The purpose of this study was to compare the presurgical preferences for pr
ofile change of patients seeking orthognathic surgery with the preferences
of "significant others" and clinicians. In this study, five features of lat
eral profile images of 11 patients scheduled for orthognathic surgery limit
ed to the mandible (ie, set-back or advancement) were animated for continuo
us change with the use of customized morphing software and video imaging. E
ach patient profile was evaluated by the patient, a significant other, thre
e orthodontists, and three oral surgeons. As the feature animated between t
wo extremes, the zone of acceptability was established by depressing the co
mputer mouse when the changing feature became acceptable and releasing the
button when the image was no longer acceptable. In a separate task, the par
ticipants were asked to indicate the most pleasing position. An analysis of
variance was used to find a significant difference (P < .017) in the zone
of acceptability for all five profile features among all groups of evaluato
rs. From smallest to largest, the order of the mean zone of acceptability w
as: orthognathic patient < oral surgeon < significant other < orthodontist.
No consistent differences were found, however, for either the midpoint of
acceptability or most pleasing distortion among the patients, significant o
thers, and professional groups. in conclusion, it was demonstrated that (1)
patients having orthognathic surgery were able to use this new video imagi
ng method to communicate to clinicians what they find acceptable; and (2) a
lthough all groups had similar preferences, orthognathic patients had the l
owest tolerance for deviation from the preferred image.