Facial profile esthetics and its correlation with cephalometric measurements in Class II patients before and after functional orthodontic treatment: perception of orthodontists and laypersons

Orthodontists heavily rely on cephalometric measurements to evaluate the esthetic outcomes of orthodontic treatments, while patients’ assessments of profile attractiveness are influenced by their personal esthetic preferences. The objective of this study was to compare facial esthetic evaluations between orthodontists and laypersons, examine the correlation between cephalometric measurements and assessments of facial attractiveness, and identify the cephalometric measurements that are most associated with profile attractiveness in teenage Class II patients. This study included 28 patients (17 boys and 11 girls, mean age of 11.83 ± 1.48 years) who fulfilled the inclusion criteria and were treated with activator appliances. An experienced orthodontist conducted objective cephalometric analyses before and after the treatment. The standard profiles of patients, pre- and post-treatment, were independently evaluated by 10 orthodontists and 20 laypersons. Pearson correlation analysis was used to analyze the relationships between objective cephalometric values and subjective facial esthetic ratings. The results indicated that laypersons generally assigned lower ratings to facial attractiveness compared to orthodontists. Significant differences in evaluations between orthodontists and laypersons were noted in the ratings of the upper lip position before treatment and the ratings of overall attractiveness, lower lip position and chin position after treatment. In addition, there were substantial correlations between objective measurements and the subjective scores provided by orthodontists. In contrast, the esthetic evaluations by laypersons correlated with only a limited set of objective measurements. The positions of the upper and lower incisors, the relationship of the upper and lower lip to E-line, and the Mentocervical Angle showed significant correlations with esthetic scores. In conclusion, the study reveals that laypersons were more critical of facial profiles compared to orthodontists. Notably, the positions of the upper and lower incisors, the E-line and the Mentocervical Angle had a significant impact on facial esthetics, highlighting their importance in evaluating orthodontic outcomes.

Class II malocclusion; Removable functional appliance; Facial esthetics; Cephalometrics

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