The perception of optimal profile in African Americans versus white Americans as assessed by orthodontists and the lay public

Facial Morphometrics in Black Celebrities: Contemporary Facial Analysis Using an Artificial Intelligence Platform

The diversity of patients pursuing facial aesthetic and facial gender-affirming surgery (FGAS) is increasing, yet there is a paucity of objective guidelines to facilitate surgical decision-making in patients of color. We conducted a quantitative analysis of black celebrities using standardized frontal photos of 21 female and 21 male celebrities. Celebrities were chosen from popular entertainment magazines and websites, including People Magazine, the Internet Movie Database (IMDb), Cosmopolitan, and Essence. For each celebrity, 100 facial landmarks were detected through a facial analysis artificial intelligence (AI) program. Black males had greater facial height, bizygomatic width, lower facial height, and bigonial width than females. However, the facial height to bigonial width ratio was similar between genders and approximated the golden ratio (1.618). Female faces demonstrated a greater mid-face height to total facial height proportion, and males had a greater lower facial height proportion. Females exhibited an upward-slanted medial brow and shorter total eyebrow length, nose height, and alar width. Forehead height above the lateral brow was greater in males, while central forehead height was similar to females. This is the first study that has utilized AI to provide ethnicity-specific facial morphometrics relevant to facial rejuvenation and FGAS in the black population.

Regional influence on the aesthetic preference of different Mongolian profiles: A comparative study of assessors from Northeast and Mainland India

OBJECTIVE

The purpose of this study was to determine the aesthetic preferences of three different groups-layperson, dentists, and orthodontists, with different ethnic and geographical backgrounds from North-eastern and Mainland India, and to evaluate whether there is any difference in the perception of facial profile aesthetics. The influence of one's ethnic and regional origin in the perception of facial profile aesthetics was evaluated in two populations of different backgrounds using VAS scale.

MATERIALS AND METHODS

Facial profile photos of 2 Mongolian descendants, 1 man and 1 woman having Class I (normal) profile were digitized and modified, sagittally, to obtain 7 sagittal variations of each profile. A total of 7 profile images were obtained for each of the male and female models. The photos were ranked by 240 participants from an aesthetic point of view between a score of 1 (very unattractive) and 10 (very attractive). Repeated measures ANOVA was used for intra-group comparison whereas one-way ANOVA and Z-test were used for inter-group comparisons.

RESULTS

The Class I profile was the most preferred in both male and female profile photos by orthodontists of both the two populations, whereas the Class III profile (prognathic mandible) was considered the least attractive (P<0.05). North-eastern layperson and dentists preferred profiles with a slightly retrusive maxilla, while mainland layperson and dentists were tolerant to a protrusive profile (P<0.05).

CONCLUSION

The participants' perception regarding the Class I profile aesthetics were found to be similar. However, differences were observed in the profile preferences in people of different ethnicities and regions. Also, professional training was found to influence the perception of profile aesthetics.

What do black patients expect from orthodontic treatment? The aesthetic perception of facial profile between orthodontists and black laypersons

Objective:

To evaluate the influence of anteroposterior position of the soft tissue on facial attractiveness in black people, and compare the perception of aesthetics and satisfaction between orthodontists and black laypersons.

Methods:

The sample was composed of 69 orthodontists and 69 laypersons of black ethnicity (n=138). Facial profile photographs of two black volunteers, a man and a woman, were digitally manipulated to change the position of the lips and chin, by making gradual changes of 4mm in relation to the true vertical line, simulating advance or retrusion of the soft tissues by -2, -6, -10, +2, +6, +10mm, totalling six images per sex. The photographs were classified by the research participants using a visual analogue scale (VAS), from 0 (unpleasant) to 100 (pleasant). The results were analyzed by generalized linear model and by the Fisher’s exact test, considering the level of significance of 5%.

Results:

The orthodontists and black laypersons considered straight profiles the most pleasant. The two groups classified the male profile as being more unpleasant in comparison with the female facial profile, which was concave. When evaluating all the images together, the image most indicated as being the most pleasant, once again, was the one with the straight profile, for both sexes.

Conclusion:

The influence of orthodontists’ and laypersons’ aesthetic perception on evaluating the facial profile of blacks was similar. The straight profile was classified as the most pleasant and the concave, as the most unpleasant.

Comparison of Antero-Posterior Lip Position in Most Favored Facial Profile of Jaipur Population

Background

The enhancement of facial esthetics is one of the essential goals of orthodontic treatment. The concept of an excellent facial profile can differ between two individuals of the same population. Esthetics is a very vital component in Orthodontic diagnosis and treatment planning. Orthodontic treatment aims to achieve facial harmony by stabilizing the occlusion and pleasing facial and dental esthetics. Therefore, the characteristics of a pleasing, well-balanced face and a functioning occlusion should be evaluated.

Aim

This study aimed to determine preferable Antero-posterior lip positions in the Jaipur population and determine the range of anteroposterior lip positions as evaluated by orthodontists, patients, and professionals from a series of different lip positions in facial silhouettes, and compare their assessments.

Materials and Methods

The sample comprised 50 subjects (25 males & 25 females) from Jaipur. All angular and linear measurements were recorded for both males and females separately. The mean value of those readings was placed in NEMOTECH cephalometric software, and an average profile construction was done. This average profile will determine the lip fullness/ facial profile of males and females of the Jaipur (Rajasthan) population. A series of 7 profile silhouettes for males and seven profile silhouettes for females was developed by altering the lip positions (protrusion & retrusion in 2mm increments till 6 mm from the average profile) parallel to Frankfort horizontal plane (F-H) plane. Constructed facial silhouettes (seven male and female) were evaluated by (50) Orthodontists, (50) oral surgeons, general dentists (50), and non-specialists population (100). Evaluators were asked for the best profile in each gender from 1 to 7 in order of their preference.

Result

On calculating the standard deviation values, the profile selected as most favored for females is 2.33 by orthodontists, on the contrary, the standard deviation for Oral Surgeons, General Dentists & Non-specialists is 2.04, 2.14, and 2.12 respectively. It was found that profile retruded -2mm for males was the most favored, and profile retruded -4mm for males was second most favored. Average Profile /the profile without retrusion or protrusion was selected by orthodontists as the most favored profile. Profile retruded -2mm was the most favored profile for males clinically significant. It was found that profile retruded -2mm for females was the most favored, and profile retruded -4mm for females was second most favored. Profile retruded -2mm was the most favored profile for females by Orthodontists, General Dentists & non-specialists. Profile retruded -4mm was the most favored for females by Oral Surgeons. overall made insignificant.

Conclusion

The most favored facial profile is -2mm (profile 1) retruded lip posture in both males and females. According to Orthodontists most favored facial profile is 0mm (profile 6) average profile in males and -2mm (profile 1) retruded lip position in females. According to non-specialists most favored facial profile is -2mm (profile 1) retruded lip position in both males and females.

An establishment of various cephalometric parameters in an Urban setup in Odisha and linking it with the discernment of pleasant profiles by lay persons

Aim:

To evaluate cephalometric parameters of orthodontic population in an urban setup in Odisha using Steiner's, Tweed's and Rakosi's analysis and compare it with the established Caucasian norms.

Methodology:

Pre-treatment patient records from a dental hospital were collected. Lateral cephalograms of the normal and supernormal sample were traced. Cephalometric features relating to various facial hard tissue that determine balance and harmony were measured using Steiner's, Tweed's and Rakosi's analysis. The values obtained were compared with the established Caucasian norms. Comparison of mean values were done via independent sample t test and ANOVA. Subsequently post hoc Tukey's was used to establish the significance of the mean difference of all the variables used.

Results:

Significant differences were obtained for lower incisor to NB, mandibular plane angle, FMA, FMIA, articular angle, basal plane angle, inclination angle, Rakosi Jarabak ratio and interincisal angle.

Conclusion:

Fundamental variations were seen in various parameters. Perception of lay persons can be of aid to the clinician in assembling commendations for alternative treatment plans.

Quantitative investigation of the esthetic impact of lip prominence in relation to the esthetic line

INTRODUCTION

The purpose of this quantitative investigation was to assess the influence of lip prominence in relation to the esthetic line (E-line) on perceived attractiveness and threshold values of desire for treatment.

METHODS

The lip prominence of an idealized silhouette male white profile image was altered incrementally between -16 mm to 4 mm from the E-line. The images were rated on a Likert scale by pretreatment orthognathic patients (n = 75), laypeople (n = 75), and clinicians (n = 35).

RESULTS

In terms of perceived attractiveness, lips to E-line distance within the ranges of -12 mm to -16 mm and 0-4 mm in relation to the E-line was associated with a reduction in median attractiveness scores to below 4 in the patient and clinician groups of observers; for the lay group, the corresponding ranges were -14 mm to -16 mm and 2-4 mm. Relative lip prominence appears to be viewed as more attractive than lip retrusion. Clinicians were generally least likely to suggest treatment for varying levels of bilabial position. For a number of the images, there was reasonable agreement among clinicians and laypeople regarding whether treatment is required. For the clinician group, the only categories for desire for treatment were at a lip to E-line distance within the ranges of -14 mm to -16 mm and 2-4 mm.

CONCLUSIONS

It is recommended that the range of normal variability of the prominence of the lips and threshold values of the desire for treatment be considered in planning.

Esthetic evaluation of profile photographs showing various sagittal and vertical patterns

INTRODUCTION

The purpose of this study was to determine the esthetic preferences of people at different levels of society and also to determine whether this preference is affected by sex, age, education level, social status, geographic region, and individual profile factors.

METHODS

Facial profile photographs of 1 man and 1 woman, each having a profile designated as ideal (the ideal profile), were digitized. The sagittal and vertical dimensions of these photographs were modified, and 9 variations of each profile picture were obtained using different combinations of alterations. The photographs were scored by 373 participants. For the analysis, Mann-Whitney U and Kruskal Wallis-H tests were used in the comparison of the scores.

RESULTS

The ideal profile was the most preferred in both sexes, whereas the least preferred was a severe Class III malocclusion with a reduced vertical dimension of 8 mm. In general, esthetics decreased as it moved away from the ideal profile in a sagittal or vertical direction.

CONCLUSIONS

Some factors from among those sampled (sex, age, education, social status, geographic region, and personal profile) affected esthetic preference, whereas others did not.

Comparision of profile macro-estethic perception among orthodontists, dentistry students, orthodontic patients and surgical orthodontic patients

Background

The patient’s needs should guide the orthodontist in choosing the most appropriate therapy. The purpose of the present survey was to compare the esthetic perception of the facial profile by orthodontists (O), dentistry students (DS), orthodontic patients (OP) and surgical-orthodontic patients (SOP) and to evaluate the influence of gender, age and level of study.

Material and Methods

A facial profile photograph of a young female was taken and twelve modified images were made, altering the position of the jaws in protrusion and in retrusion. Two hundred caucasian examiners, divided into four groups (O, DS, OP, SOP), were selected. Each examiner was asked to complete the questionnaire with an approval rating from 1 to 10. An ordinary least square OLS model was applied. Significant levels were set at P ≤ 0.05.

Results

All examiners considered a straight profile or a slight retrusion of the maxilla as the most attractive profile. Slight discrepancies (up to 2 mm) in jaw protrusion were barely perceived by patients. Mandibular retrusion (2 and 4 mm) was one of the least appreciated condition by all examiners. Surgical-orthodontic patients assigned lower ratings compared to orthodontic patients. Female subjects assigned lower ratings than males. Patients with secondary school education assigned higher statistically significant values compared to other levels of study. The lowest values were attributed by the sample of age > = 17 years.

Conclusions

The choice of the most appropriate therapy is based not only on a correct diagnosis, but on the evaluation of esthetic and psychological aspects.

Key words:Estethic, profile, orthodontic, surgical orthodontic patients.

Perception and Characterization of Posed Smile: A Photographic Study

Aims of the Study:

The aims of the study are: (a) to compare the perceptions of dental specialists and laypeople regarding smile esthetics; (b) to compare male and female smile parameters; (c) to find influence of smile parameters on esthetics of smile.

Materials and Methods:

The study was conducted on 60 subjects (30 males and 30 females) of age 18 to 25 years. Frontal posed photographs of all subjects were taken using a digital camera and rated on a visual analog scale by 10 dental specialists and 10 laypersons. Measurements made on photographs were used to analyze various parameters of smile, such as buccal corridor space, smile arc, modified smile index, anterior height of smile, most posterior maxillary tooth visible, and midline relationship of central incisors to philtrum.

Results:

Visual analog scale values showed that 6 photographs were rated as very good (3 males, 3 females), 29 as good (11 males, 18 females), 21 as average (13 males, 8 females), and 4 photographs were rated as bad (3 males, 1 female). A high correlation was observed between ratings of dental specialists and layperson’s ratings for both male and female smiles. Most of the subjects had non-consonant smile arc, and a high correlation was found between buccal corridor space on right and left sides in both males and females. Most of the male and female smiles had an average anterior height of smile; permanent maxillary first molar was the last tooth visible during smile (73.3% females, 66.7 males); and 55% subjects had coincident midline relationship of central incisors to philtrum.

Conclusion:

There was no significant difference in perception of dental specialists and laypersons regarding esthetics of smile. Smile arc and anterior height of smile influenced the esthetics of smile. No significant difference was found between male and female smile parameters except modified smile index.

A Communication Guide for Orthodontic-Restorative Collaborations: An Orthodontic Perspective on the Importance of Working in a Team

As both restorative dentists and specialists have their respective realms of expertise, it is important to develop a team of qualified providers to improve treatment outcomes for patients. In many cases, this involves collaboration between a restorative dentist and orthodontist. Effective communication is critical, with the dentist's understanding of basic orthodontic terminology and case planning considerations. Recognizing the context in which to apply normative occlusal and cephalometric values often necessitates comprehensive specialty-level experience. All providers should recognize when to involve the indicated team members when complex multidisciplinary treatment needs are present. The team approach offers an opportunity to optimize excellent patient care.

Smile attractiveness of Persian women after orthodontic treatment

INTRODUCTION

Achieving a balanced, attractive smile is an important goal in contemporary orthodontics. This study aimed to assess the smile attractiveness of Persian women after orthodontic treatment.

METHODS

In this descriptive-analytical study, frontal-view photographs were taken of posed smiles of 100 Persian women 3 months after completion of their orthodontic treatment. A total of 153 laypeople aged over 15 years were requested to score each smile in terms of attractiveness using a visual analogue scale (1-10). Next, 25 photographs that acquired the lowest score (group A) and 25 photographs that acquired the highest score (group B) were chosen and evaluated by 3 orthodontists regarding parameters related to an attractive smile. Data were analyzed using SPSS version 18.

RESULTS

The mean buccal corridor space in group A was significantly greater than that in group B (P = 0.004). The correlation of lip line and study group was significant such that 60% of patients in group B had a moderate lip line (P = 0.005). The difference in other parameters was not significant between the 2 groups (P >0.05).

CONCLUSIONS

The buccal corridor space and lip line are important factors affecting smile attractiveness of Persian women. According to the opinion of the laypeople, smaller buccal corridor space and moderate lip line yield a more attractive smile. Thus, these parameters should be taken into account in the orthodontic treatment of Persian women.

Hakeem M, Yamaki M. Perception of dental professionals and lay people to altered facial esthetics

Introduction

The aim of this study was to examine whether dental professionals and lay people group do agree in their perception of digitally altered facial components or not.

Materials and Methods

A frontal photograph of a Saudi young man was taken, imported, and digitally altered to a series of images of 16 photographs. Eyes, nose, mouth, and chin were altered gradually from the original photograph and were rotated 1°, 3°, and 5°. 225 raters (60 lay people, 41 orthodontists, 77 dentists, and 47 dental students) were invited and asked to evaluate the original and altered images using a visual analog scale.

Results

Lay people were less critical and gave higher ratings than dentists when evaluating rotated eyes of 5°. Orthodontists gave higher ratings than lay people and dental students at distinguishing of 1° of rotated nose. Orthodontists were less critical in rating larger alterations of the nose at 3° than lay people. Orthodontists were also less discriminating of minor alterations of the lips. They could not detect mouth rotation of 1° compared to lay people and dental students.

Conclusions

The results of this study underline the importance of developing an objective index to enumerate the magnitude of facial asymmetries.

Optimal antero-posterior position of the maxillary central incisors and its relationship to the forehead in adult African American females

OBJECTIVES

To determine an optimal anteroposterior (AP) position of the maxillary central incisors and their relationship to the forehead in adult African American (AA) females.

MATERIALS AND METHODS

Smile profile photographs of 150 AA females were acquired and divided into an optimal control group (N = 48) and a study group (N = 102) based on the position of the maxillary central incisors, as judged by a panel of orthodontists and orthodontic residents. The AP position of the maxillary central incisors and the forehead inclination (FI) were measured relative to Glabella vertical (GV). A two-sample t-test was used to compare the incisor AP position and the FI between the two groups. Linear regression was used to quantify the relationship between the incisor AP position and the FI.

RESULTS

In all groups, the maxillary incisors were anterior to GV. However, a significant difference was found in the incisor AP position between the groups (8.58 ± 3.96 mm for the control group and 11.2 ± 4.48 mm for the study group; P = .001). Furthermore, the control group demonstrated a positive association between the optimal AP position of the maxillary central incisors and FI ( P < .0001).

CONCLUSIONS

GV is a reliable landmark with which to access the AP maxillary incisor position in AA females. The optimal AP position of the maxillary central incisors is significantly associated with FI; the greater the FI, the more anterior the optimal maxillary incisor position. A prediction equation to determine the optimal position of the maxillary incisors relative to GV for AA females is proposed.

The association between patient's compliance and age with the bonding failure of orthodontic brackets: a cross-sectional study

Background

An efficient orthodontic treatment must aim the best occlusal result in the shortest possible time. One of the factors that can interfere in this goal is the bracket debonding during the treatment. This study aimed at assessing the different factors related to brackets failure, highlighting age and patient cooperation with treatment.

Methods

The sample comprised 199 orthodontic patients of both genders (103 women and 96 men); divided into two groups—adolescents (12 to 18 years old, 118 patients) and adults (19 to 59 years old, 81 patients). A questionnaire was applied regarding the motivation of patients to seek treatment and whether they had received information on appliance care; patients also filled out their level of cooperation with treatment in a visual analog scale (VAS). Additionally, other variables were assessed, such as the teeth with bracket debonding, the presence of deep overbite, and the use of bite plate. The Mann-Whitney test was used, and a 5% significance level was applied for analyses.

Results

It was observed that 20.1% of patients presented at least one tooth with bracket failure, and the lower arch was the most prevalent site (47.5%). Adolescents presented more debonding (25.4%) than adults (12.3%). Individuals with better VAS scores on cooperation sought treatment on their own (p = 0.042), were adults (p ≤ 0.001), and showed lower rate of failure of brackets (p ≤ 0.001). The factors related to malocclusion and treatment performed had no statistical significance.

Conclusion

Greater cooperation was expected from adult individuals who sought treatment on their own and presented low rate of bracket failure.

Evaluation of facial attractiveness in black people according to the subjective facial analysis criteria

Objective:

The objective of this study was to evaluate the facial attractiveness in 30 black individuals, according to the Subjective Facial Analysis criteria.

Methods:

Frontal and profile view photographs of 30 black individuals were evaluated for facial attractiveness and classified as esthetically unpleasant, acceptable, or pleasant by 50 evaluators: the 30 individuals from the sample, 10 orthodontists, and 10 laymen. Besides assessing the facial attractiveness, the evaluators had to identify the structures responsible for the classification as unpleasant and pleasant. Intraexaminer agreement was assessed by using Spearman's correlation, correlation within each category using Kendall concordance coefficient, and correlation between the 3 categories using chi-square test and proportions.

Results:

Most of the frontal (53. 5%) and profile view (54. 9%) photographs were classified as esthetically acceptable. The structures most identified as esthetically unpleasant were the mouth, lips, and face, in the frontal view; and nose and chin in the profile view. The structures most identified as esthetically pleasant were harmony, face, and mouth, in the frontal view; and harmony and nose in the profile view. The ratings by the examiners in the sample and laymen groups showed statistically significant correlation in both views. The orthodontists agreed with the laymen on the evaluation of the frontal view and disagreed on profile view, especially regarding whether the images were esthetically unpleasant or acceptable.

Conclusions:

Based on these results, the evaluation of facial attractiveness according to the Subjective Facial Analysis criteria proved to be applicable and to have a subjective influence; therefore, it is suggested that the patient's opinion regarding the facial esthetics should be considered in orthodontic treatmentplanning.

Esthetic perceptions of facial silhouettes after treatment with a mandibular protraction appliance

INTRODUCTION

In this retrospective study, we aimed to evaluate the effects on the facial silhouettes produced by a mandibular protraction appliance associated with corrective treatment in Class II patients.

METHODS

The sample consisted of 54 (27 initial and 27 final) lateral radiographs from 27 patients. Of these patients, 14 were girls and 13 were boys, with a mean initial age of 12.27 years and a mean treatment period of 2.9 years. An album containing the silhouettes of the pretreatment and posttreatment profiles based on the lateral cephalograms of the patients was prepared. Then, 60 orthodontists and 60 laypeople chose the more esthetic facial silhouette (A or B) and the amount of alterations they perceived between the 2 silhouettes, according to a visual analog scale. A paired t test was used to compare the 2 groups of evaluators with a 5% significance level.

RESULTS

Differences between the preferences regarding the pretreatment and posttreatment facial silhouettes were statistically significant for both groups. The posttreatment silhouettes were preferred by most evaluators. The visual analog scale scores showed that the lay evaluators identified greater differences between the pretreatment and posttreatment silhouettes than did the orthodontists (P <0.001).

CONCLUSIONS

Based on the evaluators' judgments, treatment with the mandibular protraction appliance had a positive effect on the facial silhouette, and the laypeople better perceived this effect.

Perception of changes in soft-tissue profile after Herbst appliance treatment of Class II Division 1 malocclusion

INTRODUCTION

In this study, we sought to assess the perception of changes in soft-tissue profile after Herbst appliance treatment by comparing facial profile silhouettes before treatment, immediately after treatment, and 2 years after treatment, as examined by orthodontists, general dentists, and laypersons.

METHODS

The sample comprised 21 patients (mean age, 9.5 ± 0.5 years), who were treated with the Herbst appliance for a mean period of 12 (±1.1) months. Three lateral cephalograms were obtained at different times: baseline, immediately after removal of the Herbst appliance, and 2 years after removal of the appliance. The 63 resulting profile silhouettes were evaluated by 120 examiners divided into 3 groups: orthodontists, general dentists, and laypersons. The examiners were instructed to choose their preferred profile and note how much change they perceived across profiles using a visual analog scale.

RESULTS

All groups of examiners preferred the posttreatment profiles. However, on quantitative assessment, the magnitudes of changes in the profile were found to be variable and rather small, with laypersons quantifying the greatest magnitude of change.

CONCLUSIONS

Early Herbst appliance treatment produced positive changes in the facial profile that were visually appreciable both immediately after removal of the appliance and 2 years after treatment.

The importance of using the entire face to assess facial profile attractiveness

INTRODUCTION

The aim of this study was to evaluate the importance of using the entire face to assess facial profile attractiveness. The secondary objective was to assess the facial profile preferences of orthodontists, dentists and laypeople.

METHODS

Two original cephalometric radiographs of two subjects (one man and one woman meeting the normality criteria) and 16 modified samples of these radiographs were used. The 18 radiographs were then converted into silhouettes and printed twice: the entire profile (A) and the lower third alone (B). The silhouettes were randomly distributed into two binders A and B. A survey was conducted using three panels of evaluators: orthodontists, dentists and laypeople. The esthetic appreciation was quantified according to the Visual Analogue Scale (VAS).

RESULTS

Pearson's correlation coefficient was calculated to compare the scores of the entire profile with the scores of the lower third alone. The results showed that the orthodontists panel presented a much better correlation between A and B compared to dentists and especially to laypeople. A comparison of profile scores with the correlation coefficients shows that the profiles with the highest scores present the lowest correlations. The three panels of evaluators preferred the orthogonal profiles or profiles with upper lip protrusion over profiles with lower lip protrusion.

CONCLUSION

For profiles with values close to the norm, the lower face alone does not reveal the attractiveness of the entire facial profile. Hence, the importance of using the entire facial profile to assess the beauty of the face.

Facial profile esthetic preferences: perception in two Brazilian states

OBJECTIVE:

The aim of this study was to assess the regional influence on the perception of facial profile esthetics in Rio de Janeiro state (RJ) and Rio Grande do Sul state (RS), Brazil.

METHODS:

Two Caucasian models, a man and a woman, with balanced facial profiles, had their photographs digitally manipulated so as to produce seven different profiles. First year dental students (laypeople) assessed the images and classified them according to their esthetic preference.

RESULTS:

The result of the t test for independent samples showed differences among states for certain facial profiles. The female photograph identified with the letter 'G' (mandibular retrusion) received higher scores in RS state (p = 0.006). No differences were found for male photographs (p > 0.007). The evaluators' sex seemed not to influence their esthetic perception (p > 0.007). Considering all evaluators together, ANOVA/Tukey's test showed differences among the profiles (p ≤ 0.05) for both male and female photographs. The female photograph that received the highest score was the one identified with the letter 'F' (dentoalveolar bimaxillary retrusion/ straight profile). For the male profiles, photograph identified with the letter 'E' (dentoalveolar bimaxillary protrusion/ straight profile) received the best score.

CONCLUSION:

Regional differences were observed regarding preferences of facial profile esthetics. In Rio de Janeiro state, more prominent lips were preferred while in Rio Grande do Sul state, profiles with straight lips were favored. Class III profiles were considered less attractive.

A 3D analysis of Caucasian and African American facial morphologies in a US population

INTRODUCTION

This study aimed to compare facial morphologies of an adult African-American population to an adult Caucasian-American population using three-dimensional (3D) surface imaging.

MATERIALS AND METHODS

The images were captured using a stereophotogrammetric system (3dMDface(TM) system). Subjects were aged 19-30 years, with normal body mass index and no gross craniofacial anomalies. Images were aligned and combined using RF6 Plus Pack 2 software to produce a male and female facial average for each population. The averages were superimposed and the differences were assessed.

RESULTS

The most distinct differences were in the forehead, alar base and perioricular regions. The average difference between African-American and Caucasian-American females was 1·18±0·98 mm. The African-American females had a broader face, wider alar base and more protrusive lips. The Caucasian-American females had a more prominent chin, malar region and lower forehead. The average difference between African-American and Caucasian-American males was 1·11±1·04 mm. The African-American males had a more prominent upper forehead and periocular region, wider alar base and more protrusive lips. No notable difference occurred between chin points of the two male populations.

CONCLUSIONS

Average faces were created from 3D photographs, and the facial morphological differences between populations and genders were compared. African-American males had a more prominent upper forehead and periocular region, wider alar base and more protrusive lips. Caucasian-American males showed a more prominent nasal tip and malar area. African-American females had broader face, wider alar base and more protrusive lips. Caucasian-American females showed a more prominent chin point, malar region and lower forehead.

Facial profile parameters and their relative influence on bilabial prominence and the perceptions of facial profile attractiveness: A novel approach

Objective

To evaluate the relative importance of bilabial prominence in relation to other facial profile parameters in a normal population.

Methods

Profile stimulus images of 38 individuals (28 female and 10 male; ages 19-25 years) were shown to an unrelated group of first-year students (n = 42; ages 18-24 years). The images were individually viewed on a 17-inch monitor. The observers received standardized instructions before viewing. A six-question questionnaire was completed using a Likert-type scale. The responses were analyzed by ordered logistic regression to identify associations between profile characteristics and observer preferences. The Bayesian Information Criterion was used to select variables that explained observer preferences most accurately.

Results

Nasal, bilabial, and chin prominences; the nasofrontal angle; and lip curls had the greatest effect on overall profile attractiveness perceptions. The lip-chin-throat angle and upper lip curl had the greatest effect on forehead prominence perceptions. The bilabial prominence, nasolabial angle (particularly the lower component), and mentolabial angle had the greatest effect on nasal prominence perceptions. The bilabial prominence, nasolabial angle, chin prominence, and submental length had the greatest effect on lip prominence perceptions. The bilabial prominence, nasolabial angle, mentolabial angle, and submental length had the greatest effect on chin prominence perceptions.

Conclusions

More prominent lips, within normal limits, may be considered more attractive in the profile view. Profile parameters have a greater influence on their neighboring aesthetic units but indirectly influence related profile parameters, endorsing the importance of achieving an aesthetic balance between relative prominences of all aesthetic units of the facial profile.

Facial-profile attractiveness changes in adult patients treated with the Herbst appliance

AIM

The goal of this study was to compare facial profile attractiveness changes of adult patients treated with the Herbst appliance assessed by orthodontists and laypeople.

MATERIALS AND METHODS

The patient sample comprised 28 adult Herbst patients. Facial profile photographs of the patients were randomly divided into two evaluation sets (before T0, after treatment T1). Ten members of the Angle Society of Europe (orthodontists) and 10 dental students in their third semester (laymen) rated both sets of photographs using Visual Analog Scales (VAS) with an interval of 1 day between the ratings.

RESULTS

On average, both orthodontists and students found an improvement in facial profile attractiveness through Herbst appliance treatment (VAS T1-T0 = 0.3 ± 1.9 cm). However, the interindividual perception of profile attractiveness varied greatly in the two rater groups. For both time periods (T0, T1), lower VAS ratings were given by students than by orthodontists.

CONCLUSION

Herbst therapy in adult patients generally improves facial profile attractiveness. Students rated facial profiles more critically than orthodontists.

[Beauty judgment: review of the literature]

Esthetic judgments are surely subjective, but as surely, that does not preclude them being studied objectively through rigorous scientific methods. The factual basis of a science of esthetics is not to settle whether some person or image is "objectively beautiful" but rather to determine whether some representative set or sets of individuals judge or experience him/her/it as beautiful or unattractive. The aim of this paper is to review the definitional, theoretical and methodological aspects pertaining to the perception of facial/dental attractiveness by a group of representative individuals. The first part lays down the basic principles of the perception of facial/dental attractiveness: the perception involves a jury, a field of investigation and a test providing quantitative data; the following general determinants of beauty perception are reviewed: the average morphology, the judge's cultural background, the numerology, the judge's ethnical origin. Indirect determinants are the dentition, the osseous architecture and the muscular envelope. Some disruptive factors might alter the judges' facial perception. They might be qualified as either peripheral to the face or psycho-social factors. Peripheral factors include hair style and color, skin hue, wrinkles, lips color... Psycho-social factors cover the personality of the subject being evaluated, his/her intelligence or behavior. The second part deals specifically with the methodology used to determine facial attractiveness and to correlate this latter with a specific morphology. Typically such a study aims to determine average esthetic preferences for some set of visual displays among a particular jury, given a specific task to judge esthetic quality or qualities. The sample being studied, the displays, the jury or jurys, the rating procedure must all be specified prior to collecting data. A specific emphasis will be given to the rating process and the associated morphometrics, the ultimate goal being to discriminate morphologies judged as attractive among our patients.

Evaluation of facial beauty using anthropometric proportions

The improvement of a patient's facial appearance is one of the main goals of contemporary orthodontic treatment. The aim of this investigation was to evaluate the difference in facial proportions between attractive and anonymous females in order to establish objective facial features which are widely considered as beautiful. The study included two groups: first group consisted of 83 Caucasian female subjects between 22 and 28 years of age who were selected from the population of students at the University of Belgrade, and the second group included 24 attractive celebrity Caucasian females. The en face facial photographs were taken in natural head position (NHP). Numerous parameters were recorded on these photographs, in order to establish facial symmetry and correlation with the ideal set of proportions. This study showed significant difference between anonymous and attractive females. Attractive females showed smaller face in general and uniformity of the facial thirds and fifths, and most of the facial parameters meet the criteria of the ideal proportions.

Assessment of facial profile changes in patients treated with maxillary premolar extractions

OBJECTIVE: Evaluate the facial profile changes of orthodontic treatment with extraction of two upper first premolars, from the perspective of orthodontists, dentists and lay people. METHODS: Facial profiles of radiographs taken before and after treatment of 70 patients with Class II, division 1 malocclusion were traced. The silhouettes of the 70 patients were randomly assembled in an album with, being two profiles on each sheet of the same patient. Then, 30 orthodontists, 30 dentists and 30 lay people chose the more esthetic facial profile (A or B), and the amount of change they perceived between the two profiles before and after treatment, according to a visual analog scale (VAS). RESULTS: The results revealed that 83 examiners preferred the post-treatment profiles, and only three dentists and four lay people chose the profiles pre-treatment more frequently. Thus, the orthodontists often chose the profiles after treatment, followed by dentists, with no statistically significant differences found between dentists and lay people. There were significant differences within groups in the preference of pre- and post-treatment profile. Furthermore, the three groups of evaluators indicated that pre and post-treatment profiles did not differ substantially. CONCLUSIONS: The treatment of Class II, division 1 malocclusion with extraction of two first premolars has a positive effect on facial profile esthetics.

Photos vs silhouettes for evaluation of African American profile esthetics

INTRODUCTION

Patient photos and silhouettes are commonly used in clinical evaluations and orthodontic research to evaluate profile esthetics. The purpose of this study was to determine whether the use of photos or silhouettes is a more appropriate method of evaluating African American profile esthetics and whether there are different profile esthetic preferences among clinicians when using photos compared with silhouettes.

METHODS

Pretreatment records of 20 adolescent African American patients were selected (10 male, 10 female) from the orthodontic clinic at the Albert Einstein Medical Center in Philadelphia. Each patient's profile photo was digitally changed with imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif) to fabricate a series of 7 photos and 7 silhouettes with lip positions at uniform distances relative to Ricketts' E-line standard. Fifteen raters consisting of orthodontic faculty and residents were asked to select the most esthetically pleasing profile from each patient's photo series and silhouette series.

RESULTS

More rater preferences for the photographs (86%) were within the acceptable esthetic range (within 2 mm of the E-line in either direction) than were their preferences for silhouettes (66%) (P <0.001). Flatter profiles with less lip projection than the esthetic norm were more often preferred in the silhouettes than in the photos. Thirty-one percent of the silhouettes preferred by the raters were flatter than the norm compared with 9% of the photos (P = 0.003). Fuller profiles were preferred in only 3% of the silhouettes and 5% of the photos (P = 0.6).

CONCLUSIONS

Esthetic attractiveness of faces of African American orthodontic patients is rated differently in photos and silhouettes. When evaluating soft-tissue esthetic profile preferences, rater preferences in the photographs were closer to the established esthetic norm than were their preferences in the silhouettes. Using silhouettes to evaluate patient esthetics could influence clinicians or researchers to select profiles that are flatter than the established esthetic norm.

Le facteur ethnique est-il un indicateur thérapeutique?

Face au diktat de la beauté imposée par la société à travers des stéréotypes, il est devenu légitime de s’interroger sur le concept universel du “ beau ”. Est-ce que les normes esthétiques en orthodontie, établies à partir d’échantillons de Nord-Américains, peuvent être applicables à d’autres populations? Les différentes analyses céphalométriques menées chez des sujets afro-américains, africains et asiatiques en occlusion normale non traitée mettent en évidence des critères esthétiques éloignés des critères nord-américains. Leurs conclusions relatent comme principal caractère ethnique la biprotrusion alvéolo-dentaire en relation avec un angle naso-labial réduit. Pour le sujet africain, on note très fréquemment une antéro-position du maxillaire avec une position mandibulaire inchangée ou rétruse. Pour le sujet asiatique, une similitude des profils cutanés est rapportée avec une divergence quant aux profils squelettiques : les Japonais présentent une rétrognathie maxillaire plus prononcée; les Chinois montrent souvent une promaxilie et une rétromandibulie. Les Coréens se rapprocheraient des Japonais. Il semble donc nécessaire de constituer des données spécifiques à l’origine ethnique afin d’optimiser le diagnostic esthétique et les objectifs du traitement orthodontique.

Patients' self-perception of dentofacial attractiveness before and after exposure to facial photographs

OBJECTIVE

To determine whether exposure to pretreatment photographs of themselves influenced patients' self-perception of dentofacial attractiveness and willingness to undergo treatment.

MATERIALS AND METHODS

A total of 100 subjects of white ancestry aged 18 years or older (Study Group) and 100 sex- and age-matched controls (Control Group) were selected. Photographs of the frontal view of the face and the profile view of the face, both at rest and while smiling, were taken of each participant. Only Study Group subjects were given a printed copy of their own images to be examined at home between the initial observation (T0) and a set date an average of 30 days later (T1). Each of the 200 subjects in the study completed a questionnaire at T0 and T1 exploring happiness regarding their smiles and their facial profiles, as well as willingness to undergo treatment.

RESULTS

At T1 in the Study Group, 50% of subjects responded with a lower opinion of their facial profiles than at T0; 11% and 45% were willing to undergo more comprehensive procedures to change the appearance of their smiles and profiles, respectively. No statistically significant change was seen in questionnaire answers between T0 and T1 for the Control Group.

CONCLUSION

Laypeople generally are not aware of their facial profiles. Pretreatment photograph exposure can increase profile self-awareness, an important factor in reducing the discrepancy between orthodontists' and patients' visual emphasis on dentofacial esthetics.

Facial profile preferences: differences in the perception of children with and without orthodontic history

INTRODUCTION

Improved facial esthetics can be fully achievable only if facial preferences of the treated group are known. We hypothesized that facial profile perception and preferences could be influenced by orthodontic treatment.

METHODS

Differences in facial profile preferences between children with and without an orthodontic history were investigated in a sample of 1626 children aged 12 to 19 years (mean age, 14.8 ± 2.2 years) from 24 public schools in Zagreb, Croatia, randomly selected by using a cluster sampling procedure. Eight profile distortions for each sex, morphed by a digital imaging technique, were used for estimation. Analysis of variance (ANOVA), Bonferroni, and 2 independent sample t tests were used to compare the preferences of the groups.

RESULTS

A straight profile was the most favored in both sexes, regardless of previous orthodontic history. A bimaxillary alveolar protrusive profile with thicker lips was preferred among the female profiles, and a bimaxillary retrusive profile with flat lips and a prominent chin was preferred among the male profiles. Orthodontic history and personal facial profile had little effect, and sex had a slightly greater influence on personal facial profile preferences.

CONCLUSIONS

It seems that orthodontic therapy has no clinically relevant influence on facial profile preferences. Depending on the patient's sex, orthodontists should have different criteria for treating borderline patients with bimaxillary dentoalveolar protrusion and mandibular prognathism.

Comparison of Chinese and US orthodontists' averaged evaluations of "facial attractiveness" from end-of-treatment facial photographs

INTRODUCTION

This study continues our assessment of agreement and disagreement among 25 Chinese and 20 US orthodontists in the ranking for facial attractiveness of end-of-treatment photographs of randomly sampled growing Chinese and white orthodontic patients. The main aims of this article were to (1) measure the overall pattern of agreement between the mean rankings of US and Chinese orthodontists, and (2) measure the strength of agreement between the rankings of the US and Chinese orthodontists for each patient.

METHODS

Each judge independently ranked standard clinical sets of profile, frontal, and frontal-smiling photographs of 43 US patients and 48 Chinese patients. For each patient, a separate mean rank was computed from the responses of each group of judges. Pearson correlations between the mean ranks of the 2 groups of judges were used to measure their overall agreement. Paired and unpaired t tests were used to measure the agreement between the judges of the 2 groups for each patient.

RESULTS

The overall agreement between the mean rankings of the US and Chinese judges was very high. For the US patients, the correlation between the Chinese and US judges means was r = 0.92, P <0.0001. For the Chinese patients, the analogous value was r = 0.86, P <0.0001. Agreement between the 2 groups of judges concerning each patient was also generally strong. For two thirds of the patients, the mean ranks of the US and Chinese judges differed by less than 1 unit in a scale of 12. However, for 6 patients considered individually (5 Chinese and 1 US), the assessment of the 2 groups of judges was statistically significantly different at P values ranging from 0.02 to less than 0.0001, even after the Bonferroni correction.

CONCLUSIONS

These findings demonstrate that orthodontic clinicians can reliably identify and rank subtle differences between patients, and that differences between judges and between patients can be distinguished at a high level of statistical significance, given appropriate study designs. However, the reasons clinicians give for the differences in their judgments are more difficult to investigate and will require further study.

The neuroanatomic basis of facial perception and variable facial discrimination ability: Implications for orthodontics

INTRODUCTION

Because of familial, ethnic-racial, cultural, and emotional preferences, achieving common facial understanding among orthodontist, patient, parents, and other health care professionals is a daunting communication challenge. Research into the neuroanatomic basis of human facial perception, including the roles of visual short-term memory and long-term memory, might apply to orthodontic facial learning.

METHODS

In this article, we review findings from functional magnetic resonance imaging and electrophysiology studies of the brain during visual perception and mental imaging of faces, and integrate these findings with facial learning needs in orthodontics.

RESULTS

Research distinguishes specialized brain areas for whole face and face feature perception, the spatial relationship of face features, and facial memory stores. The right anterior temporal lobe's fusiform face area helps recognize facial identity, whereas the bilateral superior temporal sulcus assists in perception of facial expression. The amygdala, hippocampus, and bilateral inferior occipital gyrus help process familiar, unfamiliar, and famous faces. Because visual perceptual experience and processing are individually variable, along with visual short-term memory and long-term memory capacities, it is likely that facial discrimination ability is variable.

CONCLUSIONS

Neuroanatomic research shows that each person's brain is as unique as his or her face. Due to variable neural hard-wiring, what the clinician sees facially might not be what the patient or parent sees, and vice versa. Enhanced facial learning is related to creation of a distinctive mental context associated with a facial stimulus and rich mixing between memory and visual perception. This context can be formed by information from clinical examinations, patient databases, patient-parent facial preference questionnaires, and functional face viewing. The more extensive the long-term memory facial links, the better the person knows the face. Facial discrimination exercises with electronic and hard-copy tools might improve facial learning and should be based on defined facial learning objectives. Tools should use facial prototypes and facial-feature spatial-relationship information, and emphasize categorization of whole faces and facial components. These are proven methods of expert recognition of objects having prototypical spatial configuration.

Análise Facial Subjetiva

INTRODUÇÃO: a análise facial tem sido um recurso diagnóstico valorizado desde os primórdios da Ortodontia. Vários autores tentaram estabelecer referências de normalidade na direção das quais os pacientes ortodônticos deveriam ser tratados. Essa preocupação da Ortodontia está em concordância com a expectativa do paciente, cuja principal motivação para o tratamento ortodôntico é a melhora estética. Para que os objetivos do profissional possam solucionar a queixa do paciente é fundamental que o ortodontista conheça os parâmetros utilizados pela sociedade na avaliação estética. Sugerimos, por meio desse trabalho, uma nomenclatura que permita a realização da Análise Facial Subjetiva, estética e morfológica. OBJETIVO: avaliar a aplicação prática da análise. METODOLOGIA: solicitou-se a um grupo heterogêneo de avaliadores (14 ortodontistas, 12 leigos e 7 artistas) que dessem notas ao perfil facial de 100 indivíduos (50 de cada gênero) classificando-os como esteticamente desagradáveis (notas 1, 2 ou 3), esteticamente aceitáveis (notas 4, 5 ou 6) e esteticamente agradáveis (notas 7, 8 ou 9). RESULTADOS: 89% dos perfis foram esteticamente aceitáveis, 8% desagradáveis e 3% agradáveis. Em 38,35% das justificativas, o nariz foi a estrutura responsável pela estética desagradável, seguida pelo mento ("queixo") em 18,9% dos relatos. CONCLUSÃO: foi possível observar, portanto, que a Análise Facial Subjetiva é mais um instrumento diagnóstico, que tem sua importância aumentada por ser o parâmetro pelo qual o paciente e as pessoas com as quais ele convive vão avaliar os resultados do tratamento.

Comparison of extraction versus nonextraction orthodontic treatment outcomes for borderline Chinese patients

INTRODUCTION

The purpose of this study was to compare orthodontic treatment outcomes in Chinese patients with borderline problems treated with and without extractions.

METHODS

Records of 39 borderline patients treated at the Faculty Clinic of the Peking University Orthodontic Department were evaluated retrospectively by 5 associate professors. Sixteen patients had been treated without extractions, and 23 had 4 first or second premolars extracted. Each judge evaluated the posttreatment records independently for tooth alignment, overbite, overjet, midline symmetry, lateral occlusion, and facial profile, and rated them on a scale from 1 to 5.

RESULTS

The only statistically significant difference between the extraction and nonextraction groups was for facial profile, with the judges preferring the extraction profiles. Fifteen soft-tissue cephalometric variables were measured to determine the source of the difference, and 6 showed statistically significant differences. When profile changes from pretreatment to posttreatment were examined, significant differences in treatment-associated changes between extraction and nonextraction groups were all related to the lower lip and chin.

CONCLUSIONS

In this sample of Chinese borderline orthodontic patients, Chinese clinicians had a statistically significant preference for the facial profiles of the extraction patients, but no statistically significant preferences for tooth alignment, overbite, overjet, midline symmetry, or posterior occlusion. Extraction treatment increases the inclination of the chin and reduces protrusion of the lower lip compared with nonextraction treatment, and this might explain the difference.

Facial profile preferences of black women before and after orthodontic treatment

INTRODUCTION

The purposes of this study were to determine (1) profile preferences of black female patients and (2) whether they can recognize their own profile images before and after orthodontic treatment.

METHODS

Fifteen black orthodontists, 15 white orthodontists, and 15 black female patients were asked to indicate the images they considered most pleasing and to determine a zone of acceptability for 3 black female profiles. Raters used the PERCEPTOMETRICS computer program (Health Programs International, Wellesley, Mass). In addition, the 15 patients were asked to identify their most accurate pretreatment and posttreatment profile images.

RESULTS

Analyses of variance showed that the white orthodontists preferred flatter profiles than the black women, who in turn preferred fuller profiles than the black orthodontists. Significant differences in lip position were detected for most pleasing and midpoint of acceptability among the 3 groups of judges, with no significant differences in any variables measured between treatments in rating the 3 images. No significant differences were detected for the magnitude of the zone of acceptability. All 15 black women recalled having fuller profiles than they actually did before treatment, but they could correctly identify their own profile images after treatment.

CONCLUSIONS

The results of this study will facilitate the understanding of the physical bases of the esthetic judgments of black and white orthodontists and black female patients.

Ethnic differences in upper lip response to incisor retraction

INTRODUCTION

The purpose of this retrospective longitudinal study was to investigate the response of the upper lip to incisor retraction and to ascertain the effect of ethnicity on this response.

METHODS

Pretreatment and posttreatment lateral cephalograms of 88 postpubertal female patients (44 black and 44 white; mean age, 18.45 years) were evaluated. The groups were matched by age and the amount of incisor retraction at incisor superius.

RESULTS

Although significant pretreatment differences existed between the groups in some cephalometric measurements, analysis of the treatment changes demonstrated significant differences only in incisor inclination. Hard and soft tissue changes of the black group were more downward, whereas changes in the white group were more backward. Multivariate regression analysis showed that the horizontal response of the upper lip to hard tissue changes at subnasale and superior labial sulcus was different in whites than in blacks. At subnasale, stepwise multivariate regression analysis showed that ethnicity contributed to the upper lip response to incisor retraction and was significantly greater in the white group.

CONCLUSIONS

The hard and soft tissue treatment changes of the black group were more downward, and those of the white group were more backward. Ethnic differences exist in the soft tissue response to hard tissue changes in the upper lip, and at subnasale and the superior labial sulcus; however, these response differences at superior labial sulcus can be explained by the ethnic differences in initial lip thickness and incisor inclination; they are not due in and of themselves to ethnicity. The change at prosthion was significantly correlated with the response of the upper lip at labrale superius to incisor retraction. Ethnicity added no increase to the predictability of the response. When incisor retraction was performed, the final horizontal upper lip position could be accurately and reliably predicted.

Treatment of a Class I malocclusion with severe bimaxillary protrusion

This report describes the treatment of a 20-year-old woman from Nigeria who had severe bimaxillary dentolveolar protrusion. The main issue in determining the appropriate treatment plan was the severity of the dentoalveolar protrusion. Four first premolars were extracted to reduce lip procumbancy. The change in the patient's facial esthetics was dramatic. Significant retraction of the upper and lower lips was achieved, and lip eversion and dentoalveolar protrusion were significantly improved. As the lips were retracted, mentalis strain was reduced; this improved chin projection. This case report was presented at an AAO meeting as part of the ABO student case display. It was chosen by committee to be published in the AJO-DO.

Changes in the African American female profile as depicted in fashion magazines during the 20th century

This study evaluated changes in the profiles of African American women presented in fashion magazines during the 20th century. Twenty-six variables were measured on a total of 119 profile photographs collected from various fashion magazines published in the 1940s through the 1990s. The photographs were divided into 6 groups corresponding to the decade in which they were published. A 1-way analysis of variance was performed, and between-group differences were examined with a Tukey multiple comparison procedure. Significant between-group differences (P <.01) were found for anteroposterior lip position, nasolabial angle, and interlabial angle, with increased fullness and more anteriorly positioned lips in the more recent decades. No significant differences were found for the frontonasal angle, the nasal tip angle, and the relationship of the chin to the upper face (total facial angle). Esthetic standards for the African-American female profile changed during the 20th century and, similar to the standards for the white profile, show a trend toward fuller and more anteriorly positioned lips.

Lateral facial soft-tissue prediction model: analysis using Fourier shape descriptors and traditional cephalometric methods

This study was designed to investigate the relationship between traditional skeletal cephalometric measurement and Fourier analysis of the lateral soft-tissue profile. A random sample of 121 untreated subjects of European descent, with wide ranges of malocclusions and underlying facial patterns, was selected in the Orthodontic Unit at the University of Melbourne. Lateral cephalograms were available for all subjects. Both traditional lateral cephalometric analysis and Fourier soft-tissue profile analysis were carried out. Multivariate statistical analysis among 11 hard-tissue cephalometric measurements and the first 50 Fourier harmonics was then performed. This analysis formed the basis for a subsequently proposed soft-tissue prediction model. From this model, 50 predicted x- and y-harmonics were generated for each subject in the total sample. Calculation of Pearson's correlation coefficients between the actual and predicted harmonics revealed strong relationships for many of the lower-order harmonics. To further test the model, the prediction-coefficients derived from all 121 subjects were then used to make predictions for the first 50 x- and y-harmonics for a subgroup of 10 independent test subjects. Once again, Pearson's correlations between the actual and predicted harmonics of the test model in the lower-order harmonics revealed strong associations. Superimposition of the actual and predicted soft-tissue outlines, however, revealed that much actual detail in the region between the nose and the chin was still lost using the predicted Fourier harmonics. This suggests that soft-tissue prediction based on this Fourier test model, while already useful in Forensic facial reconstruction, may not yet be appropriate for useful diagnosis and planning in clinical disciplines.