PERCEPTION OF FACIAL PROFILE ATTRACTIVENESS BY ORTHODONTISTS AND GENERAL PUBLIC IN DAKSHINA KANNADA POPULATION
BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY:
Modern society places a strong emphasis on attractiveness. It has been shown that people with attractive features are regarded socially as more competent, successful and likeable.1
Beauty has traditionally been thought to be in the eye of the beholder and this allows for great variability among lay people in judgments of pleasing faces and among practitioners when developing individualized treatment plans.
The desire to improve facial esthetics has been shown in many studies to be the most common reason people seek treatment by an orthodontist.2 The objectives of orthodontic treatment are to achieve facial balance, by stabilizing the dentition, and pleasing facial and dental esthetics. Therefore, it is important to identify and define characteristics of a pleasing, well-balanced face, as well as those of a functioning occlusion.3 This can be a challenging task because the perception of an attractive face is largely subjective with ethnicity, age, gender, culture and personality influencing average facial traits.4 Therefore the study of facial attractiveness should be important for orthodontists when addressing their patients need for improved facial esthetics. It is also clear that any difference in the perception of facial attractiveness between clinicians and society should be more thoroughly understood in the further development of patient- centered treatment goals. Also the public’s perception of facial beauty is mostly unconditioned compared to the orthodontists. Failure to understand the patients’ expectation of treatment could result in patient dissatisfaction, despite satisfactory outcomes from the orthodontic and surgical techniques.2 The purpose of this study is to assess and determine the perception of facial profile attractiveness by orthodontists and general public using Silhouette method. In addition Comparison of the facial profile components considered desirable for males and for females will be done by orthodontists and general public.
REVIEW OF LITERATURE :
A study was done using Silhouette profiles to determine the effects of orthodontic treatment on facial esthetics. The results support the use of the silhouette in evaluation of profiles. Also, they show the advantage of determining, in surveys of facial esthetics, whether or not preferred profiles or faces are “satisfactory” to the viewers. However since it is a simplified representation of a profile, the silhouette is a complement to other methods of profile evaluation, not a substitute.5
A study was done to assess the role of the nose, lips, and chin in achieving a balanced facial profile. The silhouettes had varied nose, lips and chin relationship as well as changes in facial angle and angle of convexity. The varied profile was rated on basis of most preferred to least preferred. The data was computed and was found that in males straighter profile was preferred in comparison with a slightly convex profile for the females. Among the most unfavorable combinations were either with excessive retrusive chin or excessively convex profiles. It was suggested that orthodontic treatment goals should be attuned to the achievement of balance and harmonious facial features rather than rigid adherence to standard average dental and skeletal parameters.6
A study was undertaken to compare the assessments of Chinese facial profile attractiveness by orthodontists and oral surgeons. The results showed a strong correlation in the profile assessment between orthodontists and oral surgeons. There was a difference in professional opinion about the most attractive male profile, with orthodontists preferring a flatter profile and oral surgeons preferring a fuller normal Chinese profile. Sex of dental professionals and number of years in clinical practice were found to affect profile rankings.7
A study was done to assess the most favored or the most balanced facial profile from a series of facial silhouettes with varying anteroposterior lip positions by a group of orthodontists and a group of young adult Japanese dental students. The results showed that both the orthodontists and students preferred a profile with slightly retruded lips. The dental students favored a more retruded lip position for women. The least favored profile was the most protrusive.3
To evaluate the perception of facial attractiveness a study was done by using profile digital photographs that were incrementally altered to produce different combination of mandibular anteroposterior position and lower anterior facial heights. The result showed that Intrarater reliability was good and general concordance was found between the providers and consumers in their perception of facial attractiveness. Interactions of the anteroposterior and vertical dimensions and the magnitude of change in each dimension influence the perception of facial attractiveness.2
A study was conducted to determine the influence of chin prominence on preferred lip position in profile. The results concluded that fuller lip positions were preferred for the more extreme retrognathic and prognathic profiles. Whereas more retrusive lip positions were preferred for the more average profiles. No differences wee found among the three evaluator groups or between male and female evaluators. Scattered differences were found among lip preferences for males and female profiles.8
A study was done to determine, assess, and compare the range of values of the most-favored facial profiles rated by young Korean and Japanese adults. The results showed that both the Korean and Japanese dental students tended to select a slightly more retruded lip profile even though their profiles have historically been characterized by more convex facial features.9
A study was done to determine whether there are differences in self-awareness and perception of an individual’s own profile among various groups. The results showed that overall agreement between the individual’s perceptions of their own profiles and evaluation by orthodontists was 53%.This suggested that about half the population cannot characterize their own profile. And subjects who perceived their own profiles as being different from average were more likely to be unhappy with their facial appearance.1
6.3 OBJECTIVES OF THE STUDY : To assess the orthodontists and layman’s visual accommodation for varied sagittal lip positions as well as their perceptions for varied facial angle, Nasolabial angle, Nasal tip angle, Mentolabial sulcus angle and angle of nasal prominence affecting facial profile.
To assess the facial profile components considered desirable for males and for females by orthodontists and laymen.
MATERIALS AND METHODS 7.1 SOURCE OF DATA:
The study will be carried out on patients visiting the out patient department in A.B.Shetty Memorial Institute of Dental Sciences.
30 Subjects; 15 males and 15 females in the age group of 18 to 25 years will be selected.
INCLUSION CRITERIA :
Subject of Dakshina Kannada origin
All teeth present (except third molars) with Class I molar and canine relationship with good interdigitation of posterior teeth.
Overjet and Overbite relationship within the range of 2 - 4 mm.
No previous orthodontic treatment.
EXCLUSION CRITERIA :
Prior orthodontic/ Surgical treatments
Missing teeth or Prosthesis
Cleft lip and Palate
7.2 METHODOLOGY METHOD OF COLLECTION OF DATA : After examining each subject for his/her dental occlusion and facial profiles, Profile photograph of the subject will be taken in a standardized and specified technique.
The following Angular and Linear measurements will be recorded on the Profile photographs.
Angle of Nasal Prominence
Nasal tip angle
Mentolabial sulcus angle
Size of the Lips
Average values of the above parameters will be calculated.
Using these average values an androgynous facial Silhouette will be constructed. Varied silhouette profiles will be made from the original constructed silhouette by incrementally varying the Size of the Lips, Angle of Nasal Prominence, Nasal tip angle, Nasolabial angle, Mentolabial sulcus angle and Facial angle. These variations will be done using Adobe Photoshop software.
There will be six series of profiles with five profiles in each series. All profiles will have static facial vertical dimension and forehead contour. Changes made in one series will be restricted to the particular parameter selected and will not be carried out to the next series. These facial Silhouettes (30) will be evaluated by 50 Orthodontists and 50 laymen from local population.
Silhouette profiles will be presented in two sets and the evaluators shall grade them separately for male and female sexes. Profiles will be graded in rank order from 1 to 5 in order of their preference, 1 being the best and 5 being the worst profile.
The results of the study will be based on the frequency (mode) as depicted by percentage of a particular profile as the most preferred and the least preferred in each series, selected by the orthodontists and laymen.
Significance levels of the most and least preferred profile among orthodontists and laymen and between male and female profiles will be calculated using Pearson Chi Square test.
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals?
Yes, the study requires the informed consent of the individual/parent/guardian for facial profile photograph.
7.4 Has the ethical clearance been obtained from your institution in case of 7.3? Yes, ethical clearance letter is enclosed.
LIST OF REFERENCES:-
Eser Tufekci, Arousha Jahangiri, steven J.Lindauer - PerceptioAn of Profile among Laypeople, Dental Students and Orthodontic Patients: Angle Orthodontist, 2008; 78(6) 983-987.
Jenny R.Maple, Katherine W.L.Vig, F.Michael Beck – A Comparison of Providers and consumers Perceptions of Facial-Profile attractiveness: American Journal of Orthodontics and Dentofacial Orthopedics 2005; 128:690-696.
Hideki Loi, shunsuke, Nakata and Amy L.counts – Anteroposterior Lip Positions of the most-favored Japanese Facial Profiles: American Journal of Orthodontics and Dentofacial Orthopedics 2005; 128:206-211.
Sandra Anicy-Milosevicy, Lapter-Varga M, Slaj M. - Analysis of the soft tissue facial profile by means of angular measurements.European Journal of Othodontics 2008; 30(2):135-140.
James G.Barrer, Joseph Ghafari – Silhouette Profiles in the Assessment of Facial Esthetics: A Comparison of cases treated with various Orthodontic Appliances: American Journal of Orthodontics and Dentofacial Orthopedics 1985; May 385-391.
S. Thomas Czarnecki, Ram S. Nanda,G. Fråns Currier - Perceptions of a balanced facial profile: American Journal of Orthodontics and Dentofacial Orthopedics 1993;104:180-187.
Jen soh, Ming Tak Chew, and Hwee Bee wong – Professional assessment of Facial Pofile attractiveness:American Journal of Orthodontics and Dentofacial Orthopedics 2005; 128: 201-205.
Grant G.Coleman, Steven J.Lindauer, Bhavna Shroff – Influence of Chin Prominence on Esthetic Lip Profile Preferences: American Journal of Orthodontics and Dentofacial Orthopedics 2007; 132:36-42.
Hideki Loi,Takahiro Shimomura, shunsuke, Nakata and Amy L.Counts – Comparison of Anteroposteior Lip Positions of the most-favored Facial profiles of Korean and Japanese People: American Journal of Orthodontics and Dentofacial Orthopedics 2008; 134:490-495.
Signature of the candidate
10.1 Remarks of the guide
This study is interesting and feasible.
10.2 Name and designation of Guide( in block letters)
PROF. (DR.) U.S. KRISHNA NAYAK
HEAD OF DEPARTMENT
DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS.
A.B.SHETTY MEMORIAL INSTITUTE OF DENTAL SCIENCES, DERALAKATTE, MANGALORE- 575018.
12.1 Head of the department
PROF. (DR.) U.S. KRISHNA NAYAK
HEAD OF DEPARTMENT
DEPARTMENT OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS.