Influence of Lower Facial Height on Frontal Facial Attractiveness as

Research
Article
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J Res Adv Dent 2015; 4:1:28-33.
Influence of Lower Facial Height on Frontal Facial Attractiveness
as Judged by Specialists and Laypeople
Shweta Dixit1* Madhu Pandey2
1Senior
2Assistant
Lecturer, Department of Orthodontics, Darshan Dental College and Hospital, Udaipur, Rajasthan, India.
Professor, Department of Orthodontics, Chhattisgarh Dental College and Research Institute, Rajnandgaon. Chhatisgarh, India.
ABSTRACT
Aim: To test the hypothesis that lower facial height has no influence on frontal facial Attractiveness.
Materials and Methods: Frontal facial silhouettes of a man and a woman with normal lower facialheight values
were modified by increasing and decreasing theirlower facial heights in steps of ±2 mm to obtain frontal images
with different lower facial heightranging from +6 mm to -6 mm. A panel of 40orthodontists, 40 oral surgeons,
40lay male and 40 lay femalejudged most attractive face. TheChi squaretest wasused to compare the grades at P
value 0 .05.
Results: For male silhouettes orthodontist ranked unaltered to be most attractive while oral surgeons choose -2
mm. Laymales and females graded +2mm and +4mm as best respectively. For a female face orthodontist ranked 2mm,Oral surgeons graded unaltered and laypersonsrated -4mm as most attractive.
Conclusion: The Lower facial height will influence frontal facial attractiveness.
Keywords: Lower facial height; Facial attractiveness.
INTRODUCTION
Among the inherent need of Man are the
need to conform and the need for identity. Man’s
awareness of facial and body esthetics extends
beyond recorded history. Beauty or physical
attractiveness in individuals has almost always
been a feature which causes people to react
favourably in social interaction. The feature of a
man which is most widely remembered is physical
attractiveness particularly facial beauty.The desire
to improve facial esthetics has been the most
common reason for seeking orthodontic or
combined orthodontic and surgical treatment.17Orthodontists also consider improvement of facial
esthetics an important treatment goal.8The vertical
discrepancy has been shown to be one of the main
reasons for seeking and receiving orthodonticsurgical treatment.TheLower facial height (LFH) can
be altered intentionally or unintentionally during
orthodontic therapy.9-10The relationship between
thesagittal changes and facial attractivenesshas
always been issue ofinterest. Few studies have
correlated attractiveness of face with different
vertical dimensionsand theprofiles with increased
vertical feature was judged to be the most
unattractive.11-16
Sometimes frontal profile may appear
significantly improved to surgeon and orthodontist
but an untrained person may have little
appreciation of the result. Some patients may even
fail to notice major change in their own appearance
after treatment.
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Copyright ©2015
Fig 1: Series of male silhouettes.
Fig 2: Series of female silhouettes.
Thus it is essential first to formulate guidelines for
the esthetic evaluation of facial morphology in
relation to orthodontics and orthognathic surgery
and second to establish to what degree these
guidelines conform to the sensitivities and esthetic
preferences by lay people.
Frontal Facial Images
Layperson generally determine the
personal attractiveness from the frontal viewand
the fact that people view each other from the frontal
perspective
during
the
usual
mode
of
17-23
communication
so the purpose of this study was
to test the hypothesis that LFH has no influence on
the frontal facial attractiveness as judged by the
orthodontist, the oral surgeons and the lay person.
MATERIALS AND METHODS
Raters
The Present study was pursued in Darshan
Dental College and Hospital, Udaipur at department
of orthodontics andthe panel of raters included 40
Orthodontists, 40 Oral Surgeons and40lay men and
40 lay women with age ranging20–42 years.
A man and a woman who were clinically
determined to have vertical frontal measurements
closely matching the normal values(71 mm for
female and81.1mm for male) introduced by Arnett
and McLaughlin volunteered to participate in the
present study. Using a SLR camera (Nikon D70,
Tokyo, Japan), their color frontal facial photographs
were obtained while they maintained natural head
position while standing. The obtained photographs
were transferred topersonal computer and
modified in Adobe Photoshop 7.0 ME at a resolution
of 600 dpi. The Lower Facial Height
(subnasalmenton) was modified in 2 mm steps and
frontal images with different alterations ranging
from +6 to -6 mm (Figures 1 and 2). A series of 7
frontal images (one unchanged, three with
increased Lower Facial Height values, and Three
with decreased Lower Facial Heightvalues) were
developed for each gender. The images were
converted to black-and-white silhouettes, and the
image size was reduced to 4× 5 inches.
29
Table 1: Perception of frontal facial attractiveness for male silhouettes(shownas frequency)
S.N.
-6mm
-4mm
-2mm
0mm
+2mm
+4mm
+6mm
Orthodontist
Oral Surgeons
Lay Males
Lay females
*Highly significant
0
0
0
0
2
0
0
0
8
24*
2
4
30*
4
6
6
0
8
32*
4
0
4
0
26*
0
0
0
0
Table 2; Perception of frontal facial attractiveness for female silhouettes (shown as frequency)
S.N.
-6mm
-4mm
-2mm
0mm
+2mm
+4mm
+6mm
Orthodontist
Oral Surgeons
Lay Males
Lay females
*Highly significant
0
0
0
0
4
2
24*
30*
28*
4
12
4
8
28*
2
4
0
6
2
2
0
0
0
0
0
0
0
0
Table 3: Most Attractive Profile-percentage frequency chart.
Choosen profile-male
Choosen profile-female
Orthodontist
0mm
75%
-2mm
70%
Oral Surgeons
Lay Males
Lay females
-2mm
+2mm
+4mm
60%
80%
65%
0mm
-4mm
-4mm
70%
60%
75%
Data Collection
Fourty Orthodontists, 40 Oral surgeons, 40
lay males and 40 lay females participated and the
frontal facial silhouettes were shown to them in
Microsoft Powerpoint presentation of seven slides
eachfor male and female respectively. The Frontal
facial silhouettes were given a number from 1-7.
The Orthodontists,the Oral surgeons andthe
laypersons were asked to choose most attractive
image for male and female respectively.
The Statistics was applied for Difference of
perception of most beautiful face among
orthodontists and oral surgeons and lay males and
females.
Statistical Analysis
All statistical analyses were carried out
using SPSS 15. The Chi square test was used at P
value 0.05 to judge significant difference between
seven profiles of male and female respectively. The
Percentage frequency test was applied to judge
significant difference between opinion of
orthodontists and oral surgeons and lay males and
females for frontal facial attractiveness.
RESULTS
There existed a significant difference
between perception of frontal facial attractiveness
between theOrthodontists, the Oral surgeons and
the lay men and women. 75% Orthodontist found
unaltered faces most attractive for males while only
10% oral surgeons and 15 % lay men and lay
women judged it as most attractive. The percentage
value for most attractive facial images is shown in
table 3.Seventy percentOrthodontist found -2mm
face most attractive for females, while only 10 % of
surgeons and lay female found that -2mm face to be
most attractive. The Oral surgeons chose -2mm for
male and 0mm for female to be most attractive
while the lay male and female found slightly
increased lower facial height to be more pleasing
for male and -4mm lower facial height to be best
suited for females.
30
DISCUSSION
The use of black-and-white facial
silhouettes offers the advantage of eliminating the
effects of lips,nose,eyes,interocular distance,hair
color and style,and ageon the attractiveness of facial
expressiveness. In the other hand, the disadvantage
of black-and-white silhouettes is that the
proportion of LFH to total face height and the
harmony values in the LFH are not considered in
evaluation and this can be accepted to be a weak
aspect of this study.25-26
According to Arnett and McLaughlin mean
values of lower one-third facial height are 71 ± 3.5
mm for females and 81.1 ± 4.7 mm for males.23 The
current study was based on these values, and the
resultsrevealed that the images that had the LFH
normal values determined by Arnett and
McLaughlinreceived the highest scores from the
raters except where Lay males and females found 4mm profile for female to be most attractive .
Although there are no studies in the literature
reporting that the LFH normal values introduced by
Arnett and McLaughlin represent the LFH values of
the Indian population, the results indicate that such
values comply with the attractiveness perception of
Indianpeople.This result illustratesthat Arnett and
McLaughlinnormal values23 can beused at the
planning stage of the treatment
When the change in theLower facial height
exceeded +4 mm and -4 mm in male and female
silhouettes, the difference between them became
statistically insignificant. In clinical practice, these
results can be used in treatment planning to
determine the vertical correction needed or how
much theLower facial heightcould be increased or
decreased without compromising the front facial
esthetic. For example, in a female patient with
aLower facial height thatis 6 mm higher than the
normal value, in order to obtain an esthetically
pleasing result it seems appropriate to decrease the
LFH by at least 3 mm.
Mostly lay people as well as the
orthodontists and the oral surgeons liked faces
within range of +4 mm to -4 mm. Lay male and
female were found to have same perception for
female silhouette but females liked +4mm increase
in lower facial height while male liked +2mm
increase in lower facial height.
Similarly, in a study by Knight and
anterior
Lower
facial
heightwasfound to be associated with lessattractive
faces for females, but no such trend existed for
males. Ioiet al.28also reported that nonexpert raters
rated slightly shorter female profile silhouettes as
the most favored. In a study by Johnston et al.,13the
images with reduced LFH proportions were found
to be more attractive, but in that study, theprofile
silhouette image of a male was used, and the study
did not specify whether the raters had any
ideaabout the gender of the silhouette subject. On
the other hand, in the study of Maple ET al.15it was
reportedthat there was no difference between the
images when the Lower facial height were increased
and decreased by the same amounts. Few studies
has also taken into count the proficiency of judging
panel.30-31
Keith27,increased
CONCLUSION
It can be concluded from the study that the
Lower facial height will influence frontal facial
attractiveness.The hypothesis that Lower facial
height has no influence on frontal facial
attractiveness was rejected. The findings of this
study showed that for specialists including
orthodontists and Oral surgeons there is a lee way
for altering lower facial height during treatment as
acceptance to increased and decreased lower facial
height was more in laypeople.When the Lower facial
height values fall outside of the 71±4 mm range for
females and outside of the 81.1±4 mm range for
males majority of raters found it to be non
attractive.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this
article was reported.
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