Profile Attractiveness in Borderline Class III Surgical/Orthodontic Cases

Introduction: This study evaluated differences between laypersons and orthodontists in rating facial attractiveness in borderline class III surgical/orthodontic cases. The purpose was to determine whether orthognathic surgery or camouflage is a better alternative for observable esthetic improvement in borderline Class III surgical/orthodontic patients. This study will aid the orthodontist in recommending treatment options to enhance profile attractiveness of borderline Class III surgical/orthodontic patients.;Materials and Methods: Thirty profile images of treated borderline class III surgical/ orthodontic cases were selected. Fifteen of the profile images were of cases that had been treated by orthodontics alone, and fifteen images were of cases that had been treated by a combination of orthodontics and surgery. Profile images were modified in Photoshop to mask the face and eyes.;Patients selected for this study: 1) were 16-25 years of age, 2) had a half-step or more Class III molar relationship, 3) had a pretreatment ANB greater than -4° and less than 1°, and 4) had a Wits appraisal less than -1.5mm and greater than -4mm. Patients with craniofacial anomalies and skin conditions were excluded from this study. Two groups of thirty raters evaluated the profile images for facial attractiveness by marking a 10 cm visual analog scale. One group of raters was composed of thirty orthodontists and the other group was composed of thirty laypersons. In order to evaluate intra-individual reproducibility of the measuring system, ten duplicate sets of profile images were added to the series.;Results: The repeated measures ANOVA F-test results found a statistically significant difference between facial attractiveness scores (p = 0.000), with higher ratings by orthodontists. There was no statistically significant difference between treatment type (p = 0.278). Intraclass correlation results indicate excellent reliability. The ICC was 0.774 (95% CI; 0.733, 0.808). The level of significance was set at &agr; = .05.;Conclusions: In evaluating facial attractiveness of borderline Class III surgical/ orthodontic cases, laypersons are more critical than orthodontists. Furthermore, surgery or camouflage treatment provides similar esthetic improvement in profile attractiveness in borderline class III surgical/orthodontic patients.