Facial Aesthetics In Adolescents.

Aesthetic improvement is the most important subjective reason to seek orthodontic treatment. Different methodologies have been advocated, but still there is an urgent need for a scoring system that is simple, and applicable in the orthodontic practice. A new measuring system to judge facial aesthetics in young Caucasians was developed using sets of three photographs of an individual as a stimulus. Scores were performed on a Visual Analogue Scale (VAS) with separate sets of reference photographs for girls and boys. Panel judgements using this system were reproducible and valid. The composition of such a panel has a great impact on the scores of the aesthetics of adolescent faces. Particularly, professional background, age, gender, and geographical region of panel members play an important role. It was shown that a panel of seven randomly selected laymen and/or orthodontists was sufficient to obtain reliable results. For the evaluation of changes in facial aesthetics after orthodontic treatment on a 5-point scale, the panel should consist of at least 9 randomly selected orthodontists, 14 randomly selected laymen, or if a mixed panel is used, the panel should consist of at least 13 panel members. From the objective parameters used in orthodontics, the Aesthetic Component of the Index of Orthodontic Treatment Need (AC/IOTN) appeared to be the most important indicator for facial aesthetics. A newly defined parameter, the 'horizontal sum', was found to be a reliable variable for the anterior-posterior characteristics of a patient. Golden proportions in the face and other 'ideal' proportions and angles are often supposed to be related to facial aesthetics. However, only few golden proportions and 'ideal' proportions and angles showed such a relation. It can be concluded that a more holistic approach to determine facial aesthetics is more promising