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Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach

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Published on: August 24, 2018

Does Andrews facial analysis predict esthetic sagittal maxillary position?

Cory M Resnick¹, Kimberly M Daniels², Maryann Vlahos³

¹Harvard School of Dental Medicine, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

|March 3, 2018

Summary

The Andrews’ Gall technique suggests ideal maxillary incisor positions for facial aesthetics. For women, 2-4mm anterior to the Gall line is preferred, while men prefer 0-4mm posterior.

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Area of Science:

Dentistry
Orthodontics
Facial Aesthetics

Background:

Cephalometric analyses have limitations in planning maxillary sagittal position for orthognathic surgery.
Andrews' Six Elements of Orofacial Harmony proposed a method to quantify maxillary position relative to forehead projection and angulation.

Purpose of the Study:

To investigate the ability of Andrews' technique to predict esthetic sagittal maxillary position.
To determine ideal maxillary incisor-to-Gall line distances for facial attractiveness.

Main Methods:

A survey study involving male and female participants with straight facial profiles.
Lateral photographs were digitally altered to create 5 variations in maxillary incisor position relative to the Gall line (-4, -2, 0, +2, +4 mm).
Healthcare professionals and laypeople rated the attractiveness of each modified photograph.

Main Results:

For females, incisor-Gall distances of +4 mm (41%) and +2 mm (40%) were rated most esthetic.
For males, peak esthetic ratings were observed at 0 mm (37%) and -4 mm (32%) incisor-Gall distances.
Statistical analysis showed significant differences in esthetic preferences for both genders (P < .001).

Conclusions:

Maxillary incisor positions 2-4 mm anterior to the Gall line are considered most attractive in women.
Maxillary incisor positions 0-4 mm posterior to the Gall line are considered most esthetic in men.
The Andrews' Gall analysis, with these modified target distances, can be a valuable tool for planning orthognathic surgery.