The treatment of severe skeletal anterior open bite is extremely difficult in adults, and orthognathic surgery is generally selected for its treatment. We report the case of an 18-year-old adult patient with skeletal anterior open bite and temporomandibular disorders who was successfully treated using temporary anchorage devices. She had an open bite of −2.0 mm and an increased facial height. Miniplates were implanted in both the maxilla and mandible, and molar intrusion resulted in counterclockwise rotation of the mandible over a period of 12 months. After active treatment, her upper and lower first molars were intruded by approximately 2 mm and her overbite became +2.5 mm. Her retrognathic profile improved with counterclockwise rotation of the mandible. Orthodontic treatment aided with skeletal anchorage is beneficial for intrusion of bimaxillary molars in patients with anterior open bite.

This case report outlines the treatment of a 17-year-old female with Class II Division 1 malocclusion with mandibular retrusion, deep bite, and convex facial profile. The Forsus fatigue resistance device with miniplate was used for this patient and it was very affecting tool in correcting both skeletal and dental parameters. The total active treatment time was 19 months. This method can serve as an alternate choice of treatment, especially those who refuse orthognathic surgery. Hence, Forsus with miniplate might be useful in both growing and postpubertal patients.

Objectives: This retrospective study aimed to evaluate the dentoalveolar, skeletal, and soft tissue effects obtained with bone-anchored pendulum appliance in patients with Class II malocclusion. Materials And Methods: A total of 18 patients (4 male, 14 female) at a mean pretreatment age of 14.0 years (+1.08) were enrolled in this study. All patients were treated with the bone-anchored pendulum appliance for an average duration of 4.8 months. Only the active distalization period was evaluated with predistalization and postdistalization lateral cephalograms. Skeletal, dentoalveolar, and soft tissue variables were obtained. Based on these variables, the treatment effects were evaluated with dependent t-test. Results: Correction of Class II molar relationship resulted from distal movement of 3.45 mm and tipping of 11.24° of the first maxillary molars. The premolars were distalized accompanying the molars. Conclusions: The bone-anchored pendulum appliance proved to be an effective method for distalization of maxillary molars in cases that require maximum anchorage, avoiding reciprocal mesial movement of premolars and incisors.

Objectives: To compare orthodontic elastics with different force extension characteristics, thereby aiming to reduce the orthodontist's inventory for elastics. Materials And Methods: Thirty nonextraction class I models were used to determine extension distances. Light, medium, and heavy forced Latex elastics of size 1/4 and 3/16 (from three manufacturers) were used. Thirty elastics from each pack were selected, for a total sample size of 540 elastics. Elastic force was measured at three extensions: three times the lumen (A), first molar to opposing canine (B), and second molar to opposing canine distance (C). Force values were compared with the analysis of variance followed by the post hoc Scheffe test. Results: Mean distance for extensions B and C were 22.3 and 38.7 mm, respectively. There was a continuous but significant increase in the force of 1/4 elastics when stretched from A to extension C. A significant increase in the force level of 3/16 elastics was only noted when stretched from A to B. Overall, 1/4 elastics had a wider range of force coverage in the extensions used, compared to 3/16 elastics. Conclusions: The use of 1/4 elastics is sufficient to cover the range of forces in orthodontic treatment.

Objective: Testing of methods to enhance the shear bond strength (SBS) between orthodontic metal brackets and amalgam by sandblasting and different primers. Materials And Methods: Three hundred samples of amalgam restorations (KerrAlloy^®) were prepared in self-cured acrylic blocks, polished, and divided into two groups: nonsandblasted and sandblasted. Each group was divided into five subgroups with different primers used in surface treatment methods, with a control group of bonded brackets on human mandibular incisors. Following the surface treatments, mandibular incisor brackets (Unitek^®) were bonded on the amalgam with adhesive resin (Transbond XT^®). The SBS of the samples was tested. The adhesive remnant index (ARI) and failure modes were then determined under a stereo-microscope. Two-way analysis of variance, Chi-square, and Kruskal–Wallis tests were performed to calculate the correlations between and among the SBS and ARI values, the failure modes, and surface roughness results. Results: There were statistically significant differences of SBS among the different adhesive primers and sandblasting methods (P < 0.05). The sandblasted amalgam with Assure Plus^® showed the highest SBS (P < 0.001). Samples mainly showed an ARI score = 1 and mix-mode failure. There was a statistically significant difference of surface roughness between nonsandblasted amalgam and sandblasted amalgam (P < 0.05), but no significant differences among priming agents (P > 0.05). Conclusions: Using adhesive primers with sandblasting together effectively enhances the SBS between orthodontic metal brackets and amalgam. The two primers with the ingredient methacryloxydecyl dihydrogen phosphate (MDP) monomer, Alloy Primer^® and Assure Plus^®, were the most effective. Including sandblasting in the treatment is essential to achieve the bonding strength required.

Introduction: Esthetics plays an essential role in orthodontic treatment. The psychological effects of malocclusion are an inspiration to improve one's esthetics and seek treatment. Objectives: This study aimed to assess relationships between self-esteem and malocclusion severity and type in adolescents using a self-esteem measurement scale and the index of treatment need (IOTN) and to investigate the influence of age, sex, and school type in these relationships. Materials And Methods: Adolescent students aged 12–19 years randomly selected from four private and two governmental schools were enrolled for this study. After completing the self-esteem questionnaire, participants were examined by researchers to evaluate malocclusion severity and type using the IOTN. Results: The sample consisted of 886 participants: 558 females (62.9%) and 328 males (37.1%) with a mean age of 16 years. Chi-square analysis showed that 17.1% of males and 31% of females showed low levels of self-esteem, with a statistically significant difference (P < 0.001). Cases with multiple malocclusions showed significantly lower self-esteem (P = 0.018) compared with single-category malocclusion. Anterior teeth spacing, crowding, and overjet malocclusion showed the highest percentages of low self-esteem. Conclusions: The present study supports that malocclusion has negative effects on self-esteem; multiple malocclusions with spacing, crowding, and overjet had the greatest effects.

A major objective of orthognatic surgery is the aesthetic outcome. Treatments only correcting for dentoskeletal deformities are not sufficient for optimal facial results because undesirable soft tissue changes may accompany skeletal manipulations. The primary objective of this study was to investigate alar base width (ABW) changes a minimum of 6 months following surgically-assisted rapid palatal expansion (SARPE). The following electronic databases and citation indices were searched: PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Virtual Health Library. The search included articles published until September 2015 without language restriction. The intervention was SARPE with maxillary vestibular incision from first molar to contralateral first molar, a modified LeFort I osteotomy with or without pterygomaxillary disjunction, and a V-Y closure. The primary outcome was the unstandardized mean difference between pre and postoperative ABW. A random effects meta-analysis was performed to combine study results, and included studies that were assessed for statistical heterogeneity using a Chi-square test for independence. The results of this meta-analysis (N = 41) showed a significant + 1.74 mm, 95% CI [0.14, 3.34] ABW increase in patients submitted to SARPE. There was no statistical heterogeneity among included studies (χ² = 0.03; df = 2; P = 0.98). ABW increases were observed despite including cinched patients in the analysis. None of the three included studies were completely free of bias. The most prominent flaws were measurement bias, limited sample size, and patient recruitment.

Multiple sclerosis (MS) is a chronic, autoimmune inflammatory disorder of the central nervous system (CNS) that affects myelinated axons, destroying the myelin and damaging axons to varying degrees. The course of MS is highly varied and unpredictable. Metals used during orthodontic treatment can negatively affect imaging techniques used to diagnose and monitor the progression of MS, while medications used to treat MS can negatively affect orthodontic tooth movement. The present case report highlights some of the challenges encountered during orthodontic treatment of a patient with MS and how to overcome them. The patient was a 20-year-old woman with complaints of diastema and spacing in the upper arch. Although closing the spaces was challenging due to some of the MS medications, she was treated successfully, without complications, within 20 months using closing loops.

OBJECTIVES: The aim of this case report was to present the procedure of fabricating a customized occlusal splint, through a revolutionary software that combines cone beam computed tomography (CBCT) with jaw motion tracking (JMT) data and superimposes a digital impression. MATERIALS AND METHODS: The case report was conducted on a 46-year-old female patient diagnosed with the temporomandibular disorder. A CBCT scan and an optical impression were obtained. The range of the patient's mandibular movements was captured with a JMT device. The data were combined in the SICAT software (SICAT, Sirona, Bonn, Germany). RESULTS: The software enabled the visualization of patient-specific mandibular movements and provided a real dynamic anatomical evaluation of the condylar position in the glenoid fossa. After the assessment of the range of movements during opening, protrusion, and lateral movements all the data were sent to SICAT and a customized occlusal splint was manufactured. CONCLUSIONS: The SICAT software provides a three-dimensional real-dynamic simulation of mandibular movements relative to the patient-specific anatomy of the jaw; thus, it opens new possibilities and potentials for the management of temporomandibular disorders.

Correction of class II molars in growing patients with acceptable facial profile can be performed by distalization of maxillary first molars. However, in patients where compliance is difficult intraoral means of molar distalization is required. This case report describes the use and effectiveness of a novel 2K appliance in an 11-year-old female having an orthognathic profile, skeletal Class I relation, and Angle's Class II division 1 malocclusion with crowding of 8 mm and 3 mm in the maxillary and mandibular arches, respectively. Nonextraction treatment was planned with bilateral distalization of the maxillary first molars. The amount of distalization achieved by 2K appliance was 3.5 mm with only 1° distal tipping. The 2K appliance required minimal patient cooperation, produced bodily movement of molars with minimal tipping/rotation, and prevented anchorage loss of the anterior teeth. This 2K molar distalization appliance was found to be an effective technique to control molars in all three planes of space.

OBJECTIVE: The aim of this study was to evaluate the histological responses of cementum, root dentin, and pulp following intentional root injuries caused via self-tapping and self-drilling miniscrews. MATERIALS AND METHODS: Fourteen patients (with a mean age of 15.7 years and age range of 14–18 years) who were scheduled for the extraction of all four first premolars as part of their orthodontic treatment plan participated in this study. The roots of the right and the left quadrants' first premolars were designedly injured using self-tapping miniscrews and self-drilling miniscrews, respectively. Teeth were extracted eight weeks after the injury. Cementum repair was assessed through histological examinations. RESULTS: In this study, 40 teeth (75.4%) showed reparative cementum formation and 13 teeth (24.5%) showed no repair. There was no significant difference between the two groups regarding the formation of reparative cementum (P = 0.3). In all examined teeth, the inflammatory response of the pulp to the cold test was within the normal range. CONCLUSION: This study showed that in most cases, the healing of cementum was observed eight weeks after the injury and the two methods of miniscrew insertion showed no significant difference when it comes to the healing process.

OBJECTIVE: To investigate the effect of different intracoronal bleaching methods on the shear bond strength and site of failure of ceramic brackets. MATERIALS AND METHODS: Sixty freshly extracted human maxillary incisors were randomly divided into four groups (n = 15). Endodontic access cavity was prepared and root canals were filled, root fillings were removed 2mm apical to the cementoenamel junction, and a 2-mmthick layer of glass ionomer cement base was applied. Group 1 served as the control. Intracoronal bleaching was performed with 35% carbamide peroxide in group 2, sodium perborate in group 3, and 37.5% hydrogen peroxide in group 4. The teeth were immersed in artificial saliva for 4 weeks before bracket bonding. Ceramic brackets were bonded with composite resin and cured with LED light. After bonding, the shear bond strength of the brackets was tested with a universal testing machine. The site of bond failure was determined by modified ARI (Adhesive Remnant Index). RESULTS: The highest value of shear bond strength was measured in control group (18.67 ± 1.59 MPa), which was statistically significant from groups 2,3, and 4. There was no significant difference between groups 2 and 4. The lowest shear bond strength was measured in group 3. ARI scores were not significant from each other. CONCLUSIONS: Intracoronal bleaching significantly affected the shear bond strength of ceramic brackets even after 4 weeks of bleaching. Bleaching with sodium perborate affects shear bond strength more adversely than does bleaching with other agents like hydrogen peroxide and carbamide peroxide.

Obstructive sleep apnea is an exciting area for orthodontists to be involved. The level of awareness of sleep apnea and related health issues is growing rapidly. The demand of integrating sleep into the orthodontic practice shortly will be driven by the need of the societies as some of our patients will be shortly coming into our offices aware of sleep apnea. However, with our busy clinical orthodontic practice, the need of condense short review become more demanding. Therefore, this review will try to summarize the clinical and orthodontic observation in the diagnoses of adult obstructive sleep apnea with clinical application in orthodontic practice.

Early treatment of scissor bite has been advocated mainly to prevent function jaw shift that can eventually lead to permanent skeletal asymmetry and temporomandibular joint pathosis. Although unilateral scissor bite is more common, most of the times, bilateral mandibular expansion is indicated. Lingual transforce appliance can be useful in such cases. This article presents a patient with unilateral scissor bite in mixed dentition with alveolar narrowing. Transforce appliance was used for scissor bite correction followed by modified twin block appliance for stabilization and settling of occlusion till the eruption of premolars. The case was finished with fixed mechanotherapy. Two years after completion of treatment, results were well maintained. Our results suggest that lingual transforce appliance along with careful management of occlusion is effective in the early management of severe unilateral scissor bite.

Objectives: The present study was conducted to evaluate the effect of nanosized aluminum trioxide (Al₂O₃) particles when added to the Nano-Bond adhesive system and its effect on the microshear bond strength of nanocomposite resin to dentin. Materials And Methods: A newly developed adhesive (Nano-Bond) and one type of light-cured resin restorative material (nanocomposite resin) were used in this study. The occlusal surfaces of extracted human molar teeth were ground perpendicular to the long axis of each tooth to expose a flat dentin surface. The adhesives were applied to the dentin surfaces according to manufacturers' instructions. The nanocomposite resin was then placed and light cured for 40 s. After immersion in water at 37°C for 24 h, the specimens were subjected to thermocycling before testing, and a microshear bond test was carried out. The recorded bond strengths (MPa) were collected, tabulated, and statistically analyzed. A one-way analysis of variance and Tukey's tests were used to test for significance between the means of the groups; statistical significance was assumed when the P ≤ 0.05. Results: The mean microshear bond strength of the Nano-Bond adhesive system containing nanosized Al₂O₃at a concentration of 2% was 23.15 MPa (Group B), which was significantly greater than that of the Nano-Bond adhesive system without additives (15.03 MPa, Group A). Conclusions: These results indicate that nanosized Al₂O₃added to the Nano-Bond adhesive system at a concentration of 2% increases the microshear bond strength.

Objective: To study the impact of orthodontic treatment on the quality of life in two patient groups, one treated with the twin block appliance and the other with fixed appliances. Materials and Methods: Ninety-eight patients, aged between 10 and 16 years, were recruited in the fixed (20 males and 29 females) or functional (29 males and 20 females) treatment groups. The oral health-related quality of life (OHRQoL) was measured before treatment and followed up at the end of the treatment. The instrument used to measure OHRQoL was a modified self-administered short version of the English Oral Health Impact profile (OHIP-16[E]) questionnaire. Results: OHRQoL worsened at the initial stages of the treatment. The overall score of OHRQoL reduced significantly at the end of the treatment in both groups. Both groups showed comparable improvements in OHRQoL as the treatment progressed (analysis of variance test P = 0.05). Conclusions: The OHRQoL patterns, during the treatment with fixed and twin block appliances, were very similar. This suggests that the functional appliance's impact on the QoL may be overestimates by clinicians. OHRQoL improved significantly with both fixed and functional appliances by the end of the treatment. The OHRQoL trends observed during the study can be communicated to patients and used to increase patients' compliance since they are made aware of the whole treatment process.

Objectives: The aim of the present systematic review was to assess the effect of functional appliances on the airway dimensions in patients with skeletal Class II malocclusion. Materials And Methods: Articles were identified through a literature survey carried out through the following databases: (1) PUBMED, (2) Google Scholar, (3) The Cochrane Library, (4) Embase, (5) Lilac, and (6) Web of Scholars. The systematic review analyzed 12 articles comprising removable functional appliances, 3 articles with fixed functional appliances, and 2 articles having both fixed and removable functional appliances. Results: Qualitative assessment was done for all the 17 studies. The effect of functional appliances in the dimensions of three airway spaces – nasopharynx, oropharynx, and hypopharynx were analyzed. Conclusions: Significant increase in the dimensions of nasopharynx and oropharynx was observed with Activator. Significant increase in the nasopharynx and hypopharynx (male patients) was observed with Bionator. Insignificant increase in the oropharynx was observed with the same. Significant increase in the oropharynx and hypopharynx was observed with Twin Block. Insignificant increase in the nasopharynx was observed with the same. Significant increase was observed only in the hypopharynx for Frankel II. Decreased or insignificant change was observed with FMA, MPA IV, and Herbst appliances.

Objective: This study was aimed to evaluate the dental age in Saudi children from panoramic radiographs using the Demirjian method to estimate their chronological age. Materials And Methods: This retrospective cross-sectional study consisted of 1902 panoramic radiographs of 955 boys and 947 girls between the ages of 3–17 years. All children were placed in the age group closest to their chronological age. The dental age was scored on all seven left mandibular teeth by calibrated examiners. Bivariate analyses using the t-test and Pearson correlation were performed. Results: There was significant difference in both boys and girls in all the age groups between their chronological age and dental age. Even though there was a slight overestimation in boys in some age groups and slight underestimation in girls in some groups, correlation analysis showed that there was a highly significant correlation between the chronological age and dental age for both boys (r² = 0.96, P < 0.001) and girls (r² = 0.98, P < 0.001). Moreover, correlation analyses for each age group showed a significant correlation between the chronological age and the dental age, using the Demirjian method, in most age groups (P < 0.01). When comparing the maturation score between boys and girls, the Student's t-test showed that there were no statistical differences between boys and girls in most age groups. Conclusion: Saudi boys and girls living in the western region of Saudi Arabia exhibited similar pattern of dental development when compared to the Demirjian method. Hence, the Demirjian method could be used as reference in children from the western region of Saudi Arabia.

Aim: The aim of this study was to evaluate sexual dimorphism in nasal proportions of Class I and Class II skeletal malocclusions in adults. Materials And Methods: The sample comprised 120 patients (females 18 years and above and males 21 years and above), with no history of previous orthodontic treatment or functional jaw orthopedic treatment. They were divided into different groups based on point A-Nasion-point B (ANB) angle and gender. Groups I and II included 30 males and 30 females with skeletal class I malocclusion (ANB 0–4 degrees). Groups III and IV included 30 males and 30 females with skeletal class II malocclusion, respectively (ANB above 4 degrees). Results: In regards to the comparison between males and females (Class I + Class II), nasal length (P < 0.001), nasal depth 1 (P < 0.001), nasal depth 2 (P < 0.001), nasobasal angle (P < 0.001), soft tissue convexity angle (P < 0.001), and nasal bone length (P < 0.008) were found to be statistically significant. Nasobasal angle was found to be significantly higher in females than in males (Class I) (P < 0.001). Nasolabial angle was prominent in class I males than in class I females (P < 0.001). Soft tissue convexity angle of Class I participants was significantly lower than that of Class II participants (P < 0.001), whereas nasobasal angle and nasomental angle of Class I participants were found to be significantly higher than that of Class II participants (P < 0.001). Conclusion: Sexual dimorphism was found in various nasal parameters. Significant amount of differences was found in the nasal proportions of Class I and Class II (male and female) participants.

Objectives: To investigate the effect of using osteogenic induced gingival fibroblasts (OIGFs) and low intensity pulsed ultrasound (LIPUS) on root resorption lacunae volume and cementum thickness in beagle dogs that received orthodontic tooth movement. Materials and Methods: Seven beagle dogs were used, from which gingival cells (GCs) were obtained and were induced osteogenically to produce OIGFs. Each third and fourth premolar was randomly assigned to one of the five groups, namely, LIPUS, OIGFs, bone morphogenetic protein-2 (BMP-2), OIGFs + LIPUS, and control. All groups received 4 weeks of bodily tooth movement, then LIPUS-treated groups received LIPUS for 20 min/day for 4 weeks, and OIGFs groups received an injection of OIGFs near the root apex. Microcomputed tomography analysis was used to calculate root resorption lacunae volume and histomorphometric analysis was performed to measure the cementum thickness of each root at 3 root levels on compression and tension sides. Results: There was no significant difference in resorption volume between the treatment groups. OIGFs + LIPUS increased cementum thickness (P > 0.05) in third premolars near the apex, and LIPUS increased cementum thickness (P > 0.05) in fourth premolars near the apex. Furthermore, BMP2 increased cementum thickness at the coronal third at the compression side. Conclusion: OIGFs, LIPUS, and BMP-2 can be potential treatments for orthodontically induced root resorption, however, improvements in experimental design and treatment parameters are required to further investigate these repair modalities.

Objectives: To establish the overall and anterior Bolton ratio among a sample of Qatari population and to investigate whether there is a difference between males and females, as well as to compare the result obtained by Bolton. Materials and Methods: The current study consisted of 100 orthodontic study participants (50 males and 50 females) with different malocclusions and age ranging between 15 and 20 years. An electronic digital caliper was used to measure the mesiodistal tooth width of all maxillary and mandibular permanent teeth except second and third molars. The Student's t-test was used to compare tooth-size ratios between males and females and between the results of the present study and Bolton's result. Results: The anterior and overall ratio in Qatari individuals were 78.6 ± 3.4 and 91.8 ± 3.1, respectively. The tooth size ratios were slightly greater in males than that in females, however, the differences were not statistically significant (P > 0.05). There were no significant differences in the overall ratio between Qatari individuals and Bolton's results (P > 0.05), whereas statistical significant differences were observed in anterior ratio (P = 0.007). Conclusions: Within the limitation of the limitations of the present study, definite conclusion was difficult to establish. Thus, a further study with a large sample in each malocclusion group is required.

Objectives: To evaluate comparatively the effect of quercetin on postbleaching shear bond strength (SBS) and adhesive remnant index (ARI). Materials and Methods: Intact maxillary premolars were divided randomly into 12 groups of 10 each: (1) bonding the bracket immediately after bleaching, (2) bonding 1 week after bleaching, (3-8) application of three experimental concentrations of quercetin (0.1%, 0.5%, and 1%) at two time durations (5 and 10 min), (9-10) application of the solvent of quercetin at two time periods (5 and 10 min), (11) application of 10% sodium ascorbate for 10 min, and (12) bonding the brackets on nonbleached teeth. Bleaching was performed using 15% carbamide peroxide gel for 5 days (6 h daily). After incubation and thermocycling, the SBS of brackets was measured. The ARI too was recorded at ×20. The data were analyzed statistically (α =0.05). Results : Bleaching reduced the SBS below 10 Megapascal (MPa) level (P < 0.05) while all the postbleaching treatments (except the application of the solvent of quercetin) recovered the SBS back to values greater than 10 MPa (P < 0.05) and also back to nonbleached SBS levels (P > 0.01). All eight postbleaching treatments had rather similar efficacies (P = 0.1396). The concentration of quercetin (beta = 0.259, P = 0.042) but not its duration (beta = 0.213, P = 0.093) significantly improved its efficacy. Conclusion: Bleaching can weaken the bond strength of orthodontic brackets below acceptable levels. The application of quercetin or Vitamin C or delaying the bracket bonding improved the postbleaching SBS.

Objectives: To assess the best temporal association between the application of a fluoride varnish on enamel and bonding procedures. Materials and Methods: Eighty mandibular bovine incisors were used. Teeth were divided into 4 groups (20 per group); Groups 1-3 were treated with fluoride varnish (Fluor Protector, Ivoclar Vivadent, Schaan, Liechtenstein), and Group 4 served as control with no pretreatment. Tooth were stored in deionized water (37°C) and subjected to thermal cycling for 400 (Group 1), 800 (Group 2), and 2500 (Group 3) cycles corresponding, respectively, to 15, 30, and 90 days in order to simulate the three different timing of bracket bonding. Shear bond strength (SBS) was measured using an Instron Universal Testing machine. Tooth surfaces were examined under a stereomicroscope at 10× magnification to assess the amount of adhesive remnant index (ARI). One-way analysis of variance (ANOVA) and Tukey's honestly significant difference post-hoc test were used for the comparison of SBS values between groups (P < 0.05). The Chi-square test was used to examine differences among ARI scores. (P < 0.05). Results: One-way ANOVA and Tukey post-hoc test showed that the SBS of different groups were significantly different and was impacted by different timing of bonding (P < 0.05). The main differences were between the control group (17.02 ± 6.38 MPa) and Group 1 (6.93 ± 4.3 MPa). The ARI scores showed that there were no significant differences between the four tested groups. Conclusions: The SBS of the brackets bonded 15 days after the application of the fluoride was set back to an optimal value.

Objective: To test the null hypothesis that there is no effect of esthetic perception of smiling profile in three different facial types by a change in the maxillary incisor inclination and position. Materials and Methods: A smiling profile photograph with Class I skeletal and dental pattern, normal profile were taken in each of the three facial types dolichofacial, mesofacial, and brachyfacial. Based on the original digital image, 15 smiling profiles in each of the facial types were created using the FACAD software by altering the labiolingual inclination and anteroposterior position of the maxillary incisors. These photographs were rated on a visual analog scale by three panels of examiners consisting of orthodontists, dentists, and nonprofessionals with twenty members in each group. The responses were assessed by analysis of variance (ANOVA) test followed by post hoc Scheffe. Results: Significant differences (P < 0.001) were detected when ratings of each photograph in each of the individual facial type was compared. In dolichofacial and mesofacial pattern, the position of the maxillary incisor must be limited to 2 mm from the goal anterior limit line. In brachyfacial pattern, any movement of facial axis point of maxillary incisors away from GALL is worsens the facial esthetics. The result of the ANOVA showed differences among the three groups for certain facial profiles. Conclusion: The hypothesis was rejected. The esthetic perception of labiolingual inclination and anteroposterior of maxillary incisors differ in different facial types, and this may effect in formulating treatment plans for different facial types.