Ubaya Narayanage, Thushala
Are post-treatment orthognathic patients attractive? A three-dimensional study.
MSc(R) thesis, University of Glasgow.
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Background: The primary objective of orthognathic surgery is to improve facial aesthetics and function to an acceptable standard and to the patient’s satisfaction. Exactly what constitutes an acceptable standard of facial aesthetics to a patient has been the topic of numerous studies and yet has so far remained elusive. The patient, as a lay person, is the final end user of orthognathic services; it is their idea of facial attractiveness that ultimately is more relevant as a treatment goal than pre-determined measurements and standards developed by the clinicians. The standards for facial attractiveness of a given population tend to reflect the arbitrary standards of beauty set by cultural background and the influence of the media and fashion trends of the time. In the past, studies on facial attractiveness have used two-dimensional photographs. Using a 3D stereophotogrammetry system to capture images presented in a 3D configuration is probably a more realistic method to replace the actual patient. The overall aim of the present study was to compare, using angular and linear measurements, 3D facial images of a group of post-surgical orthognathic patients to a group of “attractive” individuals which were selected by a lay panel as being attractive, from a population from the West of Scotland.
Aims: To determine the 3D soft tissue facial measurements of an “attractive” group of West of Scotland males and females between the age of 18 and 35 as selected by a panel of lay people.
Materials and Methods: Subjects for the attractive group were recruited from within the local population of West of Scotland on a voluntary basis. Inclusion criteria were that subjects had to be of Caucasian origin from the West of Scotland, without craniofacial defect or facial hair and had to be between 18-35 years of age. 61 females and 51 males took part in the study; the subjects were imaged using the Di3D stereophotogrammetry system. The images were assessed by a lay panel of 8 members for facial attractiveness using a VAS method. The VAS scores were ranked from most attractive to least attractive for each subject as recorded by each of the 8 lay panel members. The data was divided into three segments – most attractive, attractive and least attractive. Individuals who were thought of as being most attractive and attractive by at least 6 lay panel members were chosen to be part of the attractive control group. The attractive group comprised of 24 females and 16 males. Landmarks were placed on all the 3D images by the author. Angular and linear measurements were derived for comparison between groups. An error study of landmark localisation was performed which showed no systematic errors and all coefficients of reliability were above 90%.
Results and Conclusions: The comparison of female and male attractive groups showed that all female linear measurements were smaller then male measurements except for columella length. There was a statistical difference (p<0.05) between the majority of linear measurements for males and females except for columella length and lower lip length. In all cases except upper facial convexity and nasolabial angle, female angular measurements were smaller than male measurements. The difference in the mean for nasolabial angle was minimal. There was no statistical difference between the majority of angular measurements for males and females except for upper facial convexity (p = 0.006). Overall the results show that attractive females from this sample have smaller facial dimensions than the attractive males for the most part except for upper facial convexity where the females showed a slightly flatter upper face.
Aims: To determine whether post-operative orthognathic patients look attractive based on objective measurements of 3D soft-tissue facial landmarks.
Materials and Methods: 16 male orthognathic patients and 17 female orthognathic patients participated in the study. The post-operative orthognathic subjects were imaged using the Di3D stereophotogrammetry system. Angular and linear measurements were used for comparison between the attractive males and females to the male and female post-orthognathic groups.
Results and Conclusions: In the male orthognathic group, the only statistical difference in comparison of means to the male attractive control group was noted for the measurements lower lip length and lower lip prominence. The male orthognathic sample appeared to have longer and more prominent upper and lower lips compared with the male controls though only the measurements for lower lip were statistically different in this study.
In the female orthognathic group, the only statistical difference in comparison of means to the female attractive control group was noted for the measurements nose width, lower anterior face height, nasolabial angle, nasal tip convexity and facial convexity including nose. The values for nose width, lower anterior face height, nasal tip convexity and facial convexity angle including nose were larger in the orthognathic group than in the attractive control group whilst the value for nasolabial angle was smaller. These results suggest that the female orthognathic group in comparison to the female attractive group have more convex faces in the sagittal plane, more convex nasal tips, wider noses and smaller nasolabial angles.
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