A CBCT Evaluation of Esthetic Preference Regarding the Perceived Facial Attractiveness of Young Korean Female Adults with a Normal Skeletal Pattern
by
Jin-Hyoung Oh
1,†,
Jae Hyun Park
2,3,†,
Heon Jae Cho
4,5,
Hye Young Seo
6 and
Jong-Moon Chae
1,2,7,* 1
Department of Orthodontics, School of Dentistry, University of Wonkwang, Iksan 54538, Korea
2
Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ 85206, USA
3
International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea
4
Dr. Cho’s Orthodontic Office, Seoul 06023, Korea
5
Arthur A. Dugoni School of Dentistry, University of the Pacific, San Franciso, CA 94103, USA
6
School of Big Data and Financial Statistics, College of Natural Sciences, University of Wonkwang, Iksan 54538, Korea
7
Wonkwang Dental Research Institute, University of Wonkwang, Iksan 54538, Korea
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Sensors 2022, 22(19), 7258; https://doi.org/10.3390/s22197258
Submission received: 1 September 2022
/
Revised: 16 September 2022
/
Accepted: 22 September 2022
/
Published: 25 September 2022
(This article belongs to the Special Issue New Frontier in Advanced Dentistry: CBCT, Intraoral Scanner, Sensors, and Artificial Intelligence in Dentistry)
Abstract
:The aim of this study was to determine the factors that affect esthetic preference regarding the perceived facial attractiveness of young Korean female adults with a normal skeletal pattern using cone-beam computed tomography (CBCT). After reorienting the CBCT images of 40 young Korean female adults, three-dimensional (3D) measurements were analyzed, and five 3D facial images were digitally constructed. A computer-based questionnaire was used to determine perceived facial attractiveness by scoring from 1 (very unattractive) to 10 (very attractive). Esthetic perception and the most influential facial view and component were examined and compared by orthodontists, general dentists, and laypeople to evaluate facial attractiveness. Compared to the unattractive group, the attractive group had significantly greater values for Pog-NB, L1SI-FH, U lip thickness, L lip-U lip, and Nasolabial angle, along with significantly lower values for U1SI-FH and Cant of U lip; the attractive group also had a more retruded U1MP (p < 0.01), L1MP (p < 0.01), U lip (p < 0.05), and L lip (p < 0.01) relative to N, as well as a more retruded U lip (p < 0.05) and L lip (p <0.001) relative to esthetic lines. Orthodontists and general dentists were more likely to consider the profile view. When evaluating facial attractiveness, orthodontists and laypeople more often focused on the lips and chin. When evaluating facial attractiveness, all evaluators showed a high esthetic preference for retroclination and retrusion of the incisors and lips, but there were some differences in how they perceived facial attractiveness. Therefore, the ultimate perception of facial attractiveness needs to be based on the esthetic perceptions of laypeople.
1. Introduction
The goal of orthodontic treatment should be to create an ideal or functional occlusion and a well-balanced face. This raises a couple of questions, including “Do dental professionals and laypeople have the same perception of which facial esthetics look best?” and, if not, “Which perceptions, those of the professionals or patients, should prevail in treatment planning for orthodontic treatment?” [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20].
Two-dimensional (2D) soft tissue facial or cephalometric analyses have been performed to aid in diagnosis and treatment planning to compare soft tissue profiles, optimize facial attractiveness, and investigate soft tissue adaptability to hard tissue [2,3,4,5,6,7,8,9,10,11,13,15,16,18,19,20]. Although these studies have improved the understanding of facial attractiveness, there was a vulnerability in their evaluation of facial attractiveness because it was investigated primarily in a profile view.
The application of three-dimensional (3D) imaging may give the clinician a more accurate evaluation of facial morphologies and therefore be useful for better understanding, comparing, and predicting treatment outcomes for orthodontic treatment or orthognathic surgery [12,21,22,23,24,25,26]. The advancement of 3D radiographs and their associated software programs has improved the ability to analyze both hard and soft tissue data. Three-dimensional cephalometric analyses provide information about not only the sagittal plane but also the intricate interrelationship between the sagittal, coronal, and axial dimensions of the craniofacial structure [24,25,26].
Several studies have used 3D imaging [11,12,21,22,23,24,25,26], but only a few focused on 3D facial esthetic preferences using 3D cephalometric analysis. Therefore, the purpose of this study was to evaluate the 3D facial attractiveness of young female adults with a normal skeletal pattern and then to investigate the differences in esthetic perception between orthodontists, general dentists, and laypeople. The null hypothesis states that there is no difference between the three groups of evaluators with respect to esthetic perception.
2. Materials and Methods
2.1. Subjects and Eligibility Criteria
This study was approved by the institutional review board (IRB) of Wonkwang University Daejeon Dental Hospital (W2202/003-001). All participants agreed to participate in this study and signed a written informed consent form.
The sample consisted of 40 young female adults (23.9 ± 4.7 years) who had cone-beam computed tomography (CBCT) scans taken for orthodontic treatment at Wonkwang University Daejeon Dental Hospital from January 2016 to December 2021. The CBCT (PSR 9000N; Asahi Alphard Vega, Kyoto, Japan) images were taken in C-mode (scan size, 200 × 179 mm; voxel size, 0.39 mm; field of view, 19.97 cm; scan time, 17 s; slice thickness, 1.0 mm) for pretreatment assessment. They had a normal skeletal pattern, according to the following inclusion criteria. These criteria were determined based on a previous study for the cephalometric analysis of normal Korean samples.
Inclusion criteria (3D normal skeletal criteria):
- Sagittal: 0 mm < Pog(y) − A(y) < 4 mm
- Vertical: 54% ≤ Lower facial height (A-Me)/Total facial height (N-Me) ≤ 57%
- Transverse: −4 mm < Pog(x) < 4 mm
2.2. Standardized Reorientation of CBCT Images, 3D Coordinate System, and 3D Measurement
ON3D (3DONS, INC., Seoul, Korea) software was used for this study. First, reorientation of the head position of each CBCT scan was performed to minimize any measurement errors from non-standard head postures [24]. The 3D coordinates (x, y, z) of all landmarks represent their 3D position relative to N (0,0,0) (Figure 1).
2.3. Evaluation of Perceived Facial Attractiveness Using a Questionnaire
Images in soft tissue mode were captured from the frontal, oblique (left and right), and profile (left and right) views of 40 subjects using ON3D software. Thus, 3D soft tissue images consisting of a total of five photographs of each sample were constructed. Hair, eyes, and ears were excluded from the image to eliminate distractions, thus allowing evaluators to focus on the middle and lower face (Figure 4A).
The evaluators consisted of 42 orthodontists, 42 general dentists, and 42 laypeople. Data were collected via a computer-based questionnaire distributed personally to the participants by cell phone. The inclusion criteria for all evaluators included being at least 20 years of age and willing to participate in this study. The evaluators were asked to examine the facial 3D images for a sufficient time and then rank them from 1 (very unattractive) to 10 (very attractive) using a numeric rating scale (NRS) (Figure 4A). After that, they were asked the two questions shown on the last page of the questionnaire (Figure 4B).
According to the ranking of facial attractiveness, some of the 40 subjects were divided into either the attractive group (AG, top 20%, n = 8) or the unattractive group (UAG, bottom 20%, n = 8). Three-dimensional measurements were analyzed, and esthetic perception was compared between the three groups of evaluators. Additionally, it was determined which facial view was the most influential and which components were the most important in evaluating facial attractiveness.
2.4. Statistical Analysis
A power analysis using G*Power (version 3.1.9.7: Franz Faul, Christan-Albrechts-Universitat, Kiel, Germany) was performed to determine the sample size required for this study. It was determined that a total number of 126 subjects would provide a power of 0.87 and a two-tailed alpha value of 0.05.
To assess the reliability of the reorientation and digitizing process, CBCT scans of 10 subjects were re-digitized by the same operator after 3 weeks. Intraexaminer reliability was assessed by the intraclass correlation coefficient, which showed excellent reliability (ICC = 0.981~0.983). Statistical analysis was performed using SPSS software (version 27.0 for Windows; SPSS Corp., Chicago, IL, USA) for statistical analysis. An independent sample t-test was performed to determine the difference in 3D values according to perceived facial attractiveness between the AG and the UAG. Spearman’s rank correlation analysis was performed to determine the correlations between the ranks of the three evaluator groups. Cross-analysis was performed to determine the association between the evaluator groups for the image view and facial components when judging facial attractiveness. After the Shapiro–Wilk normality test was performed, if normality was not satisfied, a nonparametric test was performed. If the analysis of variance was significant, Scheffe’s post hoc test was performed. The significance level was 0.05.
3. Results
Compared to the UAG, the AG showed greater values for Pog-NB (p < 0.05), L1SI-FH (p < 0.01), U lip thickness (p < 0.05), L lip-U lip (p < 0.05), and Nasolabial angle (p < 0.001), and lower values for U1SI-FH (p < 0.001) and Cant of U lip (p < 0.001); the AG also exhibited a more retruded U1MP (p < 0.01), L1MP (p < 0.01), U lip (p < 0.05), L lip (p < 0.01), and ML S (p < 0.05) relative to N, as well as a more retruded U lip (p < 0.05) and L lip (p < 0.001) relative to esthetic lines (S-line and E-line). The 3D cephalometric results obtained from each of the groups of evaluators were almost the same as those obtained from the evaluators as a whole. The AG showed more retroclination and retrusion of incisors and lips than the UAG (Table 2A,B).
The most influential facial view (p < 0.05) and facial component (p < 0.001) with respect to perceived facial esthetics were significantly different between the three groups. Orthodontists (59.5%, p < 0.001) and general dentists (57.2%, p < 0.01) considered the profile view to be the most important, while laypeople (40.5%, p > 0.05) considered the frontal view the most important. Orthodontists (73.8%, p < 0.001) focused on lips, while general dentists (38.1%, p > 0.05) and laypeople (45.2%, p < 0.05) focused on the chin. The three groups of evaluators showed some differences in how they perceived facial attractiveness (Table 3).
4. Discussion
In this study, we evaluated facial attractiveness using 3D images obtained from CBCT and then derived 3D measurements and coordinates of faces that were perceived to be beautiful at the time of the study. Furthermore, we were able to acquire information about the normative mean values of the 3D coordinates and measurements of Korean female adults using data for the specific ethnic group [21,22].
Pog-NB and Pog(y)-B(y) values were greater in the AG than in the UAG in our study. This means that a more prominent Pog relative to the NB line and B(y) was considered to be more attractive; this is consistent with the results of a previous study [27]. On the other hand, Kambara et al. [27] concluded that a chin prominence (Pog-NB) greater than 4 mm could result in an unattractive face. From an esthetic standpoint, Pog-NB was related to lower lip position [6,7] and vertical skeletal pattern [28], which should be considered in order to identify the ideal lip position during treatment planning. Even so, in our study, the AG showed a more posterior position of Pog(y) relative to N than the UAG, which is consistent with the results of previous studies [1,2,3,21]. These results in young female adults may differ from those observed in young male adults [1,2,3], so further studies are necessary.
The positions of the tips of the cheeks and nose were not significantly different between the AG and the UAG in our study. However, some previous studies [12,26] suggested that maxillary skeletal expansion was correlated with forward movement of the cheek point and that cheek volume should be considered when evaluating facial attractiveness. Our study also showed that the lips were more posteriorly positioned in the AG than in the UAG, which means that somewhat retruded lips were perceived as more attractive. These results are consistent with those of previous studies [2,4] on the preference of facial esthetics in the Asian population. These studies reported that the public tends to prefer lips that are more retruded than average, although they have been distinguished by convex facial profiles.
In this study, significant differences were also found in U lip thickness and L lip(y)-U lip(y). Compared to the UAG, the AG showed greater upper lip thickness, which is consistent with some previous studies [11,29] that reported fuller lips were preferable. In addition, the L lip(y)-U lip(y) values were significantly greater in the AG. This indicates that it was considered more esthetic when the lower lip was positioned posteriorly relative to the upper lip. In addition, the preference for the lower lip position is closely related to the chin position [3,7].
Jang et al. [21] and Bayome et al. [23] reported that women chosen as Miss Korea had less chin and cheek volume than the general population. In our study, the attractive group tended to have a retrusive chin, but there were no significant differences in the values for the cheek or zygoma areas. The size and position of the cheeks and nose vary greatly from one individual to the next and should not be considered as a single factor that affects facial esthetics.
In this study, the most influential facial views and components used to judge facial esthetics were significantly different between the three evaluator groups, which is consistent with a previous study [30]. It is quite possible that esthetic perceptions are different among the evaluators depending on their training, educational background, and knowledge [2,8,15,17,20,30].
Yin et al. [2] suggested that orthodontists’ concepts of profile esthetics are influenced by their specialist training and preference for using cephalometric measurements to assess facial profiles. However, orthodontists should not forget that the ultimate perception of facial attractiveness should be based on the perceptions of laypeople and patients, not orthodontists [11,14]. Recognizing the differences in their esthetic perceptions may help orthodontists understand their patients’ expectations for orthodontic treatment and move them to consult with patients about the effects or limitations of treatment in terms of various facial areas during the diagnosis and treatment planning processes.
Smile esthetics, skin texture and color, lip color and form, etc., may affect the esthetic perception of facial attractiveness [31]. However, they were not included in this study because we could not take CBCT images that included them; this is a limitation of this study. Therefore, 3D photographs including these factors should be combined with CBCT images in future studies [32].
5. Conclusions
The null hypothesis was rejected; some differences were identified between the three groups of evaluators.
- When evaluating facial attractiveness, all three groups of evaluators showed a high esthetic preference for retroclination and retrusion of incisors and lips. Still, they showed differences in how they perceived facial attractiveness. The results are valid only in Asian populations, within the limitations of this study.
- The most influential facial views used to judge facial esthetics were the profile view for orthodontists (59.5%) and general dentists (57.2%) and the frontal view for laypeople (40.5%).
- The most influential facial components used to judge facial esthetics were the lips for orthodontists (73.8%) and the chin for general dentists (38.1%) and laypeople (45.2%).
- The ultimate perception of facial attractiveness needs to be based on the esthetic perceptions of laypeople.
- CBCT and an associated software program can be useful for evaluating facial esthetics by identifying the 3D positions of facial soft tissues.
Author Contributions
Formal analysis, H.Y.S.; Investigation, J.H.P.; Methodology, J.-H.O.; Project administration, H.J.C.; Software, H.J.C.; Supervision, J.-M.C.; Validation, H.Y.S.; Writing—original draft, J.-H.O. and J.H.P.; Writing—review & editing, J.-M.C. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of the Wonkwang University Daejeon Dental Hospital (IRB number W2202/003-001 and 23 February 2022).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The authors declare that the materials are available.
Conflicts of Interest
The authors declare no conflict of interest.
References
- Macías Gago, A.B.; Romero Maroto, M.; Crego, A. The perception of facial aesthetics in a young Spanish population. Eur. J. Orthod. 2012, 34, 335–339. [Google Scholar] [CrossRef] [PubMed]
- Yin, L.; Jiang, M.; Chen, W.; Smales, R.J.; Wang, Q.; Tang, L. Differences in facial profile and dental esthetic perceptions between young adults and orthodontists. Am. J. Orthod. Dentofac. Orthop. 2014, 145, 750–756. [Google Scholar] [CrossRef] [PubMed]
- Czarnecki, S.T.; Nanda, R.S.; Currier, G.F. Perceptions of a balanced facial profile. Am. J. Orthod. Dentofac. Orthop. 1993, 104, 180–187. [Google Scholar] [CrossRef]
- Ioi, H.; Shimomura, T.; Nakata, S.; Nakasima, A.; Counts, A.L. Comparison of anteroposterior lip positions of the most-favored facial profiles of Korean and Japanese people. Am. J. Orthod. Dentofac. Orthop. 2008, 134, 490–495. [Google Scholar] [CrossRef]
- Nomura, M.; Motegi, E.; Hatch, J.P.; Gakunga, P.T.; Ng’ang’a, P.M.; Rugh, J.D.; Yamaguchi, H. Esthetic preferences of European American, Hispanic American, Japanese, and African judges for soft-tissue profiles. Am. J. Orthod. Dentofac. Orthop. 2009, 135, S87–S95. [Google Scholar] [CrossRef]
- Coleman, G.G.; Lindauer, S.J.; Tüfekçi, E.; Shroff, B.; Best, A.M. Influence of chin prominence on esthetic lip profile preferences. Am. J. Orthod. Dentofac. Orthop. 2007, 132, 36–42. [Google Scholar] [CrossRef]
- Modarai, F.; Donaldson, J.C.; Naini, F.B. The influence of lower lip position on the perceived attractiveness of chin prominence. Angle Orthod. 2013, 83, 795–800. [Google Scholar] [CrossRef] [PubMed]
- Zarif Najafi, H.; Sabouri, S.A.; Ebrahimi, E.; Torkan, S. Esthetic evaluation of lip position in silhouette with respect to profile divergence. Am. J. Orthod. Dentofac. Orthop. 2016, 149, 863–870. [Google Scholar] [CrossRef]
- Maple, J.R.; Vig, K.W.; Beck, F.M.; Larsen, P.E.; Shanker, S. A comparison of providers’ and consumers’ perceptions of facial-profile attractiveness. Am. J. Orthod. Dentofac. Orthop. 2005, 128, 690–696. [Google Scholar] [CrossRef]
- Tugran, M.; Baka, Z.M. Esthetic evaluation of profile photographs showing various sagittal and vertical patterns. Am. J. Orthod. Dentofac. Orthop. 2021, 159, 281–291. [Google Scholar] [CrossRef]
- Turley, P.K. Evolution of esthetic considerations in orthodontics. Am. J. Orthod. Dentofac. Orthop. 2015, 148, 374–379. [Google Scholar] [CrossRef] [PubMed]
- Feng, J.; Yu, H.; Yin, Y.; Yan, Y.; Wang, Z.; Bai, D.; Han, X. Esthetic evaluation of facial cheek volume: A study using 3D stereophotogrammetry. Angle Orthod. 2019, 89, 129–137. [Google Scholar] [CrossRef] [PubMed]
- Hwang, H.S.; Kim, W.S.; McNamara, J.A., Jr. Ethnic differences in the soft tissue profile of Korean and European-American adults with normal occlusions and well-balanced faces. Angle Orthod. 2002, 72, 72–80. [Google Scholar]
- Peck, H.; Peck, S. A concept of facial esthetics. Angle Orthod. 1970, 40, 284–318. [Google Scholar] [PubMed]
- Pasukdee, P.; Cheng, J.H.; Chen, D.S. Smile preferences of orthodontists, general dentists, patients, and the general public in three-quarter and lateral views. Am. J. Orthod. Dentofac. Orthop. 2020, 159, e311–e320. [Google Scholar] [CrossRef]
- Kanavakis, G.; Halazonetis, D.; Katsaros, C.; Gkantidis, N. Facial shape affects self-perceived facial attractiveness. PLoS ONE 2021, 16, e0245557. [Google Scholar] [CrossRef]
- Kerr, W.J.; O’Donnell, J.M. Panel perception of facial attractiveness. Br. J. Orthod. 1990, 17, 299–304. [Google Scholar] [CrossRef]
- Shoukat Ali, U.; Sukhia, R.H.; Fida, M.; Kamal, A.T.; Abbas, A. The influence of incisor inclination and anterior vertical facial height on facial attractiveness in an Asian woman. Am. J. Orthod. Dentofac. Orthop. 2021, 160, 283–291. [Google Scholar] [CrossRef]
- Zarif Najafi, H.; Oshagh, M.; Khalili, M.H.; Torkan, S. Esthetic evaluation of incisor inclination in smiling profiles with respect to mandibular position. Am. J. Orthod. Dentofac. Orthop. 2015, 148, 387–395. [Google Scholar] [CrossRef]
- Kalin, K.; Iskender, S.Y.; Kuitert, R. Attractiveness assessment by orthodontists and laypeople judging female profile modifications of Class II Division 1 malocclusion. Am. J. Orthod. Dentofac. Orthop. 2021, 160, 276–282. [Google Scholar] [CrossRef]
- Jang, K.S.; Bayome, M.; Park, J.H.; Park, K.H.; Moon, H.B.; Kook, Y.A. A three-dimensional photogrammetric analysis of the facial esthetics of the Miss Korea pageant contestants. Korean J. Orthod. 2017, 47, 87–99. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gor, T.; Kau, C.H.; English, J.D.; Lee, R.P.; Borbely, P. Three-dimensional comparison of facial morphology in white populations in Budapest, Hungary, and Houston, Texas. Am. J. Orthod. Dentofac. Orthop. 2010, 137, 424–432. [Google Scholar] [CrossRef] [PubMed]
- Bayome, M.; Park, J.H.; Shoaib, A.M.; Lee, N.K.; Boettner, V.; Kook, Y.A. Comparison of facial esthetic standards between Latin American and Asian populations using 3D stereophotogrammetric analysis. J. World Fed. Orthod. 2020, 9, 129–136. [Google Scholar] [CrossRef] [PubMed]
- Cho, H.J. A three-dimensional cephalometric analysis. J. Clin. Orthod. 2009, 43, 235–252. [Google Scholar] [PubMed]
- Bayome, M.; Park, J.H.; Kook, Y.A. New three-dimensional cephalometric analyses among adults with a skeletal Class I pattern and normal occlusion. Korean J. Orthod. 2013, 43, 62–73. [Google Scholar] [CrossRef]
- Nguyen, H.; Shin, J.W.; Giap, H.V.; Kim, K.B.; Chae, H.S.; Kim, Y.H.; Choi, H.W. Midfacial soft tissue changes after maxillary expansion using micro-implant-supported maxillary skeletal expanders in young adults: A retrospective study. Korean J. Orthod. 2021, 51, 145–156. [Google Scholar] [CrossRef]
- Kambara, T.; Nagaya, K.; Hayami, H.; Kinoshita, M.; Ohsaki, Y.; Kawamoto, T. Analysis of mandibular incisor position in Japanese adults—Assessment based on the Holdaway ratio. J. Osaka Dent. Univ. 2006, 40, 153–158. [Google Scholar]
- Al-Gunaid, T.H. Assessment of incisor positions in Yemeni population with different skeletal patterns. Int. J. Orthod. Rehabil. 2019, 10, 99–104. [Google Scholar] [CrossRef]
- Hier, L.A.; Evans, C.A.; BeGole, E.A.; Giddon, D.B. Comparison of preferences in lip position using computer animated imaging. Angle Orthod. 1999, 69, 231–238. [Google Scholar]
- Ren, H.; Chen, X.; Zhang, Y. Correlation between facial attractiveness and facial components assessed by laypersons and orthodontists. J. Dent. Sci. 2021, 16, 431–436. [Google Scholar] [CrossRef]
- Işiksal, E.; Hazar, S.; Akyalçin, S. Smile esthetics: Perception and comparison of treated and untreated smiles. Am. J. Orthod. Dentofac. Orthop. 2006, 129, 8–16. [Google Scholar] [CrossRef] [PubMed]
- Alhammadi, M.S.; Al-Mashraqi, A.A.; Alnami, R.H.; Ashqar, N.M.; Alamir, O.H.; Halboub, E.; Reda, R.; Testarelli, L.; Patil, S. Accuracy and reproducibility of facial measurements of digital photographs and wrapped cone beam computed tomography (CBCT) photographs. Diagnostics 2021, 11, 757. [Google Scholar] [CrossRef] [PubMed]
Figure 1.
The coordinate system and standard reorientation of the CBCT Images. (A) Coronal view. (B) Sagittal view. (C) Axial view. The coordinate system consists of three axes (x, y, z) with their origin (0,0,0) registered at nasion (N). The Frankfort horizontal plane (FH plane) was constructed with bilateral orbitale (Or) points and the midpoint of bilateral porion (Po) points. The orbit line is a line passing both orbitale points in 3D space. The x-axis (red line) is a transverse axis passing through the N point and is also parallel to the FH plane in the coronal plane. The y-axis (blue line) is the anteroposterior axis passing through the N point and perpendicular to the x-axis. The y-axis is parallel to the FH plane in the sagittal plane. The z-axis (yellow line) is the vertical axis perpendicular to both the x- and y-axes. The x-axis is also parallel to the orbit line in the axial plane. Positive values are to the left, posterior, and superior (LPS) of the N point of the subject. Negative values are to the right, anterior, and inferior (RAI) of the N point.
Figure 1.
The coordinate system and standard reorientation of the CBCT Images. (A) Coronal view. (B) Sagittal view. (C) Axial view. The coordinate system consists of three axes (x, y, z) with their origin (0,0,0) registered at nasion (N). The Frankfort horizontal plane (FH plane) was constructed with bilateral orbitale (Or) points and the midpoint of bilateral porion (Po) points. The orbit line is a line passing both orbitale points in 3D space. The x-axis (red line) is a transverse axis passing through the N point and is also parallel to the FH plane in the coronal plane. The y-axis (blue line) is the anteroposterior axis passing through the N point and perpendicular to the x-axis. The y-axis is parallel to the FH plane in the sagittal plane. The z-axis (yellow line) is the vertical axis perpendicular to both the x- and y-axes. The x-axis is also parallel to the orbit line in the axial plane. Positive values are to the left, posterior, and superior (LPS) of the N point of the subject. Negative values are to the right, anterior, and inferior (RAI) of the N point.
Figure 2.
Three-dimensional landmarks. (A) Skeletal and dental landmarks in the coronal view. (B) Skeletal, dental, and soft tissue landmarks in the sagittal view. (C) Soft tissue landmarks in the coronal view. (D) Right cheek (R Ck) and left cheek (L Ck) points; the points located at the center of the cheek area and the most anterior point on the axial section of the red line (the red line passes through the median z value of the bilateral alar points and parallel to the x-axis). RL, right and left; N, nasion; Or, orbitale; Po, porion; Zy, zygion; Zg, zygoma; ANS, anterior nasal spine; PNS, posterior nasal spine; A, A point; B, B point; Pog, pogonion; Me, menton; Go, gonion; U1MP, the middle point of the maxillary central incisal tips; L1MP, the middle point of the mandibular central incisal tips; S Rh, soft tissue rhinion; Prn, pronasale; S Zy, soft tissue zygion; S Zg, soft tissue zygoma; Cm, columella; Sn, subnasale; Al, alar; Ck, cheek; Ls, labial superius; U lip, upper lip; Stm S, stomion superior; L lip, lower lip; Li, labial inferius; ML S, mentolabial sulcus; S Pog, soft tissue pogonion; S Go, soft tissue gonion.
Figure 2.
Three-dimensional landmarks. (A) Skeletal and dental landmarks in the coronal view. (B) Skeletal, dental, and soft tissue landmarks in the sagittal view. (C) Soft tissue landmarks in the coronal view. (D) Right cheek (R Ck) and left cheek (L Ck) points; the points located at the center of the cheek area and the most anterior point on the axial section of the red line (the red line passes through the median z value of the bilateral alar points and parallel to the x-axis). RL, right and left; N, nasion; Or, orbitale; Po, porion; Zy, zygion; Zg, zygoma; ANS, anterior nasal spine; PNS, posterior nasal spine; A, A point; B, B point; Pog, pogonion; Me, menton; Go, gonion; U1MP, the middle point of the maxillary central incisal tips; L1MP, the middle point of the mandibular central incisal tips; S Rh, soft tissue rhinion; Prn, pronasale; S Zy, soft tissue zygion; S Zg, soft tissue zygoma; Cm, columella; Sn, subnasale; Al, alar; Ck, cheek; Ls, labial superius; U lip, upper lip; Stm S, stomion superior; L lip, lower lip; Li, labial inferius; ML S, mentolabial sulcus; S Pog, soft tissue pogonion; S Go, soft tissue gonion.
Figure 3.
Three-dimensional values. (A,B) Skeletal and dental linear values in the sagittal view: 1, A(y); 2, L1MP(y); 3, U1MP(y); 4, B(y); 5, Pog(y); 6, LFH (lower facial height); 7, TFH (total facial height); 8, Maxillary incisal tip to Stm S; 9, Pog-NB. (C) Skeletal linear values in the coronal view: 10, ANS(x); 11, A(x); 12, Pog(x). (D) Skeletal and dental angular values in the sagittal view: 13, U1SI-FH (Upper incisor sagittal inclination to FH plane); 14, Facial line angle; 15, L1SI-FH (Lower incisor sagittal inclination to FH plane); 16, MxS line angle (Maxillary sagittal line angle); 17, MnS line angle (Mandibular sagittal line angle). (E) Soft tissue linear values in the sagittal view: 18, S Rh(y); 19, S Zg(y); 20, Prn(y); 21, S Ck(y); 22, Sn(y); 23, U lip(y); 24, U lip thickness; 25, L lip thickness; 26, L lip(y); 27, L lip(y)-U lip(y); 28, ML S(y); 29, Chin thickness. (F) Soft tissue linear values in the coronal view: 30, Midfacial width; 31, Bi S Zg; 32, Pronasale(x); 33, Nasal width; 34, Bi Ck; 35, Labial superius(x); 36, Mouth width; 37, Lower-facial width. (G) Soft tissue angular values in the sagittal view: 38, Cant of U lip; 39, Nasolabial angle; 40, Mentolabial angle. (H) Lip position relative to Steiner’s S-line: 41, U lip to S-line; 42, L lip to S-line. (I) Lip position relative to Ricketts’ E-line: 43, U lip to E-line; 44, L lip to E-line.
Figure 3.
Three-dimensional values. (A,B) Skeletal and dental linear values in the sagittal view: 1, A(y); 2, L1MP(y); 3, U1MP(y); 4, B(y); 5, Pog(y); 6, LFH (lower facial height); 7, TFH (total facial height); 8, Maxillary incisal tip to Stm S; 9, Pog-NB. (C) Skeletal linear values in the coronal view: 10, ANS(x); 11, A(x); 12, Pog(x). (D) Skeletal and dental angular values in the sagittal view: 13, U1SI-FH (Upper incisor sagittal inclination to FH plane); 14, Facial line angle; 15, L1SI-FH (Lower incisor sagittal inclination to FH plane); 16, MxS line angle (Maxillary sagittal line angle); 17, MnS line angle (Mandibular sagittal line angle). (E) Soft tissue linear values in the sagittal view: 18, S Rh(y); 19, S Zg(y); 20, Prn(y); 21, S Ck(y); 22, Sn(y); 23, U lip(y); 24, U lip thickness; 25, L lip thickness; 26, L lip(y); 27, L lip(y)-U lip(y); 28, ML S(y); 29, Chin thickness. (F) Soft tissue linear values in the coronal view: 30, Midfacial width; 31, Bi S Zg; 32, Pronasale(x); 33, Nasal width; 34, Bi Ck; 35, Labial superius(x); 36, Mouth width; 37, Lower-facial width. (G) Soft tissue angular values in the sagittal view: 38, Cant of U lip; 39, Nasolabial angle; 40, Mentolabial angle. (H) Lip position relative to Steiner’s S-line: 41, U lip to S-line; 42, L lip to S-line. (I) Lip position relative to Ricketts’ E-line: 43, U lip to E-line; 44, L lip to E-line.
Figure 4.
The questionnaire used to evaluate facial soft tissue esthetics. (A) Facial three-dimensional images and a numeric rating scale (NRS). (B) The two questions on the last page.
Figure 4.
The questionnaire used to evaluate facial soft tissue esthetics. (A) Facial three-dimensional images and a numeric rating scale (NRS). (B) The two questions on the last page.
Table 1.
(A). Definitions of three-dimensional landmarks. (B) Definitions of three-dimensional values.
Table 1.
(A). Definitions of three-dimensional landmarks. (B) Definitions of three-dimensional values.
| (A) | ||
|---|---|---|
| Landmarks | Definition | |
| Cranial Base landmarks | ||
| N (Nasion) | The middle point of the frontonasal suture in the coronal plane | |
| RL Or (Orbitale) | The most inferior point of the orbital rim in the coronal plane | |
| RL Po (Porion) | The most superior point of the external auditory meatus | |
| Maxillary landmarks | ||
| ANS (Anterior nasal spine) | The most anterior point of the premaxillary bone in the sagittal plane | |
| PNS (Posterior nasal spine) | The most posterior point of the palatine bone in the sagittal plane | |
| A (A point) | The deepest point in the anterior outline of the maxilla between the ANS and supradentale in the sagittal plane | |
| RL Zy (Zygion) | The most lateral point of the zygomatic arch, determined from the submento-vertex view | |
| RL Zg (Zygoma) | The point on the zygomatic bone at the turning point of bony curvature | |
| Mandibular landmarks | ||
| B (B point) | The deepest point in the anterior outline of the mandible between infradentale and pogonion in the sagittal plane | |
| Pog (Pogonion) | The most anterior point in the mandibular chin area in the sagittal plane | |
| Me (Menton) | The lowermost point on the symphysis menti in the sagittal and coronal planes | |
| RL Go (Gonion) | The point in the inferoposterior outline of the mandible at which the surface turns from the inferior border into the posterior border in the sagittal plane | |
| Dental landmarks | ||
| U1MP (Upper1midpoint) | Midpoint between both upper incisal tips | |
| L1MP (Lower1midpoint) | Midpoint between both lower incisal tips | |
| Soft tissue landmarks | ||
| S Rh (Rhinion) | Soft tissue landmark in front of Rhinion (the lower end of the suture between the nasal bones) | |
| Prn (Pronasale) | The most prominent midpoint of the nasal tip | |
| Cm (Columella) | The most inferior and anterior point of the nose | |
| Sn (Subnasale) | Midpoint of the columellar base at the junction of the upper lip | |
| RL Al (Alar) | Most lateral point of the alar contour of the nose | |
| RL S Zy (Zygion) | The point on the facial skin lateral to the Zygion along the X-axis | |
| RL S Zg (Zygoma) | The point on the facial skin lateral to the Zygoma along the X-axis | |
| RL Ck (Cheek) | The point located at the center of the cheek area | |
| RL Ch (Cheillion) | Lateral extent of labial commissure | |
| Stm S (Stomion Superior) | Midpoint of the labial fissure between gently closed lips on the upper lip | |
| Ls (Labial superius) | The point that indicates the mucocutaneous limit of the upper lip in the sagittal plane | |
| Li (Labial inferius) | The point that indicates the mucocutaneous limit of the lower lip in the sagittal plane | |
| U lip (Upper lip) | The most anterior midpoint of the upper lip | |
| L lip (Lower lip) | The most anterior midpoint of the lower lip | |
| ML S (Mentolabial sulcus) | The deepest point in the anterior outline of the face between L lip and S Pog in the sagittal plane | |
| S Pog (Pogonion) | Most prominent midpoint of the chin | |
| S Go (Gonion) | The point on the facial skin lateral to the Gonion along the X-axis | |
| (B) | ||
| Values | Definition | View |
| Skeletal Values | ||
| (1) Anteroposterior analysis | ||
| A(y) (mm) | y coordinate value of point A | sagittal |
| B(y) (mm) | y coordinate value of point B | sagittal |
| Pog(y) (mm) | y coordinate value of Pog | sagittal |
| B(y)-A(y) (mm) | Difference in y coordinate values between A and B | sagittal |
| Pog(y)-A(y) (mm) | Difference in y coordinate values between A and Pog | sagittal |
| B(y)-Pog(y) (mm) | Difference in y coordinate values between Pog and B | sagittal |
| Pog-NB (mm) | The perpendicular distance from Pog to N-B line | sagittal |
| Facial line angle (°) | Angle between the FH plane and N-Pog line | sagittal |
| SNA (°) | The angle between S, N, and A | sagittal |
| SNB (°) | The angle between S, N, and B | sagittal |
| ANB (°) | The angle between A, N, and B | sagittal |
| (2) Vertical analysis | ||
| MxS line angle (°) | (Maxillary sagittal line angle) The degree of Maxilla (ANS-PNS) relative to the FH plane | sagittal |
| MnS line angle*(°) | (Mandibular sagittal line angle) The degree of Mandible (RL Go-Me) relative to the FH plane | sagittal |
| LFH (mm) | (Lower facial height) Vertical distance between ANS and Me | |
| TFH (mm) | (Total facial height) Vertical distance between N and Me | |
| LFH/TFH (%) | Ratio of Lower facial height divided by Total facial height | |
| (3) Transverse analysis | ||
| ANS(x) (mm) | x coordinate value of ANS | coronal |
| A(x) (mm) | x coordinate value of A | coronal |
| Pog(x) (mm) | x coordinate value of Pog | coronal |
| Dental values | ||
| U1MP(y) | y coordinate value of U1MP | sagittal |
| L1MP(y) | y coordinate value of L1MP | sagittal |
| L1MP(y)-U1MP(y) | Difference in y coordinate values between U1MP and L1MP | sagittal |
| B(y)-L1MP(y) | Difference in y coordinate values between L1MP and B | sagittal |
| U1SI-FH* (°) | Upper incisor sagittal inclination to the FH plane | sagittal |
| L1SI-FH* (°) | Lower incisor sagittal inclination to the FH plane | sagittal |
| U1MP to Stm S(mm) | Vertical distance between U1MP and Stm S | sagittal |
| Soft tissue Values | ||
| S Rh(y) (mm) | y coordinate value of S Rhinion | sagittal |
| Prn(x) (mm) | x coordinate value of Pronasale | coronal |
| Prn(y) (mm) | y coordinate value of Pronasale | sagittal |
| S Zg(y)* (mm) | y coordinate value of S Zygoma | sagittal |
| Ck(y)*(mm) | y coordinate value of Cheek | sagittal |
| Sn(y) (mm) | y coordinate value of Sn | sagittal |
| Ls(x) (mm) | x coordinate value of Labial superius | coronal |
| U lip(y) (mm) | y coordinate value of U lip | sagittal |
| L lip(y) (mm) | y coordinate value of L lip | sagittal |
| L lip(y)-U lip(y)(mm) | Horizontal distance between U lip, L lip | sagittal |
| U lip to S-line (mm) | Steiner’s S-line (Columella-S Pogonion) to Upper lip | sagittal |
| L lip to S-line (mm) | Steiner’s S-line (Columella-S Pogonion) to Lower lip | sagittal |
| U lip to E-line (mm) | Ricketts’ E-line (Pronasale-S Pogonion) to Upper lip | sagittal |
| L lip to E-line (mm) | Ricketts’ E-line (Pronasale-S Pogonion) to Lower lip | sagittal |
| U lip thickness (mm) | (U1MP(y)-Upper lip(y)) Horizontal distance between U1MP and U lip | sagittal |
| L lip thickness (mm) | (L1MP(y)-Lower lip(y)) Horizontal distance between L1MP and L lip | sagittal |
| ML S(y) (mm) | y coordinate value of ML S | sagittal |
| S Pog(y) (mm) | y coordinate value of S Pog | sagittal |
| ML S(y)-Sn(y) (mm) | Difference in y coordinate values between Sn(y) and ML S(y) | sagittal |
| ML S(y)-S Pog(y) (mm) | Difference in y coordinate values between S Pog(y) and ML S(y) | sagittal |
| Chin thickness (mm) | (Pog(y)-S Pog(y)) Distance between Pog and S Pog | sagittal |
| Mid-facial width (mm) | Horizontal distance between right and left S Zy | coronal |
| Bi S Zg (mm) | Horizontal distance between right and left S Zg | coronal |
| Bi Ck (mm) | Horizontal distance between right and left Ck | coronal |
| Nasal width (mm) | Horizontal distance between right and left Al | coronal |
| Mouth width (mm) | Horizontal distance between right and left Ch | coronal |
| Lower-facial width (mm) | Horizontal distance between right and left S Go | coronal |
| LFW/MFW (%) | Ratio of Lower-facial width divided by Mid-facial width | coronal |
| Cant of U lip (°) | Angle between N-perpendicular and Sn-Ls line | sagittal |
| Nasolabial angle (°) | Angle between columella, Sn, and Ls | sagittal |
| Mentolabial angle (°) | Angle between Li, ML S, and S Pog | sagittal |
FH, Frankfort horizontal plane. S, soft tissue; RL, right and left. * Average of right and left values.
Table 2.
(A) Comparison of three-dimensional measurements of skeletal and dental values between the attractive group (AG) and the unattractive group (UAG), according to perceived facial attractiveness in total and for each group of evaluators. (B) Comparison of three-dimensional measurements of soft tissue values between the attractive group (AG) and the unattractive group (UAG) according to perceived facial attractiveness in total and for each group of evaluators.
Table 2.
(A) Comparison of three-dimensional measurements of skeletal and dental values between the attractive group (AG) and the unattractive group (UAG), according to perceived facial attractiveness in total and for each group of evaluators. (B) Comparison of three-dimensional measurements of soft tissue values between the attractive group (AG) and the unattractive group (UAG) according to perceived facial attractiveness in total and for each group of evaluators.
| (A) | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Evaluators | Total | Orthodontists | General Dentists | Laypeople | |||||||||
| Measurement | All (n = 40) | AG (n = 8) | UAG (n = 8) | p Value | AG (n = 8) | UAG (n = 8) | p Value | AG (n = 8) | UAG (n = 8) | p Value | AG (n = 8) | UAG (n = 8) | p Value |
| Skeletal Values | |||||||||||||
| A(y) (mm) | −1.44 (2.39) | 0.11 (2.45) | −1.92 (3.12) | 0.170 | −0.30 (2.77) | −2.78 (2.15) | 0.066 | 0.14 (2.49) | −1.92 (3.12) | 0.166 | 0.49 (2.24) | −1.92 (3.12) | 0.097 |
| B(y) (mm) | 1.72 (2.79) | 3.77 (3.06) | 0.58 (3.60) | 0.077 | 3.34 (3.41) | −0.16 (2.81) | 0.042 * | 3.28 (2.86) | 0.58 (3.60) | 0.119 | 4.12 (2.65) | 0.58 (3.60) | 0.042 * |
| Pog(y) (mm) | 0.78 (2.68) | 2.24 (3.06) | 0.13 (2.78) | 0.172 | 1.98 (3.37) | −0.46 (2.18) | 0.107 | 1.95 (3.15) | 0.13 (2.78) | 0.242 | 2.42 (2.92) | 0.13 (2.78) | 0.131 |
| B(y)-A(y) (mm) | 3.16 (1.29) | 3.66 (1.41) | 2.50 (1.43) | 0.124 | 3.64 (1.42) | 2.61 (1.46) | 0.176 | 3.14 (1.35) | 2.50 (1.43) | 0.370 | 3.63 (1.46) | 2.50 (1.43) | 0.140 |
| Pog(y)-A(y) (mm) | 2.23 (1.29) | 2.13 (1.27) | 2.06 (1.06) | 0.898 | 2.28 (1.03) | 2.32 (.94) | 0.950 | 1.81 (1.42) | 2.06 (1.06) | 0.702 | 1.93 (1.44) | 2.06 (1.06) | 0.842 |
| B(y)-Pog(y) (mm) | 0.94 (1.12) | 1.53 (.99) | 0.45 (1.07) | 0.054 | 1.36 (.76) | 0.30 (.94) | 0.026 * | 1.33 (1.10) | 0.45 (1.07) | 0.124 | 1.70 (.82) | 0.45 (1.07) | 0.020 * |
| Pog-NB (mm) | 1.15 (1.21) | 2.06 (1.16) | 0.44 (1.39) | 0.024 * | 1.83 (.99) | 0.18 (1.06) | 0.006 ** | 1.79 (1.19) | 0.44 (1.39) | 0.055 | 2.27 (.89) | 0.44 (1.39) | 0.007 ** |
| Facial line angle (°) | 89.52 (1.81) | 88.85 (1.60) | 89.98 (1.41) | 0.155 | 88.99 (1.76) | 90.27 (1.10) | 0.102 | 89.00 (1.63) | 89.98 (1.41) | 0.220 | 88.75 (1.52) | 89.98 (1.41) | 0.117 |
| SNA (°) | 81.63 (2.59) | 80.36 (2.23) | 82.50 (3.77) | 0.195 | 80.54 (2.41) | 83.40 (2.93) | 0.052 | 80.39 (2.48) | 82.50 (3.77) | 0.208 | 80.69 (2.25) | 82.50 (3.77) | 0.267 |
| SNB (°) | 79.24 (2.53) | 78.21 (2.89) | 80.30 (2.98) | 0.178 | 78.25 (2.91) | 80.79 (2.57) | 0.086 | 78.56 (3.11) | 80.30 (2.98) | 0.273 | 78.72 (3.03) | 80.30 (2.98) | 0.310 |
| ANB (°) | 2.39 (1.19) | 2.15 (1.18) | 2.20 (1.40) | 0.942 | 2.30 (1.23) | 2.61 (1.14) | 0.606 | 1.83 (1.30) | 2.20 (1.40) | 0.597 | 1.97 (1.28) | 2.20 (1.40) | 0.743 |
| MxS line angle (°) | 2.00 (1.31) | 2.35 (1.54) | 2.04 (1.01) | 0.640 | 2.23 (1.64) | 2.44 (1.19) | 0.777 | 2.58 (1.39) | 2.04 (1.01) | 0.387 | 2.44 (1.51) | 2.04 (1.01) | 0.539 |
| MnS line angle # (°) | 25.19 (4.11) | 25.13 (3.92) | 26.69 (3.20) | 0.398 | 24.49 (4.66) | 26.14 (3.67) | 0.443 | 25.69 (3.87) | 26.69 (3.20) | 0.582 | 24.33 (4.03) | 26.69 (3.20) | 0.215 |
| LFH (mm) | 65.31 (2.78) | 64.32 (1.89) | 65.95 (3.27) | 0.242 | 64.35 (1.86) | 65.31 (2.97) | 0.450 | 63.95 (1.94) | 65.95 (3.27) | 0.160 | 63.97 (1.98) | 65.95 (3.27) | 0.165 |
| TFH (mm) | 118.10 (4.35) | 116.96 (2.74) | 118.78 (4.98) | 0.382 | 116.89 (2.81) | 117.68 (4.94) | 0.699 | 116.21 (2.90) | 118.78 (4.98) | 0.228 | 116.43 (3.06) | 118.78 (4.98) | 0.275 |
| LFH/TFH (%) | 55.30 (.96) | 54.98 (.79) | 55.52 (1.03) | 0.265 | 55.05 (.77) | 55.50 (1.01) | 0.329 | 55.03 (.78) | 55.52 (1.03) | 0.302 | 54.94 (.76) | 55.52 (1.03) | 0.223 |
| ANS(x) (mm) | 0.15 (1.08) | −0.56 (1.25) | 0.20 (1.43) | 0.280 | −0.40 (1.26) | 0.10 (1.44) | 0.470 | 0.23 (1.04) | 0.20 (1.43) | 0.962 | −0.41 (1.37) | 0.20 (1.43) | 0.398 |
| A(x) (mm) | −0.27 (1.15) | −0.65 (1.28) | −0.25 (1.40) | 0.559 | −0.52 (1.31) | −0.46 (1.54) | 0.936 | 0.15 (1.22) | −0.25 (1.40) | 0.558 | −0.47 (1.44) | −0.25 (1.40) | 0.759 |
| Pog(x) (mm) | 0.14 (1.81) | −0.18 (1.75) | 0.37 (1.58) | 0.526 | −0.24 (1.75) | 0.25 (1.78) | 0.593 | 0.49 (.97) | 0.37 (1.58) | 0.850 | −0.23 (1.74) | 0.37 (1.58) | 0.486 |
| Dental values | |||||||||||||
| U1MP(y) | −6.76 (3.67) | −3.20 (3.46) | −9.12 (3.71) | 0.005 ** | −3.90 (3.88) | −9.88 (3.18) | 0.005 ** | −4.00 (3.35) | −9.12 (3.71) | 0.012 * | −3.21 (3.48) | −9.12 (3.71) | 0.005 ** |
| L1MP(y) | −3.77 (3.77) | −0.17 (3.69) | −6.22 (3.64) | 0.005 ** | −0.89 (4.04) | −7.18 (2.68) | 0.003 ** | −0.77 (3.70) | −6.22 (3.64) | 0.010 * | −0.09 (3.60) | −6.22 (3.64) | 0.004 ** |
| L1MP(y)-U1MP(y) | 2.99 (1.00) | 3.03 (.44) | 2.90 (1.34) | 0.808 | 3.01 (.43) | 2.71 (1.22) | 0.519 | 3.23 (.49) | 2.90 (1.34) | 0.534 | 3.13 (.35) | 2.90 (1.34) | 0.655 |
| B(y)-L1MP(y) | 5.49 (2.23) | 3.94 (1.38) | 6.79 (2.01) | 0.005 ** | 4.22 (1.21) | 7.02 (2.04) | 0.005 ** | 4.05 (1.48) | 6.79 (2.01) | 0.008 ** | 4.20 (1.49) | 6.79 (2.01) | 0.011 ** |
| U1SI-FH # (°) | 112.66 (5.48) | 107.09 (4.39) | 116.55 (3.74) | 0.000 *** | 107.86 (5.12) | 117.15 (3.91) | 0.001 ** | 109.80 (5.86) | 116.55 (3.74) | 0.016 * | 108.91 (6.04) | 116.55 (3.74) | 0.009 ** |
| L1SI-FH # (°) | 63.41 (5.81) | 66.85 (5.78) | 58.38 (3.72) | 0.004 ** | 66.23 (5.59) | 57.48 (3.58) | 0.002 ** | 67.74 (5.42) | 58.38 (3.72) | 0.001 ** | 66.84 (5.78) | 58.38 (3.72) | 0.004 ** |
| U1MP to Stm S(mm) | 2.70 (1.68) | 2.36 (1.19) | 2.99 (2.02) | 0.464 | 2.94 (1.53) | 2.50 (1.90) | 0.612 | 1.97 (1.02) | 2.99 (2.02) | 0.227 | 2.04 (1.16) | 2.99 (2.02) | 0.269 |
| (B) | |||||||||||||
| Evaluators | Total | Orthodontists | General Dentists | Laypeople | |||||||||
| Measurement | All (n = 40) | AG (n = 8) | UAG (n = 8) | p Value | AG (n = 8) | UAG (n = 8) | p Value | AG (n = 8) | UAG (n = 8) | p Value | AG (n = 8) | UAG (n = 8) | p Value |
| Soft Tissue Values | |||||||||||||
| S Rh (y) (mm) | −14.05 (2.18) | −13.25 (2.41) | −13.90 (2.42) | 0.596 | −13.76 (2.34) | −14.39 (2.46) | 0.606 | −13.29(2.38) | −13.90(2.42) | 0.617 | −13.02(2.39) | −13.90(2.42) | 0.474 |
| Prn (x) (mm) | 0.11 (1.25) | −0.05 (0.93) | −0.13 (1.63) | 0.910 | 0.07 (0.98) | −0.36 (1.70) | 0.546 | 0.15(0.98) | −0.13(1.63) | 0.687 | −0.17(1.01) | −0.13(1.63) | 0.949 |
| Prn (y) (mm) | −26.85 (2.71) | −25.34 (2.58) | −26.80 (3.21) | 0.334 | −25.88 (2.80) | −27.75 (2.41) | 0.174 | −25.41(2.53) | −26.80(3.21) | 0.355 | −25.11(2.61) | −26.80(3.21) | 0.270 |
| S Zg (y) # (mm) | 3.79 (2.57) | 4.58 (3.16) | 3.29 (2.08) | 0.351 | 4.32 (3.10) | 2.82 (1.84) | 0.259 | 4.43(3.23) | 3.29(2.08) | 0.414 | 4.93(2.81) | 3.29(2.08) | 0.205 |
| Ck (y) # (mm) | −4.28 (2.05) | −3.55 (2.30) | −4.00 (2.33) | 0.701 | −3.63 (2.32) | −4.75 (2.06) | 0.326 | −3.56(2.30) | −4.00(2.33) | 0.706 | −3.19(2.19) | −4.00(2.33) | 0.484 |
| Sn (y) (mm) | −14.30 (2.72) | −13.03 (2.48) | −14.19 (3.44) | 0.453 | −13.40 (2.62) | −15.19 (2.93) | 0.218 | −13.47(2.14) | −14.19(3.44) | 0.624 | −12.86(2.36) | −14.19(3.44) | 0.381 |
| Ls (x) (mm) | 0.11 (1.30) | −0.19 (1.01) | 0.08 (1.84) | 0.719 | −0.14 (1.01) | −0.09 (1.84) | 0.946 | 0.15(0.82) | 0.08(1.84) | 0.931 | −0.21(1.00) | 0.08(1.84) | 0.699 |
| U lip (y) (mm) | −18.85 (2.93) | −16.67 (2.79) | −20.02 (3.19) | 0.042 * | −16.80 (2.91) | −20.61 (2.49) | 0.014 * | −16.94 (2.79) | −20.02 (3.19) | 0.059 | −16.63 (2.77) | −20.02 (3.19) | 0.040 * |
| L lip (y) (mm) | −16.77 (3.26) | −13.62 (3.15) | −18.92 (3.15) | 0.005 ** | −14.13 (3.65) | −19.64 (2.34) | 0.003 ** | −14.17 (2.85) | −18.92 (3.15) | 0.007 ** | −13.54 (3.10) | −18.92 (3.15) | 0.004 ** |
| L lip (y)-U lip(y)(mm) | 1.98 (1.22) | 2.63 (1.35) | 1.08 (1.41) | 0.041 * | 2.68 (1.26) | 0.94 (1.44) | 0.022 * | 2.36 (1.41) | 1.08 (1.41) | 0.092 | 2.69 (1.37) | 1.08 (1.41) | 0.037 * |
| U lip to S-line (mm) | 0.72 (1.35) | 0.49 (1.03) | 1.94 (1.21) | 0.022 * | 0.21 (1.13) | 1.79 (1.26) | 0.019 * | 0.41 (0.93) | 1.94 (1.21) | 0.013 * | 0.56 (1.08) | 1.94 (1.21) | 0.030 * |
| L lip to S-line (mm) | 1.45 (1.85) | 0.40 (0.77) | 3.71 (0.97) | 0.000 *** | 0.48 (0.75) | 3.65 (1.01) | 0.000 *** | 0.67 (0.85) | 3.71 (0.97) | 0.000 *** | 0.48 (0.80) | 3.71 (0.97) | 0.000 *** |
| U lip to E-line (mm) | −1.31 (1.32) | −1.57 (1.12) | −0.20 (1.20) | 0.033* | −1.93 (1.10) | −0.31 (1.26) | 0.016 * | −1.50 (1.28) | −0.20 (1.20) | 0.055 | −1.40 (1.31) | −0.20 (1.20) | 0.075 |
| L lip to E-line (mm) | 0.26 (1.83) | −0.82 (0.79) | 2.44 (1.02) | 0.000 *** | −0.80 (0.79) | 2.43 (1.03) | 0.000 *** | −0.45 (0.83) | 2.44 (1.02) | 0.000 *** | −0.69 (0.86) | 2.44 (1.02) | 0.000 *** |
| U lip thickness (mm) | 12.12 (1.62) | 13.47 (1.52) | 10.99 (1.81) | 0.010 * | 12.91 (1.43) | 10.95 (1.82) | 0.031 * | 12.94 (1.65) | 10.99 (1.81) | 0.040 * | 13.42 (1.57) | 10.99 (1.81) | 0.012 * |
| L lip thickness (mm) | 13.01 (1.51) | 13.45 (1.67) | 12.75 (1.57) | 0.401 | 13.24 (1.47) | 12.52 (1.56) | 0.360 | 13.40 (1.85) | 12.75 (1.57) | 0.464 | 13.45 (1.67) | 12.75 (1.57) | 0.402 |
| ML S (y) (mm) | −9.91 (3.05) | −7.08 (3.17) | −11.02 (3.64) | 0.037 * | −7.56 (3.56) | −11.69 (2.93) | 0.024 * | −7.51 (2.95) | −11.02 (3.64) | 0.052 | −6.79 (2.97) | −11.02 (3.64) | 0.023 * |
| S Pog (y) (mm) | −11.39 (3.16) | −8.98 (3.61) | −11.17 (3.16) | 0.216 | −9.37 (4.05) | −11.96 (2.58) | 0.153 | −9.24 (3.53) | −11.17 (3.16) | 0.267 | −8.72 (3.47) | −11.17 (3.16) | 0.162 |
| ML S (y)-Sn(y) (mm) | 4.39 (1.96) | 5.95 (1.19) | 3.17 (2.40) | 0.011 * | 5.84 (1.35) | 3.50 (2.64) | 0.043 * | 5.96 (1.12) | 3.17 (2.40) | 0.010 * | 6.06 (1.14) | 3.17 (2.40) | 0.008 ** |
| ML S (y)-S Pog(y) (mm) | 1.48 (1.76) | 1.90 (1.08) | 0.15 (2.29) | 0.072 | 1.80 (0.92) | 0.27 (2.36) | 0.110 | 1.73 (0.96) | 0.15 (2.29) | 0.094 | 1.93 (1.07) | 0.15 (2.29) | 0.066 |
| Chin thickness (mm) | 12.17 (1.59) | 11.22 (1.40) | 11.39 (1.73) | 0.832 | 11.35 (1.45) | 11.58 (1.77) | 0.776 | 11.19 (1.43) | 11.39 (1.73) | 0.804 | 11.14 (1.43) | 11.39 (1.73) | 0.758 |
| Midfacial width (mm) | 147.31 (4.95) | 147.78 (6.45) | 145.94 (3.25) | 0.483 | 148.83 (6.54) | 146.23 (3.03) | 0.326 | 146.46 (6.19) | 145.94 (3.25) | 0.837 | 147.92 (6.50) | 145.94 (3.25) | 0.455 |
| Bi S Zg (mm) | 105.55 (5.21) | 103.08 (6.40) | 103.69 (1.76 | 0.804 | 34.84 (0.98) | 36.68 (3.00) | 0.120 | 102.81 (6.20) | 103.69 (1.76) | 0.710 | 102.91 (6.27) | 103.69 (1.76) | 0.745 |
| Bi Ck (mm) | 63.37 (15.42) | 65.84 (2.85) | 67.97 (2.70) | 0.146 | 103.73 (7.00) | 104.06 (1.73) | 0.900 | 65.57 (2.65) | 67.97 (2.70) | 0.094 | 65.83 (2.84) | 67.97 (2.70) | 0.145 |
| Nasal width (mm) | 36.16 (2.47) | 35.15 (1.31) | 36.20 (3.26) | 0.413 | 65.94 (2.88) | 67.62 (2.67) | 0.247 | 35.19 (1.68) | 36.20 (3.26) | 0.453 | 34.99 (1.42) | 36.20 (3.26) | 0.355 |
| Mouth width (mm) | 45.36 (3.43) | 44.09 (1.93) | 43.35 (3.63) | 0.618 | 44.04 (1.90) | 45.24 (3.94) | 0.452 | 44.32 (1.89) | 43.35 (3.63) | 0.514 | 44.36 (1.93) | 43.35 (3.63) | 0.498 |
| Lower-facial width (mm) | 118.70 (5.39) | 117.59 (4.96) | 117.87 (3.39) | 0.894 | 118.40 (3.81) | 118.98 (4.03) | 0.768 | 115.86 (4.91) | 117.87 (3.39) | 0.356 | 117.15 (4.98) | 117.87 (3.39) | 0.740 |
| LFW/MFW (%) | 80.60 (3.01) | 79.60 (2.28) | 80.79 (2.46) | 0.333 | 79.62 (2.25) | 81.40 (3.07) | 0.207 | 79.14 (2.40) | 80.79 (2.46) | 0.197 | 79.24 (2.52) | 80.79 (2.46) | 0.234 |
| Cant of U lip (°) | 17.99 (7.25) | 13.44 (4.66) | 24.57 (4.67) | 0.000 *** | 12.80 (3.74) | 23.13 (6.73) | 0.002 ** | 13.66 (4.94) | 24.57 (4.67) | 0.000 *** | 13.80 (4.90) | 24.57 (4.67) | 0.000 *** |
| Nasolabial angle (°) | 96.61 (10.23) | 102.96 (3.32) | 88.27 (8.39) | 0.000 *** | 104.02 (2.74) | 90.19 (8.39) | 0.000 *** | 102.32 (4.29) | 88.27 (8.39) | 0.002 ** | 102.45 (3.48) | 88.27 (8.39) | 0.000 *** |
| Mentolabial angle (°) | 129.62 (12.57) | 128.39 (10.89) | 129.84 (16.68) | 0.839 | 129.56 (9.00) | 128.34 (17.19) | 0.861 | 129.78 (9.47) | 129.84 (16.68) | 0.992 | 127.35 (10.14) | 129.84 (16.68) | 0.723 |
Data are presented as means (standard deviation). # Average of right and left values. Independent t-tests were performed. * p < 0.05, ** p < 0.01, *** p < 0.001 (2-tailed).
Table 3.
Perception of evaluators regarding image views and facial components on evaluating facial attractiveness.
Table 3.
Perception of evaluators regarding image views and facial components on evaluating facial attractiveness.
| Orthodontists (n = 42) | General Dentists (n = 42) | Laypeople (n = 42) | p Value | |
|---|---|---|---|---|
| Facial views | ||||
| Frontal | 6 (14.3%)a | 10 (23.8%)a | 17 (40.5%) | 0.01 * |
| Oblique | 11 (26.2%)a | 8 (19%)a | 14 (33.3%) | |
| Profile | 25 (59.5%)b | 24 (57.2%)b | 11 (26.2%) | |
| p value | 0.000 *** | 0.004 ** | 0.526 | |
| Facial components | ||||
| Nose | 2 (4.8%)a | 5 (11.9%) | 5 (11.9%)a | 0.000 *** |
| Cheeks or Zygoma | 2 (4.8%)a | 10 (23.8%) | 7 (16.7%)a | |
| Lips | 31 (73.8%)b | 11 (26.2%) | 11 (26.2%)ab | |
| Chin | 7 (16.6%)a | 16 (38.1%) | 19 (45.2%)b | |
| p value | 0.000 *** | 0.121 | 0.012* | |
Data are presented as frequency (%). Chi-square tests were performed. The letters a < b indicate vertical differences that were analyzed by Scheffe’s homogeneous subset group (p <0.05). * p < 0.05, ** p < 0.01, *** p < 0.001 (two-tailed).
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
MDPI and ACS Style
Oh, J.-H.; Park, J.H.; Cho, H.J.; Seo, H.Y.; Chae, J.-M. A CBCT Evaluation of Esthetic Preference Regarding the Perceived Facial Attractiveness of Young Korean Female Adults with a Normal Skeletal Pattern. Sensors 2022, 22, 7258. https://doi.org/10.3390/s22197258
AMA Style
Oh J-H, Park JH, Cho HJ, Seo HY, Chae J-M. A CBCT Evaluation of Esthetic Preference Regarding the Perceived Facial Attractiveness of Young Korean Female Adults with a Normal Skeletal Pattern. Sensors. 2022; 22(19):7258. https://doi.org/10.3390/s22197258
Chicago/Turabian StyleOh, Jin-Hyoung, Jae Hyun Park, Heon Jae Cho, Hye Young Seo, and Jong-Moon Chae. 2022. "A CBCT Evaluation of Esthetic Preference Regarding the Perceived Facial Attractiveness of Young Korean Female Adults with a Normal Skeletal Pattern" Sensors 22, no. 19: 7258. https://doi.org/10.3390/s22197258
Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.
