Perception Of Facial Esthetics Research Articles

Evaluation of the Influence of Nasolabial Angle, Upper Sulcus Depth, and Nasal Tip Protrusion in the Perception of Facial Attractiveness

ABSTRACT Objective: To evaluate the influence of variations in the upper sulcus depth, nasal tip protrusion, and nasolabial angle on the esthetic perception of profiles. Design: A web-based survey study and was conducted in the Department of Orthodontics and Dentofacial Orthopaedics. This survey was conducted for a period of 10 months and included orthodontists practicing in India. Methods: This study included lateral cephalograms of the most esthetic profiles from a set of 30 profiles that were within Holdaways norms; the most esthetic profile was determined by a panel of two orthodontists and two general dentists. The most esthetic profile photograph will be transferred to a computer in Corel software. The outline of the profile will remain the same, with the inner aspect converted into a dark area (black); now, the profile is completely converted into facial silhouettes. This black facial silhouette is presented to avoid any distractions and bias. There will be a total of 27 silhouettes by various combinations of increased, decreased, and normal values for nasolabial angle, upper sulcus depth, and nasal tip protrusions. Results: Both the orthodontist and layman chose the most favored profile as a normal profile having a normal nasal tip, normal nasolabial angle, and normal upper sulcus depth, whereas among dentists, 50% chose the most favored profile in which the nasolabial angle was normal but the nasal tip and upper labial sulcus were decreased. When it comes to the least favored profiles, opinions varied between orthodontists, dentists, and laymen. Conclusion: The perception of facial esthetics has always been and still is varied between the layman, the dentist, and the orthodontists. Profiles with normal to sharp noses with normal and increased nasolabial angles were considered more attractive than the others. Profiles with fuller upper labial sulci were considered least attractive with other parameters changing.

The perception of lip aesthetics in the context of facial proportions—An eye‐tracking‐based analysis

AbstractBackgroundMinimally invasive lip volumizing and contouring soft tissue filler procedures are frequently requested by both female and male aesthetic patients. Guidance on how to achieve the most beautiful outcome is inconsistent.ObjectiveTo investigate what the most beautiful proportions are in relation to vermillion thickness, the distance of the upper and lower lip in relation to nose and chin, and relation to the bigonial distance.MethodsThis study included a total of n = 101 volunteers (52 females, 49 males, 100% Caucasian) who inspected frontal images of modified facial proportions and answered a related questionnaire showcasing the same images. Image presentation followed a randomized sequence both for the eye tracking and for the survey component of this study but was equal for all observers.ResultsThe most attractive vertical position of lips was the 1:2 ratio in which the distance between lips and chin is double the length as the distance between lips and nose. For the ratio between the width of the lips and the bigonial distance, it was the 1:2.5 ratio, whereas for the thickness of the upper lip vermilion in relation to the upper lip ergotrid it was the 1:3/1:2 (male/female) ratio and for the lower lip vermilion and lower lip ergotrid it was the 1:4 ratio for both genders.ConclusionThe results of this eye tracking and survey‐based investigation revealed that instead of one single universal ratio, multiple facial proportions exist that are perceived as most attractive/masculine/feminine. Regarding the perception of facial aesthetics, it appears there is a distinction between attractiveness and masculinity/femininity: the most attractive male/female face is not necessarily the most masculine or feminine.

Perception of facial esthetics in young North Indian population.

INTRODUCTION:A person's ability to recognize a beautiful face is innate, but translating this into defined treatment goals is a challenge for clinicians.AIM:To determine if faces considered esthetic and pleasing in the young North Indian population (both males and females) exhibit similar cephalometric measurements as used for ideal treatment and successful results.MATERIALS AND METHOD:A panel of five judges evaluated a set of one frontal, one frontal during smiling, and one profile extra-oral photograph of 160 students (80 females and 80 males) on a five-point attractiveness scale. For each photographic set, the mean and final scores were calculated. Once the sample was assessed, 60 subjects (30 females and 30 males) with the highest final facial aesthetic score were selected and cephalometric analysis was performed. The obtained data were subjected to statistical analysis using SPSS 20 software.RESULTS:Both males and females with class I skeletal jaw bases were found to be attractive. The females with short faces; mild facial convexity and lower lip closer to the esthetic line were found to be attractive. The males with a prominent chin, straight profile, prominent nose, increased upper lip thickness, upper lip length, and lower lip length were found to be attractive.CONCLUSION:The faces considered attractive in this study fulfilled most of the cephalometric norms commonly used for the diagnosis and treatment planning except for a few inconsistencies which may be attributed to the gender and demographic origin.

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

Background: The perception of facial aesthetics is a complex topic due to its subjective nature and it can be influenced by several factors. The purpose of this study was to compare the perception of general dentists, orthodontists, maxillofacial surgeons, and lay people by evaluating facial aesthetics in skeletal class III patients, especially for maxillary sagittal position. Methods: A survey consisting of three sets of pre-treatment photographs of four dysmorphic patients was used. The questionnaire was submitted to a total of 200 participants divided into the following four subgroups: general dentists, orthodontists, maxillofacial surgeons, and lay people. Their opinion on facial disharmony, sagittal position of the jaws, asymmetry of the chin, projection of the cheekbone area, and lip aesthetics was recorded. Results: Significant differences were found between experts and non-experts in the perception of the maxillary position, asymmetry of the chin and zygomatic area (p < 0.01). No statistically significant differences were found among the groups in the perception of mandibular position and lip aesthetics. Conclusion: The respondents with a medical or dental background perceived the presence of maxillary retrusion more than others. Only orthodontists and maxillofacial surgeons have recognized an alteration of the middle facial third as a greater component of skeletal class III malocclusion.

Strategic management of the minor-form and microform cleft lip: A long-term outcome assessment

The treatment of the lesser form cleft lip deformity (i.e., minor-form, microform, and mini-microform) is challenging to achieve patient satisfaction. There are no studies investigating how treatment outcomes balance patients' expectations and satisfaction with surgical or non-surgical care relative to the initial nasolabial findings. Based on Mulliken's classification, consecutive records of patients with the lesser-form cleft lip from 1990 to 2015 were selected for analysis. Demographics, management, and revisions were reviewed. A panel analysis was performed based on the ratings from both professionals and non-professionals using patients' photographs. FACE-Q questionnaires were used to compare patient/parent-reported satisfaction to the normal controls. A total of 135 patients were included. All of the minor-form (23/23), 89% (58/65) of the microform, and 62% (29/47) of the mini-microform patients underwent surgery. Fifty-two percent (15/29) of the mini-microform patients, who underwent surgery, showed no significant improvement. Post-operative upper lip scars and remaining nasal asymmetry were the most common concerns in the treatment group. However, the FACE-Q results showed that patients experienced a statistically significant improvement in their overall facial appearance and social function in their respective groups. This study showed that differences exist in the perception of facial esthetics between the surgeon and the patient/parent. To achieve optimal individual treatment outcome and patient satisfaction, an awareness of the differences and treatment selection for patients are critical in surgical planning. This understanding and an open detailed discussion of overall long-term outcomes help in the management of patient expectations.

Relationship of chronic rhinosinusitis with dental malocclusion: a prospective study

<p class="abstract"><strong>Background:</strong> The purpose of this study was to find the effect of chronic rhinosinusitis on dental malocclusion. A malocclusion is defined as an irregularity of the teeth or a mal relationship of the dental arches beyond the range of what is accepted as normal. Malocclusion may not be life-threatening, but it is an important public health issue as it compromises the health of oral tissues and also can lead to psychological and social problems. There are numerous studies in the literature about prevalence of the dental malocclusion but there is no study regarding association of CRS and malocclusion. Several factors related to malocclusion, such as anterior crowding, midline malalignment, and facial asymmetry, have strong effects on the perception of facial aesthetics, which influence the psychological development and in turn, influence social acceptance and self‑perception.</p><p class="abstract"><strong>Methods:</strong> This was a prospective cross-sectional observational study was conducted from September 2015 to August 2017 and 57 patients with diagnosis of having chronic sinusitis, were evaluated for dental occlusion. Malocclusion is then classified by angle’s classification. </p><p class="abstract"><strong>Results:</strong> Most patients of chronic rhinosinusitis had dental malocclusion in grade II, followed by grade I, then grade III.</p><p class="abstract"><strong>Conclusions:</strong> While treating the patients of CRS one must keep in mind that he may have class II malocclusion which may cause gum disease, poor oral hygiene, impaired speech, mastication and aesthetics of face and need orthodontics management as well.</p>

Effects of different nose types on class II treatments for female patients

BackgroundThe aim of this study was to evaluate the effect of different nose types on the perception of facial aesthetics following camouflage treatment and orthognathic surgery for skeletal class II female patients.MethodsA pre-treatment profile photograph of a skeletal class II adult patient was selected from the department archive. Two constructed photographs were created to represent orthognathic surgery and camouflage treatments with the aid of computer software. A total of 18 constructed images was composed using three profiles (pre-treatment, post-camouflage, and post-orthognathic surgery) and six nose types. These photographs were shown to the three groups (orthodontists, plastic surgeons, and lay people), and they were asked to assign an attractiveness score to each photo ranging from 0 to 100, with 0 indicating the least attractive and 100 indicating the most attractive.ResultsFor the convex nose profiles, anterior movement of the mandible obtained by orthognathic surgery did not result in a significant change in the scores given by the lay people. When surgical or camouflage treatment was not implemented and, instead, just rhinoplasty was performed for these profiles, there was a significant increase in the aesthetic scores given by all groups. For the straight nose profiles, orthognathic surgery increased the attractiveness scores given by all groups. Furthermore, for all the profiles, extraction treatment did not affect the aesthetic scores given by any of the groups (P > 0.05).ConclusionsThe lay people perceived that having a convex-bridged nose was a bigger problem than having a retrognathic profile. Overall, in terms of skeletal and dental orthodontic treatments, nose shape should be considered during the treatment planning process.

Lip Morphology and Aesthetics: Study Review and Prospects in Plastic Surgery.

The lip profile plays an important role in the perception of facial aesthetics; lip morphology and aesthetics research is receiving increasing attention. The advancement of research tools such as three-dimensional imaging technology has led to the clarification of lip morphologic and aesthetic characteristics. After studies of lip characteristics according to gender, ethnicity and age provided basic data, studies on lip aesthetics have been conducted by scholars worldwide. These studies could provide a basic theory to support diagnosis and treatment options, as well as the basis for evaluative criteria for precise treatment and technical improvements. According to the conclusions of the above studies, new ideas for cosmetic surgery design, including lip, perioral and labial-facial relationships, have been discovered.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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.

Esthetic preferences of orthodontists, oral surgeons, and laypersons for Persian facial profiles.

The patient's perception of facial esthetics is not necessarily consistent with that of the practitioner. The aim of this study was to compare the perceptions of Persian orthodontists, oral surgeons, and laypersons with regard to facial profile attractiveness and the most favorable mandibular position. Software (Dolphin Imaging and Management Systems, Chatsworth, Calif) was used to alter the mandibular position depicted on profile photographs of a young man and a young woman. Nine construction profile photos were produced with incremental changes of the G'-Sn-Pg' angle at 2° intervals (6° to 22°). Thirty-two orthodontists, 32 maxillofacial surgeons, and 32 laypersons were asked to score all 18 profiles on a 1-to-10 visual analog scale. They also evaluated whether each profile needed orthognathic surgery for improvement of facial esthetics. Actual agreement and intraclass correlation coefficient tests were used to assess reliability. The data were analyzed using 2-way repeated measures analysis of variance and Wilcoxon signed-rank tests. The intraparticipant reliability was acceptable (intraclass correlation coefficient>72%; actual agreement,>79%). The sex of the participants was not a significant factor influencing the scores, although the sex of the models was a discriminating factor for the most acceptable mandibular horizontal position. The scores given by the 3 groups were different, especially for the female model. The orthodontists had similar opinions and preferred a slightly more protrusive mandible (G'-Sn-Pg', 12°-14°). Laypersons' scores were the most inconsistent, and they generally preferred a retrusive profile (G'-Sn-Pg', 14°-18°). There was no significant correlation with regard to the necessity of orthognathic surgery for G'-Sn-Pg' angles over 20° in men and below 8° in women. Although the laypersons' perceptions were slightly different from those of the clinicians, most participants preferred a more protrusive mandible for male models compared with female models.

Clinician, dental student, and orthognathic patient perception of black-and-white silhouette lateral profile dimensions of ideal chin position in a Chinese population

This study aimed to investigate differences in the influence of chin prominence and length on perception of facial aesthetics by Chinese dental clinicians, orthognathic patients, and dental students. Male and female silhouette lateral profiles were modified to obtain 28 facial profiles by altering chin prominence and length by 3 mm in the sagittal and vertical planes. Images were rated by 70 clinicians, 30 orthognathic patients, and 100 dental students on a 7-point Likert scale. Perceived attractiveness was highest when the male chin prominence (MCP) was -3 mm to 3 mm and the female chin prominence (FCP) was 3 mm. In contrast, male chin length (MCL) of 0 to 3 mm and female chin length (FCL) of 0 mm were considered the most attractive. In the sagittal and vertical profiles, MCP (-9 mm), FCP (-9 mm), FCL (-9 mm), and MCL (-9 mm) were ranked least attractive. The overall aesthetic opinions of orthognathic patients, clinicians, and dental students are similar. The greater the retrusion or protrusion of the chin and the shorter or longer the chin length, the lower were the rates of facial aesthetics and the greater were the desire for surgery.

Influencia de seis maloclusiones en la percepción de inteligencia, atractivo físico y habilidades interpersonales

Se ha sugerido que el comportamiento social es marcadamente determinado por la percepción de la estética facial. Dentro de los rasgos faciales, la apariencia dental es un factor muy importante dentro de las interacciones sociales; las maloclusiones no solamente reducen el atractivo facial sino que también suponen un mayor riesgo de desventajas sicológicas y reacciones sociales adversas que pudieran afectar al bienestar de los pacientes. El objetivo del presente estudio fue determinar la influencia de diferentes maloclusiones en la percepción de las personas en cuanto a la inteligencia, atractivo físico, y habilidades interpersonales, mediante la evaluación de fotografías de un sujeto masculino y otro femenino que presentaban: mordida abierta anterior, mordida profunda, mordida cruzada anterior, resalte horizontal excesivo, apiñamiento anterior y diastemas interincisales. Se realizaron 500 encuestas a estudiantes de la Universidad San Francisco de Quito, en las que los observadores evaluaron dichos rasgos mediante la observación de fotografías que habían sido manipuladas digitalmente para exponer una oclusión normal y cada una de las seis maloclusiones, usando una escala de 5 puntos de Likert. Las calificaciones de dichos rasgos difirieron significativamente según la maloclusión (P<.000). Ambos sujetos con oclusión normal recibieron calificaciones más altas para las tres características, mientras que los sujetos con mordida cruzada anterior recibieron las calificaciones más bajas. No se encontró una diferencia estadísticamente significativa entre la percepción de observadores masculinos y femeninos. En la muestra estudiada el modelo masculino recibió calificaciones más bajas en los tres rasgos evaluados para cada maloclusión. Los sujetos con oclusión normal fueron calificados más positivamente mientras que la mordida cruzada anterior fue la maloclusión que mayor impacto negativo tiene sobre estas características.

Orthodontic treatment need for adolescents in the Campania region: the malocclusion impact on self-concept.

BackgroundDental malocclusions can be considered not only as an oral health problem, because they are linked to quality of life perception. Many factors related to malocclusion have strong influences on the perception of facial esthetics (eg, anterior tooth alignment, tooth shape and position, lip thickness, symmetric gingival or tooth contour, lip profile, and overjet). Many reports have shown that the perception of facial esthetics can influence psychological development from early childhood to adulthood. The aim of this study is to investigate the effect of dental malocclusion on self-esteem in a sample of adolescents.Materials and methodsThe study population was composed of 516 orthodontically untreated subjects (256 males) mean ages 13.75±1.977 years recruited from schools in the Campania region of Italy between January 2011 and July 2011. To evaluate the self-esteem grade in our population, all subjects filled out the Multidimensional Self Concept Scale questionnaire and attended an orthodontic clinical evaluation to estimate dental occlusal aspects.ResultsPearson’s analysis shows the relationship in our sample between some occlusal characteristics (crossbite and dental crowding) and aspects of self-concept evaluation (social, competence, academic, physical, and global score) of the Multidimensional Self Concept Scale questionnaire. Moreover, logistic regression analysis shows the potential role of dental crowding (odds ratio 5.359; 95% confidence interval 3.492–8.225) and crossbite (odds ratio 6.153; 95% confidence interval 3.545–10.678) as risk factors for development of global self-concept score abnormalities.ConclusionOur findings confirm the relationship between psychosocial well-being, self-esteem, and dental malocclusion among adolescents.

The perception of facial aesthetics in a young Spanish population

Improved facial aesthetics is one aim of orthodontic treatment. This study was designed to determine if the faces considered more beautiful in a young population exhibit the same parameters used by orthodontists to assess successful results. A panel of 34 laypeople (30 females and 4 males) evaluated a set containing one frontal, one frontal during smiling, and one profile photograph of 89 students (77 females and 12 males) on a 5-point attractiveness scale, in relation to a set of reference photographs. For each photographic set, the mean and final scores were calculated. Once the sample was established, 11 subjects (9 females and 2 males) with the highest final facial aesthetic score were selected and cephalometric analysis was performed. All cephalometric measurements were within the norm for the total sample. When the sample was divided by gender, Wilcoxon's W non-parametric test showed significant differences between the male and female photographs; while females tended to a Class II malocclusion, with the mandible slightly retrusive to the maxilla, males tended to a Class III and showed a straighter profile with a prominent chin; the face height ratio was higher in males. There were no significant differences between genders for lower lip to E plane. The findings show that the faces considered more attractive fulfilled the cephalometric and facial norms.

LETTERS FROM OUR READERSTo: Editor, The Angle Orthodontist Re: Perception of Facial Esthetics: A Comparison of Similar Class II Cases Treated with Attempted Growth Modification or Later Orthognathic Surgery. Angle Orthod. 2003;73:365–373.

LETTERS FROM OUR READERSTo: Editor, The Angle Orthodontist Re: Perception of Facial Esthetics: A Comparison of Similar Class II Cases Treated with Attempted Growth Modification or Later Orthognathic Surgery. Angle Orthod. 2003;73:365–373.

The Role of Cosmetic Dentistry in Facial Rejuvenation

Introduction: Enhancement of facial beauty is one of the primary goals of patients seeking facial rejuvenation treatment. The lower third of the face, which is affected by the dentoalveolar complex, has a major impact on the perception of facial esthetics. This article aims to educate cosmetic surgeons about the impact that cosmetic dentistry can have on creating facial harmony and esthetics. Methods: A simple method of bioesthetic dental evaluation of the patient and common cosmetic dental procedures are discussed. Discussion: The importance of a multidisciplinary and multimodality approach by both the cosmetic surgeon and the cosmetic dentist toward creating a more complete, harmonious facial esthetic is emphasized. Results: As demonstrated by figures representative of typical cases, a combined cosmetic surgery and cosmetic dental approach yields excellent esthetic results. Conclusion: The incorporation of fundamental principles of proper smile design and dental esthetics into a facial enhancement treatment plan can achieve excellent results on a consistent basis.

Perspective of facial esthetics in dental treatment planning

Enhancement of facial beauty is one of the primary elective goals of patients seeking dental care. The lower one third of the face has a major impact on the perception of facial esthetics. Frequently improvements in natural beauty can be expected to follow restoration of ideal relationships between the denture and the facial soft tissues. By improving deficient facial proportion and integumental form, surgeons, orthodontists, and restorative dentists have the unique opportunity to address these esthetic needs. Comprehensive evaluation that relates the facial soft tissues to underlying skeletal form provides this possibility. Fundamental relationships exist that allow correlation of deficiencies in facial form to existing dentoalveolar anatomy. Classical evaluation of mounted casts and occlusal analysis does not offer this insight.

The perception of facial esthetics in patients requiring orthodontics and orthognathic surgery: Michael A. CampbellUniversity of Alabama School of Dentistry, Birmingham, 1986

The perception of facial esthetics in patients requiring orthodontics and orthognathic surgery: Michael A. CampbellUniversity of Alabama School of Dentistry, Birmingham, 1986