Perception of facial esthetics by different observer groups of Class II malocclusion with mandibular retrusion

Aim: To compare the esthetic perception of different observer groups of 14 photos of two patients with Class II, division 1 malocclusion with severe mandibular retrusion. Materials and methods: A sample of 441 participants, of which 191 were laypeople, was obtained through a snowball sampling method. Fourteen photos of two children with Class II, division 1 malocclusion with severe mandibular retrusion were used, before and after orthodontic treatment (OT), with advance genioplasty simulation. For the evaluation of esthetic perception, the photos were rated using a numerical scale from 0 (very unesthetic) to 10 (extremely esthetic). Results: Despite a parallelism of opinions, there were statistically significant differences (P 0.05) in the assessments made by the different observer groups. Laypeople tended to attribute higher values (statistically significant difference of P 0.05) compared to the other observer groups, with the exception of the girl's lateral profile and smile photos before OT (P > 0.05). Although they did not agree on all the photos, the other groups expressed similar scores between them. Pretreatment photos obtained the lowest scores, and those with advance genioplasty simulation obtained the highest. Conclusions: Mandibular retrusion has a strong impact on the perception of facial attractiveness. The esthetics of the lateral profile in children with severe mandibular retrusion is improved by OT. As a rule, laypeople tend to assign higher ratings.