Mandibular advancement analysis among orthodontists, lay people and patients in class II malocclusion subjects. A three-dimensional imaging study.

OBJECTIVE

To evaluate the acceptance of orthodontists, laypeople and the patient when progressive mandibular advancements are performed in class II subjects with mandibular retrognathism.

SETTING AND SAMPLE: 3D images were obtained by an optical surface scanning of fifteen individuals (12 males and three females, mean age of 23 years and 8 months) with mandibular retrognathism in three mandibular positions: maximum intercuspation (MIC) and progressive mandibular advancement of 2 and 4 mm.

METHODS

The images (n = 45) were evaluated through a scale by two groups of panellist, 20 orthodontists, 20 laypeople and by the patients themselves (n = 15). The participants evaluated and rated each video and give scores between 0 and 10, according to their perception of facial harmony. MANOVA for repeated measures was used for intra- and intergroup differences and to evaluate the patients' self-perception.

RESULTS

Laypeople reported better face acceptance than orthodontists in MIC and progressive mandibular advancement of 2 and 4 mm (P < .0001). 80% of the patients evaluated their own face as pleasant in MIC. Around half of them did not note significant difference following mandibular advancement of 2 mm as compared with MIC and even two-third attributed lower scores when the mandible was advanced 4 mm.

CONCLUSION

A high variability was observed among all groups of raters. Patient´s opinion should be taken into account when mandibular advancement of 4 mm or more is planned. This study suggests that a thorough discussion of facial changes resulting from mandibular advancement should be carried out among professionals, parents and patients.