Does Maxillary Retrusion in Skeletal Class III Malocclusion Affect the Perception of Facial Aesthetics? Evaluation of Different Groups

Background: The perception of facial aesthetics is a complex topic due to its subjective nature and it can be influenced by several factors. The purpose of this study was to compare the perception of general dentists, orthodontists, maxillofacial surgeons, and lay people by evaluating facial aesthetics in skeletal class III patients, especially for maxillary sagittal position. Methods: A survey consisting of three sets of pre-treatment photographs of four dysmorphic patients was used. The questionnaire was submitted to a total of 200 participants divided into the following four subgroups: general dentists, orthodontists, maxillofacial surgeons, and lay people. Their opinion on facial disharmony, sagittal position of the jaws, asymmetry of the chin, projection of the cheekbone area, and lip aesthetics was recorded. Results: Significant differences were found between experts and non-experts in the perception of the maxillary position, asymmetry of the chin and zygomatic area (p < 0.01). No statistically significant differences were found among the groups in the perception of mandibular position and lip aesthetics. Conclusion: The respondents with a medical or dental background perceived the presence of maxillary retrusion more than others. Only orthodontists and maxillofacial surgeons have recognized an alteration of the middle facial third as a greater component of skeletal class III malocclusion.