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.