Evaluation of facial attractiveness from end-of-treatment facial photographs.
BACKGROUND
Orthodontists typically make judgments of facial attractiveness by examining groupings of profile, full-face, and smiling photographs considered together as a "triplet." The primary objective of this study was to determine the relative contributions of the 3 photographs-each considered separately-to the overall judgment a clinician forms by examining the combination of the 3.


METHODS
End-of-treatment triplet orthodontic photographs of 45 randomly selected orthodontic patients were duplicated. Copies of the profile, full-face, and smiling images were generated, and the images were separated and then pooled by image type for all subjects. Ten judges ranked the 45 photographs of each image type for facial attractiveness in groups of 9 to 12, from "most attractive" to "least attractive." Each judge also ranked the triplet groupings for the same 45 subjects. The mean attractiveness rankings for each type of photograph were then correlated with the mean rankings of each other and the triplets.


RESULTS
The rankings of the 3 image types correlated highly with each other and the rankings of the triplets (P <.0001). The rankings of the smiling photographs were most predictive of the rankings of the triplets (r = 0.93); those of the profile photographs were the least predictive (r = 0.76). The difference between these correlations was highly statistically significant (P = .0003). It was also possible to test the extent to which the judges' rankings were influenced by sex, original Angle classification, and extraction status of each patient. No statistically significant preferences were found for sex or Angle classification, and only 1 marginally significant preference was found for extraction pattern.


CONCLUSIONS
Clinician judges demonstrated a high level of agreement in ranking the facial attractiveness of profile, full-face, and smiling photographs of a group of orthodontically treated patients whose actual differences in physical dimensions were relatively small. The judges' rankings of the smiling photographs were significantly better predictors of their rankings of the triplet of each patient than were their rankings of the profile photographs.
Shafiee
Roxanne
R
Department of Restorative Dentistry, School of Dentistry, University of the Pacific, San Francisco, CA 94115, USA.
Korn
Edward L
EL
Pearson
Helmer
H
Boyd
Robert L
RL
Baumrind
Sheldon
S
D000293:Adolescent; D004955:Esthetics, Dental; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008312:Malocclusion, Angle Class II / Q000628:therapy; D015588:Observer Variation; D009971:Orthodontics, Corrective / Q000379:methods; D023861:Photography, Dental; D012044:Regression Analysis; D012904:Smiling; D018709:Statistics, Nonparametric; D016896:Treatment Outcome