Bimaxillary protrusion in black Americans--an esthetic evaluation and the treatment considerations.

This study attempted to discover what black Americans find attractive about their profile. Fifteen black patients (eight males, seven females) were selected at random and used as models. Lateral photographs were taken on each patient, and a computer was used to alter the profiles to depict different levels of bimaxillary protrusion. Each patient was manipulated into four different profile types according to specific numerical guidelines. A vertical reference line from soft tissue glabella, perpendicular to Frankfort horizontal, was used to measure the lip position. In each profile type only the horizontal lip position was altered. The four profile types were classified as S (straight) BM1, (bimax one), BM2 (bimax two) and BM3 (bimax three). The S profile was considered a straight or white facial profile, and the BM3 was an extreme example of bimaxillary protrusion. The photographs were surveyed among black and white laypersons, general dentists, and orthodontists. The results found the BM1 profile to be the most attractive. This was consistent with all groups surveyed. The BM1 profile would be considered a slightly convex profile and is more protrusive than white orthodontic norms. In this study comparisons of this profile to other standards are made and treatment considerations for black patients are discussed.