Extraction of Four Premolars in Black Patients with Bi-protrusion: Aesthetic Perceptions of Professionals and Lay People

Objective To assess the aesthetic perceptions and expectations regarding the results of orthodontic treatment for alterations in the profile of Black patients with bi-protrusion through the extraction of four premolars and maximal anchorage. Design Cross-sectional. Setting Offices of plastic surgeons and orthodontists in the city of Belo Horizonte, Brazil. Subjects and methods 152 individuals participated in the study and were divided into four groups: Group 1, 38 orthodontists; Group 2, 38 plastic surgeons; Group 3, 38 White laypersons; and Group 4, 38 Black laypersons. The patient sample was composed of six Black individuals (three males and three females) with varying degrees of bi-protrusion. Each participant was shown altered photographs of the profile of the final result of treatment, simulating three different bi-protrusion reduction options (2, 4 and 6 mm), which were united with the original initial and final photographs. Outcomes Aesthetic preferences and expectations regarding the true result of treatment. Data analysis The chi-square test for linear trend with Bonferroni correction (á = P<0·008). Results The aesthetic preference for the majority of participants was for a straighter profile than those provided by the orthodontic treatment. Moreover, the actual profile resulting from the orthodontic treatment was correctly identified by just 22% of the Black laypersons, 22% of the White laypersons, 21% of the orthodontists and 17% of the plastic surgeons. There were significant differences between groups. Conclusions This study supports the view that society perceives straight profiles as aesthetically more pleasing in comparison to protruding or slightly protruding profiles.