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.
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.
Similar content being viewed by others
References
Angle EH (1899) Classification of malocclusion. Dental Cosmos 41:248–264
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
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 16:108–120
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 102:443–448
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
De Smit A, Dermaut L (1984) Soft-tissue profile preference. Am J Orthod 86:67–73
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
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)
Herzberg BL (1952) Facial esthetics in relation to orthodontic treatment. Angel Orthod 22:9
Holdaway RA (1983) A soft-tissue cephalometric analysis and its use in orthodontic treatment planning. Part I. Am J Orthod 84:1–28
Howells DJ, Shaw WC (1985) The validity and reliability of ratings of dental and facial attractiveness for epidemiologic use. Am J Orthod 88:402–408
Hungerford MW (1890) Molly Bawn. Smith, Elder and Company, London
Jefferson Y (2004) Facial beauty-establishing a universal standard. Int J Orthod 15:9–22
Kawakami S, Tsukada S, Hayashi H, Takada Y, Koubayashi S (1989) Golden proportion for maxillofacial surgery in orientals. Ann Plast Surg 23:417–425
Kerns LL, Silveira AM, Kerns DG, Regennitter FJ (1997) Esthetic preference of the frontal and profile views of the same smile. J Esthet Dent 9:76–85
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
Koury ME, Epker BN (1992) Maxillofacial esthetics: anthropometrics of the maxillofacial region. J Oral Maxillofac Surg 50:806–820
Lusterman EA (1963) The esthetics of the occidental face: a study of dentofacial morphology based upon anthropologic criteria. Am J Orthod Dentofacial Orthop 49:826–850
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
Matoula S, Pancherz H (2006) Skeletal Morphology of attractive and nonattractive faces. Angle Orthod 76:204–210
Moorrees CF (1994) Natural head position—a revival. Am J Orthod Dentofacial Orthop 105:512–513. doi:10.1016/S0889-5406(94)70014-1
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
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
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 17:124–131
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
Proffit WR (2000) The soft tissue paradigm in orthodontic diagnosis and treatment planning: a new view for a new century. J Esthet Dent 12:46–49
Ricketts RM (1982) The biologic significance of the divine proportion and Fibonacci series. Am J Orthod 81:351–370
Ricketts RM (1982) Divine proportion in facial esthetics. Clin Plast Surg 9:401–422
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 2:9–17
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 419
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
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
Shell TL, Woods MG (2004) Facial aesthetics and the divine proportion: a comparison of surgical and non-surgical class II treatment. Aust Orthod J 20:51–63
Tedesco LA, Albino JE, Cunat JJ, Slakter MJ, Waltz KJ (1983) A dental-facial attractiveness scale. Part II. Consistency of perception. Am J Orthod 83:44–46
Tweed CH (1944) Indications for the extraction of teeth in orthodontic procedure. Am J Orthod Oral Surg 42:22–45
Tweed CH (1954) Frankfort mandibular incisor angles in diagnosis, treatment planning and prognosis. Angle Orthod 24:121–169
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
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.
Additional information
Assistant Professor Seden Akan.
Rights and permissions
About this article
Cite this article
Akan, S., Torgut, A.G. & Oktay, H. Effects of malocclusions on facial attractiveness and their correlations with the divine proportion. J Orofac Orthop 78, 427–436 (2017). https://doi.org/10.1007/s00056-017-0097-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00056-017-0097-x