| Purpose. To determine whether profile improvement following mandibular advancement surgery was correlated with improved frontal facial esthetics, the perspective from which patients most often view their face. Methods. The sample consisted of 54 patients treated with combined orthodontics and mandibular advancement. Groups of 81 orthodontists, 16 oral surgeons and 20 lay people evaluators rated randomly displayed pre and posttreatment frontal and profile photographs. Results. On average after surgery, pogonion moved forward 4.2mm (S.D. 2.4), lower anterior face height increased 5.6mm (S.D. 2.7) and ANB angle decreased 2.6° (S.D. 2.8). Wilcoxon rank sums tests revealed a significant difference in change in frontal Likert score for subjects with pretreatment ANB ≥6°, as compared to those with ANB <6°. For profile esthetic rating, the threshold for significant difference in Likert score was initial ANB ≥ 7°. Repeated Measures ANOVA and Chi-squared analysis showed evaluator group differences for preference for posttreatment faces. Conclusions. Profile and frontal esthetic changes were positively correlated. An initial ANB of 7° was the threshold for greater profile enhancement. Lay evaluators rated those with a pretreatment ANB <6° equally as attractive prior to surgery as after, when viewed from the front. Changes in vertical length from lower lip to chin were correlated with frontal and profile esthetic rating for all three evaluator groups. |
