults: A cross-sectional population study.

The aim of this study was to explore the association of soft tissue profile and severity of overbite and overjet in a large adult population. The study population consisted of 1630 adults (age, 46years; 712 men, 919 women), all part of the Northern Finland Birth Cohort 1966. A clinical examination was performed on all subjects, including recording of overjet and overbite, and digital facial (frontal and profile) photographs were obtained. A multivariate regression model was developed to study the correlation of soft tissue measurements with overjet and overbite, considering the effect of sex. The regression model explained approximately 30% of the variability in overjet in our sample and approximately 22% of the variability in overbite. Overjet was related more significantly to upper and lower anteroposterior lip position, and upper and lower facial height (P<0.05). Overbite showed a stronger association with anteroposterior position of the lower lip, pogonion, and soft tissue B-point (P<0.05). Soft tissue profile was weakly to moderately correlated with severity of overjet and overbite in the entire sample. However, in subjects with negative overjet (mandibular prognathism), this association was highly significant.

Association of facial sagittal and vertical characteristics with facial aesthetics in the Northern Finland Birth Cohort 1966.

To explore the association of facial sagittal and vertical dimensions with aesthetic assessment by three panel groups. The study population comprised adult individuals from the Northern Finland Birth Cohort 1966 (NFBC1966). A clinical oral examination including digital facial photographs was performed. The study population was divided into subjects with the lowest and highest values in soft tissue measurements in lower anterior facial height percentage (LAFH%) (60 subjects) and antero-posterior jaw relationship [soft tissue A-point, nasion, and B-point (ANB) angle; 60 subjects] and a control group (30 subjects). Frontal and profile facial photographs were presented to three panel groups: five orthodontists, five dentists, and five laypersons, who evaluated the photographs using the visual analogue scale (VAS). This study showed significant differences in VAS mean scores between the panel groups. Curve estimation revealed a significant quadratic association between aesthetic VAS evaluation and ANB angle for all panel groups. The association between ANB angle and perceived facial attractiveness was highest among orthodontists (R2 = 0.276, P = 0.001 for males; R2 = 0.285, P = 0.001 for females). However, no statistically significant association was found between facial attractiveness and LAFH%. Facial sagittal dimensions appeared to influence facial aesthetics more than vertical dimensions in middle-aged adults. In their perception of facial aesthetics, orthodontists were more influenced by antero-posterior jaw relationships than dentists and laypersons. The overall perception of facial attractiveness related to facial dimensions appeared to differ between the panel groups in female and male faces.

Facial Anthropometric Evaluation of Unilateral Cleft Lip and Palate Patients: Infancy Through Adolescence.

Craniofacial anthropometric studies measure the differences in humans' craniofacial dimensions. The aim of this study was to determine facial anthropometric dimensions of newborn to 12-year-old girls with nonsyndromic unilateral cleft lip and palate (UCLP). In this cross-sectional analytical study, data was collected from 65 infant to 12-year old girls with UCLP. Digital frontal and profile facial photographs were transferred to a computer and desired anthropometric landmarks were traced on each image. Fifteen anthropometric parameters were measured which were the angles of facial, nasofacial, nasomental, Z, nasolabial, inclination of nasal base and labial fissure, nasal deviation, mentocervical, facial convexity and also ratios of nasal prominence relative to nasal height, middle to lower facial third, upper lip to lower lip height, columellar length relative to upper lip, and incisal show relative to incisal width. Pearson coefficient and linear regression were used for statistical analysis. Upper lip to lower lip height ratio and angles of nasofacial, nasolabial, and facial convexity decreased with the age of the patients. In contrast, nasomental angle and the ratios of columellar length to upper lip length, middle facial height to lower facial height, and incisal show relative to incisal width increased. Other parameters studied did not appear to have any significant correlation with age. In the girls with UCLP, various craniofacial dimensions have different growth rates with some parts growing slower than others. Some of the parameters studied were significantly correlated with age, thus growth-related curves and equations were obtained and presented.

Do laypeople, students and orthodontists have similar concepts regarding facial aesthetics?

Introduction: A harmonious profile is one of the objectives of the orthodontic planning. It is as important as to establish functional occlusion, since facial aesthetics is not only a concern for the orthodontist, but also for individuals who want to undergo orthodontic treatment. Objective: To analyze the facial profile considered pleasant for the white Brazilians, verify their common characteristics and, thus, guide the orthodontists in relation to facial aesthetics. Methods: Facial profile photographs from 100 adult white Brazilians wereanalyzed and evaluated by 15 lay people, 15 orthodontic students and 15 orthodontists. Tracings and cephalometric analysis were made from the best rated facial profiles, including linear and angular measurements and facial proportions. Results: Considerable similarities were found between the simulatedprofiles which were shaped according to each group’s outcome. These results can be attributed to the influence of the media that, somehow, contributed to homogenize the population’s standards related to facial esthetics. Conclusion: Despite the great similarity in relation to the aesthetic concepts showed by theevaluators, lay people seem to prefer more concave profiles when compared with the other groups.

Evaluation of profile aesthetics of skeletal Class Ⅱ patients with different treatment methods

To study the aesthetic appearance of skeletal Class Ⅱ patients with maxillary protrusion and mandibular retrusion treated with different methods. The facial profile photographs and lateral cephalometric radiographs of a Chinese woman suffering from skeletal Class Ⅱ with maxillary protrusion and mandibular retrusion was digitized.The digital images were modified to obtain orthodontic compensatory treatment, genioplasty with different advancement ranges and orthognathic treatment comprising 6 profiles by Photoshop software，orthodontic professionals and non-professionals were chosen to score the pictures. Post hoc tests were done with ANONA and the Student Keuls method to analyze the data Using SPSS22.0 software package. The profile with the highest score was the picture treated by orthognathic and orthodontic treatment. The profile with genioplasty (advancement of 4 mm) took the second place. When the advancement distance of genioplasty was 8 mm, the score was under the score of orthodontic compensatory treatment profile. Orthognathic-orthodontic treatment of skeletal Class Ⅱ is still the best treatment option to improve facial aesthetics. Genioplasty, as a adjuvant treatment, improves the appearance based on compensatory orthodontic treatment to some extent, but not comparable to orthognathic-orthodontic treatment.

Facial profile esthetics in operated children with bilateral cleft lip and palate.

ABSTRACTObjective: The aim of this study was to evaluate the facial profile esthetics of rehabilitated children with complete bilateral cleft lip and palate (BCLP), comparing the judgment of professionals related and not related to cleft rehabilitation and laypersons. Methods:Thirty children in the mixed dentition (24 male; 6 female) with a mean age of 7.8 years were evaluated using facial profile photographs by 25 examiners: 5 orthodontists and 5 plastic surgeons with experience in cleft care, 5 orthodontists and 5 plastic surgeons without experience in oral cleft rehabilitation and 5 graduated laymen. Their facial profiles were classified into esthetically unpleasant (grade 1 to 3), esthetically acceptable (grade 4 to 6), and esthetically pleasant (grade 7 to 9). Intraexaminer and interexaminer errors were evaluated using Spearman correlation coefficient and Kendall’s test, respectively. Inter-rater differences were analyzed using Friedman test and Student-Newman-Keuls test for multiple comparisons. Results: Orthodontists dealing with oral clefts rehabilitation considered the majority of the sample as esthetically pleasant. Plastic surgeons of the cleft team and laypersons classified most of the sample as esthetically acceptable. Most of the orthodontists and plastic surgeons not related to cleft care evaluated the facial profile as esthetically unpleasant. The structures associated to unpleasant profiles were the nose, the midface and the upper lip. Conclusions: The facial profile of children with BCLP was classified as esthetically acceptable by laypersons. Professionals related to cleft rehabilitation were more lenient and those not related to cleft care were stricter to facial esthetics than laypersons.

The influence of sagittal position of the mandible in facial attractiveness and social perception.

ABSTRACTOBJECTIVE: This study aims at comparing the perception of orthodontists, maxillofacial surgeons, visual artists and laypersons when evaluating the influence of sagittal position of the mandible - in lateral view - in facial attractiveness; at a job hiring; and in the perception of socioeconomic profile. METHODS: A black male, a white male, a black female and a white female with harmonic faces served as models to obtain a facial profile photograph. Each photograph was digitally manipulated to obtain seven facial profiles: an ideal, three simulating mandibular advancement and three simulating mandibular retrusion, producing 28 photographs. These photographs were evaluated through a questionnaire by orthodontists, maxillofacial surgeons, visual artists and laypersons.RESULTS: The anteroposterior positioning of the mandible exerted strong influence on the level of facial attractiveness, but few significant differences between the different groups of evaluators were observed (p < 0.05).CONCLUSIONS: The profiles pointed as the most attractive were also pointed as more favorable to be hired to a job position and pointed also as having the best socioeconomic condition.