Abstract
Objective: Limited studies are available regarding the position of occlusal plane and dental midline in asymmetrical faces, and most of them only evaluated the preferences of laypeople. Thus, this study aimed to assess the preferences of laypeople, general dentists, and dental specialists regarding the position of transverse occlusal plane (TOP) and dental midline in asymmetrical faces. Materials and Methods: In this analytical cross-sectional study, 20 facial photographs were designed, including one photograph of a symmetrical facial model (SFM), three photographs of asymmetrical faces with a left shift of the chin and nose (asymmetrical facial model [AFM]1), canted interpupillary line (IPL; AFM2), and canted commissure line (CL; AFM3), six photographs of asymmetrical faces with different dental midline shifts to the right and left, and four photographs of asymmetrical faces with altered position of TOP relative to the IPL and CL. The photographs were rated by 334 raters using a 4-point Likert scale. Data were statistically analyzed (α = 0.05). Results: According to the opinion of all raters, photographs with 1 and 2 mm of midline deviation in the same direction as the chin and nose deviation had no significant difference with AFM1 (p > 0.05). According to the opinion of laypeople, general dentists, and oral and maxillofacial (OMF) surgeons, this difference was not significant for photographs with 1 mm of midline shift in the opposite direction (p > 0.05). No significant difference was found in raters' preferences regarding the position of TOP in AFM2 and AFM3 (p > 0.05), except for prosthodontists and general dentists who preferred parallel position of TOP to the horizon in AFM2. Conclusion: Clinicians and specialists tend to tolerate mild asymmetries more than laypeople. While demographic traits had limited impact overall, professional expertise played a significant role in shaping esthetic preferences.