Esthetic perceptions of facial silhouettes after treatment with a mandibular protraction appliance

•Patients were treated with the mandibular protraction appliance plus orthodontics.•Facial profile silhouettes were rated by orthodontists and laypersons.•Both groups preferred the posttreatment profiles over pretreatment.•Preferences for posttreatment profiles were stronger among orthodontists.•Laypeople reported greater improvement than did orthodontists.

IntroductionIn this retrospective study, we aimed to evaluate the effects on the facial silhouettes produced by a mandibular protraction appliance associated with corrective treatment in Class II patients.MethodsThe sample consisted of 54 (27 initial and 27 final) lateral radiographs from 27 patients. Of these patients, 14 were girls and 13 were boys, with a mean initial age of 12.27 years and a mean treatment period of 2.9 years. An album containing the silhouettes of the pretreatment and posttreatment profiles based on the lateral cephalograms of the patients was prepared. Then, 60 orthodontists and 60 laypeople chose the more esthetic facial silhouette (A or B) and the amount of alterations they perceived between the 2 silhouettes, according to a visual analog scale. A paired t test was used to compare the 2 groups of evaluators with a 5% significance level.ResultsDifferences between the preferences regarding the pretreatment and posttreatment facial silhouettes were statistically significant for both groups. The posttreatment silhouettes were preferred by most evaluators. The visual analog scale scores showed that the lay evaluators identified greater differences between the pretreatment and posttreatment silhouettes than did the orthodontists (P <0.001).ConclusionsBased on the evaluators' judgments, treatment with the mandibular protraction appliance had a positive effect on the facial silhouette, and the laypeople better perceived this effect.