The Importance and Utilization of the Facial Frontal View in Orthodontic Treatment Planning

Abstract

Objectives: The purpose of this study was to evaluate whether differences exist in: (1) orthodontists’ aesthetic analysis of treatment need from profile and frontal view photos of the same patient; (2) orthodontists’ proposed treatment type and their aesthetic analysis of treatment need from the frontal view, and (3) orthodontists’ treatment plans when given a frontal photo versus no frontal photo. A survey questionnaire was designed to test the utility of the frontal view in orthodontic treatment planning. Materials And Methods: The survey was dispersed through the Schulman Orthodontic Group utilizing SurveyMonkey. Part 1 of the survey implemented a Likert scale rating of the aesthetics of 5 patients’ frontal and profile photos. In part 2, SurveyMonkey randomly allocated participants into two groups. Survey-takers could proceed through any of the 20 customized pathways of the survey depending on their proposed treatment plans. Groups 1 and 2 were presented the same example patients; Group 1 was presented all diagnostic information and asked to formulate a treatment plan and Group 2 was given all diagnostic information minus the frontal view and asked to formulate a treatment plan, and subsequently presented with the frontal view photos to determine whether the newly revealed diagnostics changed their proposed treatment. Results: Data collection included seventy-three completed surveys from the Schulman Group composed of 140 orthodontists. A paired sample T-Test revealed significant differences in orthodontists’ analyses of need for treatment based on facial aesthetics from the frontal and profile view in all patients (p≤0.05). A Kruskal-Wallis non-parametric ANOVA test revealed no differences in proposed treatment type and orthodontists’ assessment of need for treatment based on facial view photos (p>0.05). A chi-squared analysis revealed no differences exist between treatment type proposed when a frontal view photo was provided versus not provided in 3 of 5 patients (p>0.05). Conclusion: Despite being heavily weighted from an aesthetic analysis of treatment need, the frontal view photo failed to affect significant differences in proposed treatment intervention and type. A stronger emphasis should be placed on information gained from the frontal view photos such as smile arc, buccal corridors, and incisor display, which are not being adequately considered in orthodontic treatment planning.