Effects of malocclusions on facial attractiveness and their correlations with the divine proportion

  • Seden AkanEmail author
  • Ayse Gul Torgut
  • Hüsamettin Oktay
Original Article



The aim of this study was to evaluate the effects of malocclusions on facial attractiveness and to determine if it was correlated with the divine proportion.


Standard frontal facial photos were taken from 335 subjects in natural head position. Facial attractiveness of the subjects was evaluated by 10 dental students using a 10-point visual analog scale (VAS). All of the evaluations were arranged in order, and 30 attractive subjects with the highest score and 30 nonattractive subjects having the lowest score were chosen. On the frontal photos of these subjects, 13 landmarks were determined and 12 ratios were measured. Two way ANOVA was used to determine the effects of malocclusions on facial attractiveness, Student’s t test was used to compare the facial proportions of the attractive and nonattractive subjects, and one sample t test was used to define the relationships between the divine proportion and facial ratios.


No statistically significant difference was found between malocclusion groups in terms of facial attractiveness. Of the 12 facial ratios, significant differences were found between attractive and nonattractive subjects regarding trichion-menton/nasion-menton, subnasale-menton/stomion-menton, nasion-subnasale/stomion-menton, nasion-subnasale/nasal width, and trichion-menton/right-left frontotemporale ratios. All of the ratios except nasion-subnasale/stomion-menton in the attractive group and subnasale-menton/stomion-menton and nasion-menton/nasion-trichion in the nonattractive group were found to be different from the divine proportion.


Sagittal skeletal malocclusions evaluated by ANB angle are not effective on facial attractiveness. Facial ratios used in this study have little effect on attractiveness, and are different from the divine proportion.


Facial proportion Divine proportion Esthetic perception Malocclusions Anthropometry 

Auswirkungen von Malokklusionen auf die Gesichtsattraktivität und Korrelationen mit den Proportionen des Goldenen Schnitts



Evaluiert werden sollten die Auswirkungen von Malokklusionen auf die Gesichtsattraktivität. Ferner sollte bestimmt werden, ob Korrelationen mit dem Goldenen Schnitt bestehen.


Von 335 Individuen wurden Standardportraitfotos in natürlicher Kopfposition angefertigt. Die Gesichtsattraktivität wurde von 10 Zahnmedizinstudenten mit einer 10-Punkte-VAS (visuelle Analogskala) bewertet und in eine Rangfolge geordnet. Die 30 attraktivsten Individuen mit den höchsten und die 30 nichtattraktiven Individuen mit den niedrigsten Scores wurden in die Studie aufgenommen. Auf den en-face Aufnahmen dieser Teilnehmenden wurden 13 Referenzpunkte und 12 Verhältniswerte bestimmt. Um die Effekte von Malokklusionen auf die Gesichtsattraktivität zu evaluieren, wurde eine Varianzanalyse (ANOVA) durchgeführt, zum Vergleich von attraktiven und nichtattraktiven Individuen der Student-t-Test und zur Definition der Beziehungen zwischen Goldenem Schnitt und fazialen Verhältniswerten der Einstichproben-t-Test.


Zwischen den Gruppen mit Malokklusionen fand sich kein statistisch signifikanter Unterschied hinsichtlich der Gesichtsattraktivität. Signifikante Unterschiede zwischen den attraktiven und nichtattraktiven Teilnehmenden wurden bei den folgenden der 12 Verhältnisse in den Gesichtsproportionen ermittelt: Trichion-Menton/Nasion-Menton, Subnasale-Menton/Stomion-Menton, Nasion-Subnasale/Stomion-Menton, Nasion-Subnasale/Nasenbreite und Trichion-Menton/rechts-linke frontotemporale Verhältnisse. Alle Verhältniswerte – mit Ausnahme von Nasion-Subnasale/Stomion-Menton in der Gruppe mit attraktiven und Subnasale-Menton/Stomion-Menton und Nasion-Menton/Nasion-Trichion in der Gruppe mit nichtattraktiven Teilnehmenden – erwiesen sich als nicht den Proportionen des Goldenen Schnitts entsprechend.


Sagittale skelettale Malokklusionen, evaluiert mittels ANB-Winkel, haben keine Auswirkung auf die Gesichtsattraktivität. Die in dieser Studie untersuchten fazialen Verhältnisse stehen nicht im Zusammenhang mit Attraktivität und unterscheiden sich von den Proportionen des Goldenen Schnitts.


Gesichtsproportionen Goldener Schnitt Ästhetische Wahnehmung Malokklusionen Anthropometrie 


Compliance with ethical guidelines

Conflict of interest

S. Akan, A.G. Torgut, and H. Oktay declare that they have no conflicting interests.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the Istanbul Medipol University institutional research committee (with the number of 108400987-96-85) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


This study was not funded by any company or commitee.


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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • Seden Akan
    • 1
    Email author
  • Ayse Gul Torgut
    • 1
  • Hüsamettin Oktay
    • 1
  1. 1.Department of Orthodontics, School of DentistryIstanbul Medipol UniversityIstanbulTurkey

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