Effects of facial forms and midline deviations and rolls on female facial beauty according to laypeople, orthodontists, and prosthodontists or restorative dentists

No study has examined the simultaneous effect of facial forms, midline deviations and midline angulations on facial beauty. Therefore, this comprehensive study aimed to evaluate these and many other hypotheses. This psychometric study was performed on 15,042 observations. A female frontal photograph was edited to 45 perceptometric images with controlled anatomical alteration: 3 facial forms (euryprosopic [brachyfacial], mesoprosopic [mesofacial], leptoprosopic [dolichofacial]), each having either 9 bidirectional midline deviations (0, 1, 2, 3, and 4 mm deviated to the left and right) or 7 bidirectional midline angular deviations (0°, 5°, 10°, and 15° deviated to the left and right). One of the photographs were repeated. These 46 images were esthetically judged by 327 participants (243 laypeople, 49 orthodontists, and 35 'prosthodontists or restorative dentists'). Hierarchical mixed-model multiple linear regressions and post hoc tests were adopted to evaluate the simultaneous impacts of the photomodel's facial forms, midline deviations to the right or left, and midline rolls to the right or left plus sex, age, experience, and dental specialty of the referees on their perception of facial beauty as well as the tolerable zones of midline alterations. These were also done separately for each specialty group, and also for each facial face. Ideal combinations of anatomic features were determined using repeated-measures ANOVAs. Differences between esthetic preferences of different groups in terms of each image were assessed using one-way ANOVAs and t-tests (α = 0.05, α = 0.008, α = 0.001). All 5 anatomical features significantly and independently influenced perception of facial beauty. The tolerance threshold for midline deviations was 1 mm deviations to the right and left sides. For midline rolls, the only tolerable form was the no-roll ('on') midline; the judges preferred right-oriented defects over left-sided ones. The most beautiful facial form was mesoprosopic, followed by leptoprosopic. Men perceived the female face slightly more attractive than did women. The viewers' specialty (or lack of it), their age, or their experience did not affect their esthetic preferences. Predictors of esthetic preferences were all 5 anatomical features plus views' sex, but not their dental specialty, age, or experience. Zones of acceptability and also the ideal range of anatomical features were determined.