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Eur J Orthod. 2013 Oct;35(5):590-8. doi: 10.1093/ejo/cjs004. Epub 2012 Feb 29.

The influence of combined orthodontic-orthognathic surgical treatment on perceptions of attractiveness: a longitudinal study.

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  • 1Kingston and St George's Hospitals and St George's Medical School, London and.


The purpose of this investigation was to quantitatively evaluate the influence of completing the orthognathic treatment process on patients' perceptions of attractiveness and their desire for surgical correction. The mandibular prominence of an idealized profile image was altered in 2 mm increments from -16 to 12 mm, in order to represent retrusion and protrusion of the mandible, respectively. These images were rated on a seven-point Likert scale by 50 patients at T1 (pre-treatment) and T2 (6 months following orthodontic appliance removal). At T1, mandibular retrusion became noticeable at -4 mm and protrusion at 2 mm. The results remained unchanged at T2. Surgery was desired from -9 mm at T1 and -10 mm at T2. For mandibular protrusion, surgery was desired from 3 mm at T1 and 4 mm at T2. The odds of desire for surgery were reduced by 85 per cent for those patients who had undergone bimaxillary surgery in relation to those with single jaw surgery. The lowest rated images demonstrated severe degrees of mandibular protrusion and retrusion. The highest rated images represented the idealized facial profile and minor variations thereof; there was little change in perception between T1 and T2. Going through the process of orthognathic treatment does not appear to have any significant effect on patients' perceptions of facial profile attractiveness or the limits of mandibular sagittal deviation at which they would desire surgery. The clinician's information provision during treatment does not seem to unduly influence orthognathic patients and does not make them more critical of jaw deformities.

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