Determinants of Facial Esthetics in Caucasian and Asian Orthodontic Patients

Objectives: To determine whether observer and patient sex, race, and culture determine esthetic preferences for various lip profiles manipulated relative to Rickett's E-line. Methods: Three independent panels each consisting of 30 lay person judges (15 male, 15 female) viewed silhouette profiles of 20 Caucasian (10 male, 10 female) and 20 Asian (10 male, 10 female) Angel Class I and II orthodontic patients. The judge panels comprised the following racial/cultural groups: (1) Japanese, (2) Caucasian American, and (3) Asian American. Profiles were traced from lateral cephalograms and manipulated using Adobe Illustrator so that the lip profile lay on the E-line, 2mm and 4mm anterior, and 2mm and 4mm posterior to the E-line. Judges rank ordered the 5 profiles for each patient from "1 = least attractive" to "5 = most attractive". Results: There was no significant difference among the 3 groups of judges. When considering the most preferred profiles (rank = 5), we obtained a significant main effect for patient race [F(1,85)=4.46, p = 0.38]. The means ± standard error were: for Asian patients -1.45 ± 0.13 mm and for Caucasian patients -1.65 ± 0.12 mm. We also obtained a significant main effect for patient sex [F(1,85)=12.42, p=.001]. The means ± standard error were: for female patients -1.68 ± 0.13 mm and for male patients -1.42 ± 0.12 mm. Conclusions: Judge race, culture, and sex did not significantly influence judge standards for assessing the attractiveness of patient profiles. Judges ranked both Asian and Caucasian profiles most attractive when slightly posterior to E-line; however, they preferred Caucasian profiles more retruded than Asian profiles. Judges also ranked both male and female profiles most attractive when slightly posterior to E-line; however, they preferred female profiles more retruded than male profiles. Supported by 2003 AADR student fellowship (sponsor: John O. Butler).