Advertisement

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

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

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Facial proportion Divine proportion Esthetic perception Malocclusions Anthropometry 

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

Zusammenfassung

Ziel

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

Methoden

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.

Ergebnisse

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.

Schlussfolgerungen

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.

Schlüsselwörter

Gesichtsproportionen Goldener Schnitt Ästhetische Wahnehmung Malokklusionen Anthropometrie 

Notes

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.

Funding

This study was not funded by any company or commitee.

References

  1. 1.
    Angle EH (1899) Classification of malocclusion. Dental Cosmos 41:248–264Google Scholar
  2. 2.
    Arnett GW, Bergman RT (1993) Facial keys to orthodontic diagnosis and treatment planning. Part I. Am J Orthod Dentofacial Orthop 103:299–312. doi: 10.1016/0889-5406(93)70010-L CrossRefPubMedGoogle Scholar
  3. 3.
    Baker BW, Woods MG (2001) The role of the divine proportion in the esthetic improvement of patients undergoing combined orthodontic/orthognathic surgical treatment. The Int J Adult Orthodon Orthognath Surg 16:108–120PubMedGoogle Scholar
  4. 4.
    Ben-Bassat Y, Dinte A, Brin I, Koyoumdjisky-Kaye E (1992) Cephalometric pattern of Jewish East European adolescents with clinically acceptable occlusion. Am J Orthod Dentofacial Orthop 102:443–448CrossRefPubMedGoogle Scholar
  5. 5.
    Bishara SE, Abdalla EM, Hoppens BJ (1990) Cephalometric comparisons of dentofacial parameters between Egyptian and North American adolescents. Am J Orthod Dentofacial Orthop 97:413–421. doi: 10.1016/0889-5406(90)70113-Q CrossRefPubMedGoogle Scholar
  6. 6.
    De Smit A, Dermaut L (1984) Soft-tissue profile preference. Am J Orthod 86:67–73CrossRefPubMedGoogle Scholar
  7. 7.
    Ferrario VF, Sforza C, Miani A, Tartaglia G (1993) Craniofacial morphometry by photographic evaluations. Am J Orthod Dentofacial Orthop 103:327–337. doi: 10.1016/0889-5406(93)70013-E CrossRefPubMedGoogle Scholar
  8. 8.
    Ferrario VF, Sforza C, Poggio CE, Tartaglia G (1995) Facial morphometry of television actresses compared with normal women. J Oral Maxillofac Surg 53:1008–1014 (discussion 1014–1005) CrossRefPubMedGoogle Scholar
  9. 9.
    Herzberg BL (1952) Facial esthetics in relation to orthodontic treatment. Angel Orthod 22:9Google Scholar
  10. 10.
    Holdaway RA (1983) A soft-tissue cephalometric analysis and its use in orthodontic treatment planning. Part I. Am J Orthod 84:1–28CrossRefPubMedGoogle Scholar
  11. 11.
    Howells DJ, Shaw WC (1985) The validity and reliability of ratings of dental and facial attractiveness for epidemiologic use. Am J Orthod 88:402–408CrossRefPubMedGoogle Scholar
  12. 12.
    Hungerford MW (1890) Molly Bawn. Smith, Elder and Company, LondonGoogle Scholar
  13. 13.
    Jefferson Y (2004) Facial beauty-establishing a universal standard. Int J Orthod 15:9–22Google Scholar
  14. 14.
    Kawakami S, Tsukada S, Hayashi H, Takada Y, Koubayashi S (1989) Golden proportion for maxillofacial surgery in orientals. Ann Plast Surg 23:417–425CrossRefPubMedGoogle Scholar
  15. 15.
    Kerns LL, Silveira AM, Kerns DG, Regennitter FJ (1997) Esthetic preference of the frontal and profile views of the same smile. J Esthet Dent 9:76–85CrossRefPubMedGoogle Scholar
  16. 16.
    Kiekens RM, Kuijpers-Jagtman AM, van’t Hof MA, van’t Hof BE, Maltha JC (2008) Putative golden proportions as predictors of facial esthetics in adolescents. Am J Orthod Dentofacial Orthop 134:480–483. doi: 10.1016/j.ajodo.2006.10.041 CrossRefPubMedGoogle Scholar
  17. 17.
    Koury ME, Epker BN (1992) Maxillofacial esthetics: anthropometrics of the maxillofacial region. J Oral Maxillofac Surg 50:806–820CrossRefPubMedGoogle Scholar
  18. 18.
    Lusterman EA (1963) The esthetics of the occidental face: a study of dentofacial morphology based upon anthropologic criteria. Am J Orthod Dentofacial Orthop 49:826–850CrossRefGoogle Scholar
  19. 19.
    Macias Gago AB, Romero Maroto M, Crego A (2012) The perception of facial aesthetics in a young Spanish population. Eur J Orthod 34:335–339. doi: 10.1093/ejo/cjr014 CrossRefPubMedGoogle Scholar
  20. 20.
    Matoula S, Pancherz H (2006) Skeletal Morphology of attractive and nonattractive faces. Angle Orthod 76:204–210PubMedGoogle Scholar
  21. 21.
    Moorrees CF (1994) Natural head position—a revival. Am J Orthod Dentofacial Orthop 105:512–513. doi: 10.1016/S0889-5406(94)70014-1 CrossRefPubMedGoogle Scholar
  22. 22.
    Naini FB, Moss JP, Gill DS (2006) The enigma of facial beauty: esthetics, proportions, deformity, and controversy. Am J Orthod Dentofacial Orthop 130:277–282. doi: 10.1016/j.ajodo.2005.09.027 CrossRefPubMedGoogle Scholar
  23. 23.
    Peck H, Peck S (1970) A concept of facial esthetics. Angle Orthod 40:284–318. doi: 10.1043/0003-3219(1970)040<0284:ACOFE>2.0.CO;2 PubMedGoogle Scholar
  24. 24.
    Peron APLM, Morosini IC, Correia KR, Moresca R, Petrelli E (2012) Photometric study of divine proportion and its correlation with facial attractiveness. Dental Press J Orthod 17:124–131CrossRefGoogle Scholar
  25. 25.
    Phillips C, Beal KN (2009) Self-concept and the perception of facial appearance in children and adolescents seeking orthodontic treatment. Angle Orthod 79:12–16. doi: 10.2319/071307-328.1 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Proffit WR (2000) The soft tissue paradigm in orthodontic diagnosis and treatment planning: a new view for a new century. J Esthet Dent 12:46–49CrossRefPubMedGoogle Scholar
  27. 27.
    Ricketts RM (1982) The biologic significance of the divine proportion and Fibonacci series. Am J Orthod 81:351–370CrossRefPubMedGoogle Scholar
  28. 28.
    Ricketts RM (1982) Divine proportion in facial esthetics. Clin Plast Surg 9:401–422PubMedGoogle Scholar
  29. 29.
    Rodriguez GLC, Cambron ZH, Vargas RM (2014) Relationship between facial golden ratio and malocclusion in Mexican patients who attended the Orthodontics Clinic at Facultad de Odontología de la Universidad Tecnológica de México during 2009 with facial aesthetics criteria evaluated with Marquardt mask. Revista Mexicana de Ortodoncia 2:9–17CrossRefGoogle Scholar
  30. 30.
    Ronchi P, Guariglia A (2011) Surgical orthodontic treatment of class III malocclusions. In: Naretto S (ed) Principles in contemporary orthodontics. In Tech, Rijeka, Croatia, p 419Google Scholar
  31. 31.
    Rossetti A, De Menezes M, Rosati R, Ferrario VF, Sforza C (2013) The role of the golden proportion in the evaluation of facial esthetics. Angle Orthodt 83:801–808. doi: 10.2319/111812-883.1 CrossRefGoogle Scholar
  32. 32.
    Sforza C, Laino A, D’Alessio R, Grandi G, Binelli M, Ferrario VF (2009) Soft-tissue facial characteristics of attractive Italian women as compared to normal women. Angle Orthod 79:17–23. doi: 10.2319/122707-605.1 CrossRefPubMedGoogle Scholar
  33. 33.
    Shell TL, Woods MG (2004) Facial aesthetics and the divine proportion: a comparison of surgical and non-surgical class II treatment. Aust Orthod J 20:51–63PubMedGoogle Scholar
  34. 34.
    Tedesco LA, Albino JE, Cunat JJ, Slakter MJ, Waltz KJ (1983) A dental-facial attractiveness scale. Part II. Consistency of perception. Am J Orthod 83:44–46CrossRefPubMedGoogle Scholar
  35. 35.
    Tweed CH (1944) Indications for the extraction of teeth in orthodontic procedure. Am J Orthod Oral Surg 42:22–45PubMedGoogle Scholar
  36. 36.
    Tweed CH (1954) Frankfort mandibular incisor angles in diagnosis, treatment planning and prognosis. Angle Orthod 24:121–169Google Scholar

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

Personalised recommendations