Boonipat Thanapoom, Lin Jason, Cherukuri Sai, Ng Zhi Yang, Chen Eugene Yu-Jen, Yao Chuan-Fong
Department of Plastic and Reconstructive Surgery, Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Saint Louis University, St. Louis, MO, USA.
Arch Craniofac Surg. 2025 Jun;26(3):115-123. doi: 10.7181/acfs.2025.0007. Epub 2025 Jun 20.
The attractiveness of a person's smile is influenced by several factors, including gingival display, incisor show, and facial asymmetries. Malocclusion has long been recognized as having a significant negative impact on smile aesthetics. Addressing dentofacial deformities is a major treatment goal in orthodontic and orthognathic interventions, aiming to improve both functional and aesthetic outcomes. We sought to quantify and assess the impact of orthognathic surgery on a patient's expression of happiness within their smile, thereby addressing the current research gap in this highly subjective field.
We utilized FaceReader, a commercially available and previously validated artificial intelligence (AI) system, to analyze preoperative and postoperative facial photographs of 216 Chinese patients who underwent orthognathic surgery between January 1, 2021, and December 31, 2022. The AI software measures seven cardinal emotions and associated facial action units, providing an objective evaluation of emotional outcomes.
Our findings indicated a significant postoperative increase in patients' expression of "happiness" while smiling, accompanied by a concurrent decrease in their estimated age. Patients with insufficient incisor show and open bite exhibited notable improvements in emotional expression, while those with a gummy smile showed no significant change. Additionally, stratification based on malocclusion classification (class I, II, III) revealed consistent improvements in emotional outcome scores among class II and III patients.
Our findings underscore the potential of AI in providing objective insights into emotional changes following orthognathic surgery.
一个人笑容的吸引力受多种因素影响，包括牙龈暴露、切牙显露和面部不对称。错颌畸形长期以来被认为对笑容美观有重大负面影响。矫正牙颌面畸形是正畸和正颌干预的主要治疗目标，旨在改善功能和美观效果。我们试图量化并评估正颌手术对患者笑容中幸福表达的影响，从而填补这一高度主观领域当前的研究空白。
我们使用了FaceReader，这是一个市售且先前已验证的人工智能（AI）系统，来分析2021年1月1日至2022年12月31日期间接受正颌手术的216名中国患者的术前和术后面部照片。该AI软件测量七种主要情绪及相关的面部动作单元，对情绪结果进行客观评估。
我们的研究结果表明，术后患者微笑时“幸福”表达显著增加，同时估计年龄有所下降。切牙显露不足和开颌的患者在情绪表达上有显著改善，而牙龈微笑的患者则无显著变化。此外，根据错颌分类（I类、II类、III类）分层显示，II类和III类患者的情绪结果评分持续改善。
我们的研究结果强调了AI在提供正颌手术后情绪变化客观见解方面的潜力。
