The role of the divine proportion in the esthetic improvement of patients undergoing combined orthodontic/orthognathic surgical treatment.

This study was designed to investigate the changes in a number of facial proportions as a result of combined orthodontic/orthognathic surgical treatment. According to some authors, in beautiful faces, the values of the proportions measured are likely to approximate the divine proportion (1.618:1). The hypothesis for this study was that, as a result of treatment, the faces of patients in the sample would be more esthetic and therefore the measured proportions would be closer to the divine proportion than they were before treatment. Forty-six patients were included in the sample. Pre- and posttreatment photographs were each given a score (out of a possible 100) by 12 judges using a visual analog scale. Judges were shown frontal and profile views simultaneously. Ten ratios were measured from pre- and posttreatment lateral cephalograms, and 11 were measured from the frontal photos. Pearson's correlation coefficient was used to determine the correlation between changes in esthetic rating and changes in the measured proportions. No correlations were found between changes in esthetic ratings and changes in the proportions. While most subjects were considered more esthetic after treatment than before, the proportions were equally likely to move away from or toward the divine proportion. For this reason, if it is to be used as an aid to orthodontic/orthognathic treatment planning, the divine proportion should perhaps be used along with other methods of anteroposterior and vertical cephalometric and facial assessment.