ORIGINAL ARTICLE   

Minerva Stomatologica 2018 June;67(3):77-85

DOI: 10.23736/S0026-4970.18.04111-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Facial attractiveness of skeletal class I and class II malocclusion as perceived by laypeople, patients and clinicians

Michela PACE ¹, Iacopo CIOFFI ², Vincenzo D’ANTÒ ¹, Alessandra VALLETTA ³, Rosa VALLETTA ¹, Massimo AMATO ⁴ ✉

¹ Department of Neuroscience and Reproductive and Odontostomatologic Sciences, Faculty of Medicine and Surgery, School of Orthodontics, Federico II University, Naples, Italy; ² Center for the Study of Pain, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; ³ Department of Neuroscience and Reproductive and Odontostomatologic Sciences, Faculty of Medicine and Surgery, Federico II University, Naples, Italy; ⁴ Department of Medicine, Surgery and Dentistry, Faculty of Medicine and Surgery, University of Salerno, Fisciano, Salerno, Italy

BACKGROUND: Physical attractiveness is dependent on facial appearance. The facial profile plays a crucial role in facial attractiveness and can be improved with orthodontic treatment. The aesthetic assessment of facial appearance may be influenced by the cultural background and education of the assessor and dependent upon the experience level of dental professionals. This study aimed to evaluate how the sagittal jaw relationship in Class I and Class II individuals affects facial attractiveness, and whether the assessor’s professional education and background affect the perception of facial attractiveness.
METHODS: Facial silhouettes simulating mandibular retrusion, maxillary protrusion, mandibular retrusion combined with maxillary protrusion, bimaxillary protrusion and severe bimaxillary protrusion in class I and class II patients were assessed by five groups of people with different backgrounds and education levels (i.e., 23 expert orthodontists, 21 orthodontists, 15 maxillofacial surgeons, 19 orthodontic patients and 28 laypeople).
RESULTS: Straight facial profiles were judged to be more attractive than convex profiles due to severe mandibular retrusion and to mandibular retrusion combined with maxillary protrusion (all P<0.05). Convex profiles due to a slightly retruded position of the mandible were judged less attractive by clinicians than by patients and laypeople (all P<0.05).
CONCLUSIONS: Convex facial profiles are less attractive than Class I profiles. The assessment of facial attractiveness is dependent on the assessor’s education and background. Laypeople and patients are considerably less sensitive to abnormal sagittal jaw relationships than orthodontists.

KEY WORDS: Esthetics - Facial asymmetry - Malocclusion, angle class I - Malocclusion, angle class II