American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics · 2026
The role of sagittal maxillary-mandibular relationships on perceptions of facial shape esthetics: A three-dimensional morphometric analysis.
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Decoste Janick, Cioffi Iacopo, Caminiti Marco F, Aponte Jose D, Hallgrímsson Benedikt, Oberoi Snehlata, Gong Siew-Ging, Young Nathan M
Аннотация
INTRODUCTION: This study aimed to assess whether sagittal maxillary-mandibular skeletal relationships influence perceived facial esthetics in patients with varying sagittal skeletal discrepancies.
METHODS: We analyzed 3-dimensional facial models from cone-beam computed tomography scans of 40 patients (17 males and 23 females aged 14-48 years; ANB = 0°-10°), lacking skin color or hair, to isolate shape. A total of 100 laypeople rated these for esthetics and sexual dimorphism using visual analogue scales. Procrustes-based 3-dimensional geometric morphometrics quantified shape, and multivariate linear regression estimated vectors for visual analogue scales ratings. Linear regression tested correlations between shapes linked to the ANB angle and esthetics.
RESULTS: Perceived attractiveness was unrelated to age, asymmetry, or deviation from the population average shape. Esthetics correlated with lower facial third shape (r2 = 0.473, P = 0.058, 4.5% variation), particularly with anterior or inferior gnathion and pogonion displacement, with consistent patterns across sexes (rv = 69.2°, P <0.0001). Shapes associated with higher ANB angles (indicating convexity) showed a negative association with attractiveness (r2 = 0.494, P <0.001). Sexual dimorphism was linked to cheek placement, facial roundness, and nasal tip position (r2 = 0.558, P = 0.001, 9.0% variation).
CONCLUSIONS: Sagittal maxillary-mandibular relationships, as measured by the ANB angle and sagittal skeletal discrepancy, modestly influence facial esthetics, with straighter profiles and prominent chins rated more attractive. These findings suggest a partial biological basis for esthetic preferences, though individual and cultural factors, including smile esthetics and dental symmetry, also play a role. The study informs orthodontic treatment planning by highlighting the esthetic impact of jaw alignment.
METHODS: We analyzed 3-dimensional facial models from cone-beam computed tomography scans of 40 patients (17 males and 23 females aged 14-48 years; ANB = 0°-10°), lacking skin color or hair, to isolate shape. A total of 100 laypeople rated these for esthetics and sexual dimorphism using visual analogue scales. Procrustes-based 3-dimensional geometric morphometrics quantified shape, and multivariate linear regression estimated vectors for visual analogue scales ratings. Linear regression tested correlations between shapes linked to the ANB angle and esthetics.
RESULTS: Perceived attractiveness was unrelated to age, asymmetry, or deviation from the population average shape. Esthetics correlated with lower facial third shape (r2 = 0.473, P = 0.058, 4.5% variation), particularly with anterior or inferior gnathion and pogonion displacement, with consistent patterns across sexes (rv = 69.2°, P <0.0001). Shapes associated with higher ANB angles (indicating convexity) showed a negative association with attractiveness (r2 = 0.494, P <0.001). Sexual dimorphism was linked to cheek placement, facial roundness, and nasal tip position (r2 = 0.558, P = 0.001, 9.0% variation).
CONCLUSIONS: Sagittal maxillary-mandibular relationships, as measured by the ANB angle and sagittal skeletal discrepancy, modestly influence facial esthetics, with straighter profiles and prominent chins rated more attractive. These findings suggest a partial biological basis for esthetic preferences, though individual and cultural factors, including smile esthetics and dental symmetry, also play a role. The study informs orthodontic treatment planning by highlighting the esthetic impact of jaw alignment.