Esthetic preferences of European American, Hispanic American, Japanese, and African judges for soft-tissue profiles

Introduction: Our objectives were to determine whether observer and patient sex and race or ethnicity determine esthetic preferences for lip positions. Methods: Four independent panels each consisting of 30 lay judges viewed pretreatment silhouette profiles of 10 European American, 10 Japanese, and 10 African American Angle Class I and Class II orthodontic patients. The panels included European Americans, Hispanic Americans, Japanese, and Africans. Profiles were traced from lateral cephalograms and manipulated so that the lip profile lay on the Ricketts' E-line or at various distances from the E-line from -8 to +4 mm in 2-mm increments. The judges selected the profile that they considered the most attractive and then classified the remaining 6 profiles as either acceptable or unacceptable. Results: The mean preferred lip positions (mean ± SD) were -2.58 ± 1.92 mm for European American, -3.28 ± 2.26 mm for Hispanic American, -3.45 ± 1.92 mm for Japanese, and -2.13 ± 1.95 mm for African judges. The African judges preferred more protrusive profiles compared with the Hispanic American (P <0.01) and Japanese (P <0.001) judges. Patient race or ethnicity and sex also contributed significantly to the judgments of profile esthetics (P <0.001). Conclusions: Judge race or ethnicity and patient race or ethnicity and sex significantly influence laypersons' standards for lip profile esthetics.