A Comparison of Esthetic Preferences on Female Skeletal Class II Alterations among Laypeople of Different Facial Profiles.

Objectives:  This study aimed to investigate the influences of assessors' different personal profiles on the esthetic perception of Class II facial profile corrections and the agreement between profile and silhouette images.

Materials and methods:  A profile photo of a female with skeletal Class II was digitally altered into three profile and three silhouette images (most pronounced Class II division 1 characteristic, more retruded upper lip position, and more protruded mandibular position). Ninety-six laypeople from three facial profile groups (straight, convex, and concave profiles) chose these images for facial attractiveness. Data were analyzed using an SPSS program. Cohen's kappa coefficient and intraclass correlation coefficients were applied to determine intraparticipant and intra-examiner reliabilities. Chi-square tests were used to test between-group preferences and the relationship of profile preference with other factors. Cohen's kappa coefficient was used to test the agreement in selecting profile and silhouette images (p = 0.05).

Results:  All groups favored profiles with a protruded mandibular position (11-degree facial contour angle [FCA] and 91-degree nasolabial angle [NLA]). Despite facial profile differences, preference remained consistent (p = 0.649). The convex group showed a stronger inclination toward an untreated-simulating profile (17-degree FCA and 91-degree NLA). Preferences were consistent regardless of sex (p = 0.198) and education (p = 0.105). The percentage of agreement between profile and silhouette images in the total sample was 67.71% (kappa = 0.386). All groups of participants chose the more retruded upper lip position (17-degree FCA and 107-degree NLA) profile in silhouette more than in photograph.

Conclusion:  All groups preferred a mandibular advancement-simulating profile. Using the photographs or silhouettes to assess the esthetic preference resulted in a similar trend. However, the flatter profile was more preferred in silhouette than in photograph.