Introduction: The objective of this study was to determine the anterior/posterior position of the mandible at which an orthodontist and oral surgeon would advise bilateral sagittal split osteotomy advancement or set back when evaluating adult female photos and silhouettes. Material & Methods: Fifty-one adult female profile photos and lateral cephalograms were collected. Subjects were selected who met three criteria: 1) ANB of 0-2, 2) balanced profile image, and 3) age greater than 18. The image and cephalometric tracing were morphed together to allow software simulation of mandibular prognathia and retrognathia in 2 mm increments. Orthodontists and oral surgeons evaluated morphed photos and silhouettes to find the profile break point at which BSSO surgery would be recommended. Both prognathic and retrognathic profile break points were evaluated. A two group repeated measures ANOVA test was used to determine a group effect. Results: The two group repeated measures ANOVA test found a statistically significant difference between orthodontists and oral surgeons when evaluating class II and class III profiles for surgery (P = 0.000). There was a statistically significant difference between photos and silhouettes when evaluating class III profiles (P = 0.014), but not when evaluating class II profiles (P = 0.213). Conclusions: Oral surgeons and orthodontists do not recommend surgery for the same level of jaw discrepancy when they use photos and silhouettes. Oral surgeons recommended BSSO surgery at a lesser degree of retrognathia. Orthodontists recommended surgery at a lesser degree of prognathia. Photos and silhouettes were evaluated differently for patients with prognathic mandibles

LLU Discipline

Orthodontics and Dentofacial Orthopedics


Orthodontics and Dentofacial Orthopedics


School of Dentistry

First Advisor

Leggitt, V. Leroy

Second Advisor

Andreiko, Craig

Third Advisor

Neufeld, Roland

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded

January 2013

Date (Title Page)




Library of Congress/MESH Subject Headings

Maxillofacial Abnormalaties - surgery; Malocclusion - surgery; Oral Surgical Procedures; Facial Bones - Surgery; Esthetics, Dental; Surgery - Aethetic aspects; Orthognathic Surgery

Subject - Local

Orthognathic surgery; Facial attractiveness; Bilateral Sagittal split Osteotomy



Page Count

40 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives