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23 February 2021

A current tool in facial aesthetics perception of orthodontic patient: the digital warping

Authors:Alessandra Putrino, Maria Rosaria Abed, Ersilia Barbato, Gabriella Galluccio


the procedure of warping, usually and interchangeably called morphing, elicit profile aesthetic preferences in orthodontic patients using the most common cephalometric softwares. It’s a method makes it easy to construct a prediction picture of the face based on changes to the soft-tissue profile effected by orthodontic or surgical treatment. In the age of new generations increasingly influenced by selfies and photo editing applications on smartphones, this study aims to determine general aesthetic preference and to find out whether it was affected by sex, age or real profile.

Materials and Methods: 72 patients (12-20 years old; 37M; 35 F) at early stage of therapy at our dental offices valued their own and others digitized series of three distinct distortions from initial lateral cephalograms and photos translated into soft-tissue changes of third lower of the face. We didn’t indicate photos showing the real profiles to not influence their answers. Chi-square test and Goodman-Kruskal lambda index (λ) were used to compare and measure the association of patients’ preferences according to sex, age, facial profile. (P=0.005)

Results: both sexes deemed positively orthognathic profiles whereas prognathic and retrognathic profiles were the least preferred (χ²=0.78). Age and own patient profile don’t seem to have significative influence on choices. The poor association of the considered variables is highly presumed due to their reciprocal independence (λ=0; λ=0.02).

Conclusions: Generational models influence the concept of attractiveness. Explaining limits and viewing possible results of orthodontic therapies prevent disappointments. Patients’ expectations should be never neglected by orthodontists. Morphing procedure offers distorted images useful like predictive method but also tool of communication to assay the self-perception and opinions of our patients.

Clinical significance: Understanding the patient's aesthetic needs within the orthognatodontic treatment plan can be considered the prerequisite for a "conscious" therapy in which the patient's expectations and the clinician's operational possibilities converge towards the common goal of achieving the best possible result. Using traditional digital tools, as done in this study, can be a winning weapon in communicating with the patient. The morphing tool of cephalometric software through the warping function, which we can customize according to our indications, provides us with a simple and effective help for this purpose.


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