ABSTRACT

Objective

To evaluate the esthetic perceptions of orthodontists and laypersons for facial profile changes after orthodontic treatment using Herbst or Forsus appliances.

Materials and Methods

Pre- and posttreatment facial profile contour images of 20 Class II patients treated with Herbst (group H; n = 10) and Forsus (group F; n = 10) appliances were analyzed by 30 orthodontists and 30 laypersons, who graded them from 1 (unattractive) to 10 (very attractive) using a visual analog scale. Two assessments were carried out with a 15 day-interval. In the first evaluation, 40 images were presented in a random sequence. In the second evaluation, initial and final facial profile images of each patient were randomly presented side by side. To compare groups in relation to treatment method, Mann-Whitney tests were used. To evaluate differences between time points, Wilcoxon tests were used.

Results

In the first evaluation, there was a significant difference between initial and final images only for group H, for both laypersons (P = .017) and orthodontists (P = .037). There was also a significant difference between laypersons and orthodontists in their ratings of posttreatment Herbst appliance profiles (P = .028). There was no significant difference between initial and final facial profile images for group F and no significant differences between or within evaluator groups in their ratings of initial or final Forsus appliance profiles. In the second evaluation, there was a significant difference between appliance groups only for laypersons, who considered cases treated with the Herbst appliance more attractive than those treated with the Forsus (P = .031). Laypersons also considered Herbst profiles more attractive than did orthodontists (P = .047).

Conclusions

Class II malocclusion treatment using the Herbst appliance may produce a more esthetically improved facial profile silhouette compared with Forsus appliances. The magnitude of perceived changes may not be considered clinically relevant.

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Author notes

a

Graduate Student, School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil.

b

Professor, School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil.

c

Associate Professor, Division Head of Orthodontics, Orthodontic Graduate Program Director, Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada.

d

Professor, School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, and Associate Professor, Department of Orthodontics, Federal University of Paraná, Curitiba, Paraná, Brazil.

e

Associate Professor, Department of Orthodontics, Federal University of Paraná, Curitiba, Paraná, Brazil.