Attractiveness assessment by orthodontists and laypeople judging female profile modifications of Class 11 Division 1 malocclusion

Introduction: The objective of this study was to evaluate the differences in preference between orthodontists and laypeople, judging soft tissue digital alterations of a Class II Division 1 profile of a female patient with mandib- ular retrognathia, produced by simulated camouflage and mandibular advancement therapy. Methods: The profile image of a White woman with a Class II Division 1 mandibular retrognathic profile was digitally modified to produce 7 pictures: 1 baseline, 3 stepwise increase in the nasolabial angle of 113 degrees, 121 degrees, and 129 degrees, and 3 stepwise increase in chin-neck length of 51 mm, 54 mm, and 57 mm. Forty-four orthodontists and 162 laypeople assessed these 7 images. Results: The untreated baseline profile was found to be least attractive for both orthodontists and laypeople, with orthodontists scoring significantly lower than laypeople. The profiles representing mandibular advancement therapy were judged significantly better by both groups than camouflage therapy. Orthodontists preferred straighter profiles than laypeople, giving the highest-ranking to a chin-neck length of 57 mm, whereas laypeople gave the highest rank to a chin-neck length of 54 mm. Conclusions: Orthodontists prefer straighter profiles and gave a lower ranking to the untreated Class II Division 1 female profile compared with laypeople. Orthodontists and laypeople favor mandibular advancement therapy over camouflage therapy. However, both groups seem to prefer the effect of both treatment modalities over the untreated baseline Class II Division 1 profile.