Facial profile attractiveness in orthodontically treated Class III malocclusion patients: a comparison of extraction and non-extraction protocols

ABSTRACT Introduction: The treatment of Class III malocclusion has an important impact on facial and smile esthetics. Objective: To compare the facial profile attractiveness (FPA) of Class III malocclusion patients treated with and without premolar extractions. Material and Methods: A retrospective sample of 39 Class III malocclusion patients was divided into two groups: Non-extraction group, composed of 20 patients (8 males, 12 females; mean age: 13.7 years); and the Extraction group, comprising 19 patients (9 males, 10 females; mean age: 15.0 years). Both groups were treated with orthodontic fixed appliances. Facial profile silhouettes were created from the pretreatment and posttreatment lateral cephalometric radiographs. The silhouettes were evaluated by 30 laypeople (20 males, 10 females; mean age: 32.2 years) and 29 orthodontists (13 males, 16 females; mean age: 48 years). The evaluators rated FPA using a scale ranging from 1 (least attractive) to 10 (most attractive). Intergroup comparisons of FPA between treatment protocols and evaluators were performed using Mann-Whitney tests. For intragroup comparisons of pre- and posttreatment stages, Wilcoxon tests were performed. Results: The extraction group was statistically more attractive in the pretreatment stage, when compared to the non-extraction group. Both groups showed no significant differences in the intragroup comparisons of pre- and posttreatment stages. Laypeople rated FPA significantly lower than orthodontists at both stages. Conclusion: Class III malocclusion patients treated with and without extractions presented similar FPA at the posttreatment stage. No differences were observed for the FPA in the intragroup comparisons of pre- and posttreatment stages. Orthodontists were significantly less critical than laypeople.