Esthetic evaluation of Asian-Chinese profiles from a white perspective.

Introduction: Immigration from Asian countries to North America and Australia has resulted in more Asian patients treated by white orthodontists. Planning treatment for patients of different ethnicities can be a challenge. The aim of this study was to establish baseline data for the assessment of Asian-Chinese profiles from a white perspective.

Methods: Two Asian-Chinese profile images, 1 male and 1 female, were modified to create 7 profiles for each gender. Each profile showed a distinct characteristic: bimaxillary protrusion, protrusive mandible, retrusive mandible, normal profile (Class I incisor with Class I skeletal pattern), retrusive maxilla, protrusive maxilla, and bimaxillary retrusion. The images were viewed and ranked by 142 white examiners in 3 cohorts: 31 orthodontists, 31 dental students, and 80 laypersons from a mixed multi-ethnic metropolitan community. The facial anatomy that played the most important role in their decision making was also noted. Collected data in the form of ranks were statistically analyzed by using repeated measures analysis of variance.

Results: All examiners preferred the normal Class I or bimaxillary retrusive profiles in both sexes; the male profile ranked the least attractive was the protrusive mandible, and the female profiles ranked the least attractive were the protrusive mandible and the retrusive mandible. Orthodontists, dental students, and laypersons demonstrated similar trends in ranking the profiles. The preferred profiles diverged from bimaxillary protrusive and Class III profiles (maxillary retrusion and mandibular protrusion), which are the usual norms for ethnic Asian-Chinese. The upper lip, the lower lip, and the chin had the most emphasis when the examiners were ranking the profiles. This finding was also common in all 3 groups.

Conclusions: This study demonstrated strong cohesive trends in establishing ideal facial esthetics of Asian-Chinese profiles evaluated by white persons in a multi-ethnic metropolitan community.