Evaluation of the Relationship Between Facial Measurements and Esthetic Evaluation of the Face in Patients With a Vertical Growth Pattern

BACKGROUND: Soft tissue specifications and facial values ​​vary depending on the underlying skeletal structures. To achieve the ideal treatment result and patient satisfaction, one must know the attractive soft tissue specifications compatible with each type of malocclusion. This study aims to analyze the facial measurements that contribute to perceived facial attractiveness in patients with vertical growth patterns and skeletal class I malocclusion, focusing on gender-specific differences.

METHODOLOGY: A panel of 30 laypersons, including raters from both genders equally, aged 19-24 years, evaluated extraoral photographs taken before the treatment of 60 patients (evenly divided between males and females employing a disproportionate stratified sampling method through a computer-generated list) with skeletal class I malocclusion, vertical growth pattern based on the Bjork sum, aged 18-25 years (with an average age of 22 ± 1.53 years), with the photographs taken in three positions (frontal relaxed, frontal during a smile, and relaxed profile). The raters utilized the visual analog scale (VAS) to assign an esthetic quality score to each photograph. Based on the average esthetic scores of each photo, two groups were created: the most attractive group, which received the highest esthetic score, and the least attractive group, which received the lowest esthetic score. After selecting 12 patients for each group, the angles and proportions of the frontal and lateral photos were calculated, and the results were compared between the two groups using an independent-sample t-test to see any significant differences.

RESULTS: The most attractive females had a significantly lower value of mouth width to lower facial height than the least attractive females (P = 0.039). In addition, the most attractive males had a substantially greater value of facial convexity angle than the least attractive males (P = 0.041). Regarding other profile and frontal variables, no statistically significant differences existed between the most and least attractive males and females.

CONCLUSIONS: In patients with vertical growth pattern malocclusion, it is important to consider the chin protrusion of male patients during treatment planning and diagnosis because it enhances masculine features in these patients, as well as the lower facial height of female patients.