Oral and Maxillofacial Surgery

, Volume 23, Issue 4, pp 439–451 | Cite as

Effects of laterality on esthetic preferences of orthodontists, maxillofacial surgeons, and laypeople regarding the lip position and facial convexity: a psychometric clinical trial

  • Seyed Mohammad Mousavi
  • Parinaz Saeidi Ghorani
  • Arash Deilamani
  • Vahid RakhshanEmail author
Original Article



There are few, controversial, and limited studies on factors associated with the perception of profile beauty. Moreover, no study has ever assessed the role of laterality in esthetic judgment. Hence, this clinical trial was conducted.


Photographs of 6 patients (3 women) with normal lip position (Ricketts norm = 0 mm) and facial convexity (Legan-Burstone norm = 12°) were digitally manipulated to create two series of 9 gradient images each, with convexity changes of 2° and anteroposterior lip modifications of 1 mm. Half of profiles were flipped horizontally. Laypeople (n = 35), orthodontists (n = 19), and maxillofacial surgeons (n = 10) selected the esthetically acceptable images (6912 esthetic evaluations [2 parameters × 6 sets × 9 images × 64 judges]). Effects of photogrammetric stimuli and other factors on judges’ zone of esthetical acceptability (ZA) and its midrange were assessed statistically (α = 0.05).


Orthodontists and surgeons had respectively the broadest and narrowest ZAs (p < 0.05, ANOVA). Mean midranges of surgeons, orthodontists, and laypeople were respectively 0.27 ± 1.35, 0.56 ± 1.46, and 0.41 ± 1.77 mm for males’ lower lips (p = 0.710, ANOVA); 0.27 ± 1.10, − 0.44 ± 0.91, and 0.03 ± 1.56 mm for females’ lower lips (p = 0.034); 10.40 ± 3.17°, 11.09 ± 2.86°, and 11.57 ± 3.84° for men’s profile convexity (p = 0.246); 10.27 ± 3.20°, 11.05 ± 1.87°, and 11.13 ± 3.26° for women’s profile convexity (p = 0.346). Judges’ gender did not affect their esthetic perception (p > 0.1). When patients’ left side of face was visible, judges’ esthetic preference parameters shifted towards a less convex profile and a narrower ZA (p < 0.05).


Slightly protruded lips (for men) and slightly less convex profiles (for men/women) might be favored by all groups. Women’s esthetic lip positions might differ among groups. Judges’ gender might not be a determinant. Subjects’ face side can influence judges’ esthetic perception of facial convexity.


Esthetics Perception Orthodontics Maxillofacial surgery Lip prominence Profile convexity Laterality 



The authors express their sincere gratitude to Prof. Donald B. Giddon for his in-depth review of the methods, statistics, and article as well as his extensive contributions and edit to the text.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from orthodontic patients.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Seyed Mohammad Mousavi
    • 1
  • Parinaz Saeidi Ghorani
    • 2
  • Arash Deilamani
    • 3
  • Vahid Rakhshan
    • 4
    • 5
    Email author
  1. 1.Orthodontics Department, School of DentistryAhvaz Jundishapur University of Medical SciencesAhvazIran
  2. 2.AhvazIran
  3. 3.Student Research Committee, Ahvaz Jundishapur University of Medical ScienceAhvazIran
  4. 4.Department of Cognitive Neuroscience Institute for Cognitive Science StudiesTehranIran
  5. 5.Department of Dental Anatomy, Dental FacultyAzad UniversityTehranIran

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