Radiographic evaluation of the effect of various facial parameters on facial esthetics using Indian Silhouette profile-an in-vitro study

Introduction: Facial esthetics significantly influence orthodontic diagnosis and decision-making, this study examined esthetic preferences for digitally modified Indian silhouette profiles. Standardized male and female profiles were systematically altered to produce eleven variations per sex, which were assessed by orthodontists, dentists, others and analyzed using Chi-square test to identify significant differences in preference patterns.Materials and Methods: Average male and female Indian facial profiles were obtained from lateral cephalograms and digitally modified in WebCeph by adjusting the nasolabial angle, mentolabial sulcus, and lower facial height to create eleven variations per sex. These profiles were further altered for inter-rater reliability, producing sixty-six silhouettes representing Class I, II, and III malocclusions, which were evaluated by 34 orthodontists, 34 dentists, and 34 others using a questionnaire rating each profile as “most attractive,” “average,” or “least attractive.” Data were analyzed using the Chi-square test to assess differences in preferences among groups.Results: All groups preferred reduced lower anterior facial height (LAFH). Orthodontists favored a reduced nasolabial angle (NLA) and shallow mentolabial sulcus (MLS), whereas dentists and others preferred increased NLA, with dentists favoring average MLS and others favoring deep MLS. Significant differences were also observed between preferences for male and female profiles.Conclusion: Esthetic preferences vary by gender and professional background, emphasizing the necessity of integrating patient-specific expectations into orthodontic treatment planning to optimize both functional and esthetic outcomes.