Extraction of four premolars in Black patients with bi-protrusion: aesthetic perceptions of professionals and lay people

Abstract

Objective: To assess the aesthetic perceptions and expectations regarding the results of orthodontic treatment for alterations in the profile of Black patients with bi-protrusion through the extraction of four premolars and maximal anchorage.

Design: Cross-sectional.

Setting: Offices of plastic surgeons and orthodontists in the city of Belo Horizonte, Brazil.

Subjects and methods: 152 individuals participated in the study and were divided into four groups: Group 1, 38 orthodontists; Group 2, 38 plastic surgeons; Group 3, 38 White laypersons; and Group 4, 38 Black laypersons. The patient sample was composed of six Black individuals (three males and three females) with varying degrees of bi-protrusion. Each participant was shown altered photographs of the profile of the final result of treatment, simulating three different bi-protrusion reduction options (2, 4 and 6 mm), which were united with the original initial and final photographs.

Outcomes: Aesthetic preferences and expectations regarding the true result of treatment.

Data analysis: The chi-square test for linear trend with Bonferroni correction (á = P<0·008).

Results: The aesthetic preference for the majority of participants was for a straighter profile than those provided by the orthodontic treatment. Moreover, the actual profile resulting from the orthodontic treatment was correctly identified by just 22% of the Black laypersons, 22% of the White laypersons, 21% of the orthodontists and 17% of the plastic surgeons. There were significant differences between groups.

Conclusions: This study supports the view that society perceives straight profiles as aesthetically more pleasing in comparison to protruding or slightly protruding profiles.

Keywords:

• Esthetic perception
• black patient
• orthodontic treatment
• biprotrusion

Acknowledgments

We would like to thank Antônio Carlos Ruellas and Ana Maria Bolognese for treating the patients whose images were used in this study.