ABSTRACT
INTRODUCTION: The patient's perception of facial esthetics is not necessarily consistent with that of the practitioner. The aim of this study was to compare the perceptions of Persian orthodontists, oral surgeons, and laypersons with regard to facial profile attractiveness and the most favorable mandibular position. METHODS: Software (Dolphin Imaging and Management Systems, Chatsworth, Calif) was used to alter the mandibular position depicted on profile photographs of a young man and a young woman. Nine construction profile photos were produced with incremental changes of the G'-Sn-Pg' angle at 2° intervals (6° to 22°). Thirty-two orthodontists, 32 maxillofacial surgeons, and 32 laypersons were asked to score all 18 profiles on a 1-to-10 visual analog scale. They also evaluated whether each profile needed orthognathic surgery for improvement of facial esthetics. Actual agreement and intraclass correlation coefficient tests were used to assess reliability. The data were analyzed using 2-way repeated measures analysis of variance and Wilcoxon signed-rank tests. RESULTS: The intraparticipant reliability was acceptable (intraclass correlation coefficient >72%; actual agreement, >79%). The sex of the participants was not a significant factor influencing the scores, although the sex of the models was a discriminating factor for the most acceptable mandibular horizontal position. The scores given by the 3 groups were different, especially for the female model. The orthodontists had similar opinions and preferred a slightly more protrusive mandible (G'-Sn-Pg', 12°-14°). Laypersons' scores were the most inconsistent, and they generally preferred a retrusive profile (G'-Sn-Pg', 14°-18°). There was no significant correlation with regard to the necessity of orthognathic surgery for G'-Sn-Pg' angles over 20° in men and below 8° in women. CONCLUSIONS: Although the laypersons' perceptions were slightly different from those of the clinicians, most participants preferred a more protrusive mandible for male models compared with female models.