The role of sagittal maxillary-mandibular relationships on perceptions of facial shape esthetics: A three-dimensional morphometric analysis

Introduction This study aimed to assess whether sagittal maxillary-mandibular skeletal relationships influence perceived facial esthetics in patients with varying sagittal skeletal discrepancies. Methods We analyzed 3-dimensional facial models from cone-beam computed tomography scans of 40 patients (17 males and 23 females aged 14-48 years; ANB=0°-10°), lacking skin color or hair, to isolate shape. A total of 100 laypeople rated these for esthetics and sexual dimorphism using visual analogue scales. Procrustes-based 3-dimensional geometric morphometrics quantified shape, and multivariate linear regression estimated vectors for visual analogue scales ratings. Linear regression tested correlations between shapes linked to the ANB angle and esthetics. Results Perceived attractiveness was unrelated to age, asymmetry, or deviation from the population average shape. Esthetics correlated with lower facial third shape (r 2 = 0.473, P = 0.058, 4.5% variation), particularly with anterior or inferior gnathion and pogonion displacement, with consistent patterns across sexes (r v = 69.2°, P