Abstract
The purpose of this study was to validate an already published facial anteroposterior
reference: upper incisor (UI) to soft tissue plane or so-called Barcelona line (BL)
to trace the most aesthetic sagittal position of the maxilla. A cross-sectional multicentre
evaluation of Caucasian patients from Spain and Brazil with different anteroposterior
maxillary positions was designed. Sagittal images in natural head orientation of grouped
patients according to the horizontal distance from the UI to BL were ranked by healthcare
professionals and non-professional Caucasian raters according to the aesthetic perception
of each profile, using a digital survey. Seventy-four raters (50 laypeople, 12 orthodontists,
and 12 maxillofacial surgeons) rated 40 profiles. The best-rated profile corresponded
to group 3 (0–4 mm UI-BL) with 61.8% of positive evaluations, followed by group 4
(≥ 4 mm UI-BL): with 61.1%. On the other hand, group 1 (≤−4 mm UI-BL) was the worst-ranked
profile with 71.8% of negative evaluations, followed by group 2 (−4–0 mm UI-BL): with
59.6% of negative evaluations. The correlation between the mean assessment score and
UI-BL showed a moderately-strong association (r = 0.68, p < 0.001). The inter-rater
reliability of assessment (74 evaluators) was moderate (k = 0.49, 95% CI: 0.39 to
0.59). The results suggest that protrusive middle-third facial profiles are preferable.
The BL is proposed as a simple, individualised, and reproducible tool to trace an
aesthetic sagittal position of the maxilla in orthognathic surgery.
Keywords
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Article info
Publication history
Published online: October 12, 2022
Accepted:
October 10,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
