Aesthetic evaluation and therapeutic procedures related to main facial profiles

COSTA, PEDRO HERMESSON OLIVEIRA; COELHO, VICTOR CAVALCANTI; OLIVEIRA, WANESSA VENTURA DE; SOARES, DIEGO MOURA; SOUSA JÚNIOR, JOSÉ ROMERO SOUTO DE; SANTOS, MARCONI EDUARDO SOUSA MACIEL

doi:10.5935/2177-1235.2015RBCP0141

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Revista Brasileira de Cirurgia Plástica

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Original Article • Rev. Bras. Cir. Plást. 30 (2) • Apr-Jun 2015 • https://doi.org/10.5935/2177-1235.2015RBCP0141 copy

Aesthetic evaluation and therapeutic procedures related to main facial profiles

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Orthognathic surgery for correction of dentofacial deformities provides a more-symmetrical face, and functional and aesthetic benefits. The aim of this study was to evaluate the perception of buccomaxillofacial surgeons regarding the aesthetics of facial profiles patterns I, II, and III in related to sex, ethnicity, and the main therapeutic procedures.

Methods:

We interviewed 18 specialist surgeons or surgeons in training in buccomaxillofacial surgery by using a standardized clinical report form for aesthetic evaluation and therapeutic procedures of 12 manipulated images simulating facial profiles, sex, and race.

Results:

As for aesthetics, the highlights were that facial profile type I had the highest mean values, whereas facial profile type III had the lowest mean values. However, no significant differences were found between the mean values obtained in different facial profiles in relation to sex and race. The therapeutic procedures were homogeneous in profiles II and III, with higher percentages for classical procedures in the orthosurgical treatment of these dentofacial deformities.

Conclusion:

Facial profile I was considered more aesthetic. Furthermore, sex and racial type effects on aesthetics for the studied sample. Facial profiles I were the most difficult to assess as to therapeutic procedures, which resulted in a wide range of options in relation to profiles II and III.

Keywords:
Perception; Therapeutic procedures; Maxillofacial abnormalities; Dental aesthetics

No treatment needed

Only corrections and/or orthodontic compensation
Maxillary advancement
Mandibular advancement
Only mentoplasty
Vertical decrease of maxilla
Maxillary advancement and mandibular retreat with or without mentoplasty
Maxillary retreat and mandibular advancement with or without mentoplasty
Maxillary advancement and mentoplasty
Mandibular retreat and mentoplasty
Mandibular advancement and mentoplasty
Maxillary retreat
Mandibular retreat
Maxillary retreat with mentoplasty
Vertical increase of the maxilla
Aumento vertical de maxila

Gender	Ethnicity	Facial Type			p Value
		Type I	Type II	Type III
		Mean ± SD	Mean ± SD	Mean ± SD
Male	White	7.22 ± 2.32	4.44 ± 2.38	3.56 ± 259	p(¹1 Delalíbera HVC, Silva MC, Pascotto RC, Terada HH, Terada RSS. Avaliação estética de pacientes submetidos a tratamento ortodôntico. Acta Scient Health Sci. 2010;32(1):93-100.) < 0.001^* * Significant differences at a 5.0% level.
	Black	5.94 ± 2.21	4.06 ± 2.18	3.28 ± 2.57	p(¹1 Delalíbera HVC, Silva MC, Pascotto RC, Terada HH, Terada RSS. Avaliação estética de pacientes submetidos a tratamento ortodôntico. Acta Scient Health Sci. 2010;32(1):93-100.) = 0.003^* * Significant differences at a 5.0% level.
	p value	p(²2 Feitosa DAS, Dantas DCRE, Guênes GMT, Ribeiro AIAM, Cavalcanti AL, Braz R. Percepção de pacientes e acadêmicos de odontologia sobre estética facial e dentária. Rev Fac Odontol Univ Passo Fundo. 2009;14(1):23-6.) = 0.099	p(²2 Feitosa DAS, Dantas DCRE, Guênes GMT, Ribeiro AIAM, Cavalcanti AL, Braz R. Percepção de pacientes e acadêmicos de odontologia sobre estética facial e dentária. Rev Fac Odontol Univ Passo Fundo. 2009;14(1):23-6.) = 0.613	p(²2 Feitosa DAS, Dantas DCRE, Guênes GMT, Ribeiro AIAM, Cavalcanti AL, Braz R. Percepção de pacientes e acadêmicos de odontologia sobre estética facial e dentária. Rev Fac Odontol Univ Passo Fundo. 2009;14(1):23-6.) = 0.744
Female	White	6.61 ± 1.94	4.94 ± 2.01	3.72 ± 2.37	p(¹1 Delalíbera HVC, Silva MC, Pascotto RC, Terada HH, Terada RSS. Avaliação estética de pacientes submetidos a tratamento ortodôntico. Acta Scient Health Sci. 2010;32(1):93-100.) = 0.001^* * Significant differences at a 5.0% level.
	Black	6.94 ± 2.18	4.39 ± 2.00	3.56 ± 2.48	p(¹1 Delalíbera HVC, Silva MC, Pascotto RC, Terada HH, Terada RSS. Avaliação estética de pacientes submetidos a tratamento ortodôntico. Acta Scient Health Sci. 2010;32(1):93-100.) < 0.001^* * Significant differences at a 5.0% level.
	p value	p(²2 Feitosa DAS, Dantas DCRE, Guênes GMT, Ribeiro AIAM, Cavalcanti AL, Braz R. Percepção de pacientes e acadêmicos de odontologia sobre estética facial e dentária. Rev Fac Odontol Univ Passo Fundo. 2009;14(1):23-6.) = 0.632	p(²2 Feitosa DAS, Dantas DCRE, Guênes GMT, Ribeiro AIAM, Cavalcanti AL, Braz R. Percepção de pacientes e acadêmicos de odontologia sobre estética facial e dentária. Rev Fac Odontol Univ Passo Fundo. 2009;14(1):23-6.) = 0.413	p(²2 Feitosa DAS, Dantas DCRE, Guênes GMT, Ribeiro AIAM, Cavalcanti AL, Braz R. Percepção de pacientes e acadêmicos de odontologia sobre estética facial e dentária. Rev Fac Odontol Univ Passo Fundo. 2009;14(1):23-6.) = 0.838
p value		p(³3 Kiekens RM, Maltha JC, van ‘t Hof MA, Kuijpers-Jagtman AM. A measuring system for facial aesthetics in Caucasian adolescents: reproducibility and validity. Eur J Orthod. 2005;27(6):579-84. DOI: http://dx.doi.org/10.1093/ejo/cji053 http://dx.doi.org/10.1093/ejo/cji053... ) = 0.331	p(³3 Kiekens RM, Maltha JC, van ‘t Hof MA, Kuijpers-Jagtman AM. A measuring system for facial aesthetics in Caucasian adolescents: reproducibility and validity. Eur J Orthod. 2005;27(6):579-84. DOI: http://dx.doi.org/10.1093/ejo/cji053 http://dx.doi.org/10.1093/ejo/cji053... ) = 0.668	p(³3 Kiekens RM, Maltha JC, van ‘t Hof MA, Kuijpers-Jagtman AM. A measuring system for facial aesthetics in Caucasian adolescents: reproducibility and validity. Eur J Orthod. 2005;27(6):579-84. DOI: http://dx.doi.org/10.1093/ejo/cji053 http://dx.doi.org/10.1093/ejo/cji053... ) = 0.960
p value		p(⁴4 Veronez FS, Tavano LDA. Modificações psicossociais observadas pós-cirurgia ortognática em pacientes com e sem fissuras labiopalatinas. Arq Ciênc Saúde. 2005;12(3):133-37.) = 0.397	p(⁴4 Veronez FS, Tavano LDA. Modificações psicossociais observadas pós-cirurgia ortognática em pacientes com e sem fissuras labiopalatinas. Arq Ciênc Saúde. 2005;12(3):133-37.) = 0.501	p(⁴4 Veronez FS, Tavano LDA. Modificações psicossociais observadas pós-cirurgia ortognática em pacientes com e sem fissuras labiopalatinas. Arq Ciênc Saúde. 2005;12(3):133-37.) = 0.842
p value		p(⁵5 Ambrizzi DR, Franzi SA, Pereira Filho VA, Gabrielli MAC, Gimenez CMM, Bertoz FA. Avaliação das queixas estético-faciais em pacientes portadores de deformidades dentofaciais. R Dental Press Ortodon Ortop Facial. 2007;12(5):63-70. DOI: http://dx.doi.org/10.1590/S1415-54192007000500009 http://dx.doi.org/10.1590/S1415-54192007... ) = 0.181	p(⁵5 Ambrizzi DR, Franzi SA, Pereira Filho VA, Gabrielli MAC, Gimenez CMM, Bertoz FA. Avaliação das queixas estético-faciais em pacientes portadores de deformidades dentofaciais. R Dental Press Ortodon Ortop Facial. 2007;12(5):63-70. DOI: http://dx.doi.org/10.1590/S1415-54192007000500009 http://dx.doi.org/10.1590/S1415-54192007... ) = 0.636	p(⁵5 Ambrizzi DR, Franzi SA, Pereira Filho VA, Gabrielli MAC, Gimenez CMM, Bertoz FA. Avaliação das queixas estético-faciais em pacientes portadores de deformidades dentofaciais. R Dental Press Ortodon Ortop Facial. 2007;12(5):63-70. DOI: http://dx.doi.org/10.1590/S1415-54192007000500009 http://dx.doi.org/10.1590/S1415-54192007... ) = 0.738

Procedure	Male				Female				Total group
	White		Black		White		Black		Total group
	n	%	n	%	n	%	n	%	n	%
No treatment needed	8	44.4	1	5.7	4	22.2	11	61	24	33.3

Procedure	Male				Female				Total group
	White		Black		White		Black		Total group
	n	%	n	%	n	%	n	%	n	%
Only corrections and/or orthodontic compensation	-	-	-	-	1	5.6	1	5.6	2	2.8
Maxillary advancement	1	5.6	-	-	-	-	-	-	1	1.4
Mandibular advancement	10	55.6	5	27.8	7	38.9	5	27.8	27	37.5
Mentoplasty only	-	-	-	-	-	-	1	5.6	1	1.4
Maxillary retreat and mandibular advancement with or without mentoplasty	-	-	8	44.4	2	11.1	4	22.2	14	19.4
Maxillary advancement and mentoplasty	-	-	-	-	1	5.6	1	5.6	2	2.8
Mandibular advancement and mentoplasty	7	38.9	5	27.8	7	38.9	3	16.7	22	30.6
Maxillary retreat	-	-	-	-	-	-	2	11.1	2	2.8
Maxillary retreat with mentoplasty	-	-	-	-	-	-	1	5.6	1	1.4
Total	18 100.0		18 100.0		18 100.0		18 100.0		72	100.0

Procedure	Male				Female				Total group
	White		Black		White		Black		Total group
	n	%	n	%	n	%	n	%	n	%
No treatment needed	-	-	1	5.6	-	-	-	-	1	1.4
Maxillary advancement	4	22.2	-	-	2	11.1	-	-	6	8.3
Maxillary advancement and mandibular retreat with or without mentoplasty	12	66.7	16	88.9	13	72.2	14	77.8	55	76.4
Maxillary advancement and mentoplasty	1	5.6	-	-	-	-	1	5.6	2	2.8
Mandibular retreat and mentoplasty	1	5.6	1	5.6	3	16.7	2	11.1	7	9.7
Mandibular retreat	-	-	-	-	-	-	1	5.6	1	1.4
Total	18 100.0		18 100.0		18 100.0		18 100.0		72	100.0

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[1] *Corresponding author: Marconi Eduardo Sousa Maciel Santos Av. Portugal, 584, Bairro Universitário, Caruaru, PE, Brazil Zip code 55016-400, E-mail: marconimaciel@gmail.com