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Facial attractiveness is an important aspect to take into account, given that children with skeletal Class II are often bullied by their peers and have low self-esteem and a lower social perception. The aim of the present study was to evaluate the aesthetic perception of facial profiles by a large number of observers, before and after treatment with a functional appliance, compared to untreated controls. The pre- and post-treatment cephalograms of 20 Class II subjects treated with Sander\u2019s bite-jumping appliance and 20 untreated historical controls were collected and transformed into black and white silhouettes depicting only the lower third of the face. An online questionnaire comprising the silhouettes of the two groups, three \u201ccalibration\u201d profiles and an \u201cideal\u201d profile was submitted to dentists, orthodontists, undergraduates and laypeople, asking them to rate the profile\u2019s attractiveness using a Visual Analogue Scale (VAS). The effect of treatment, and observers\u2019 age, expertise and gender were analysed. The calibration images and the ideal profiles were used to evaluate the coherence of each observer\u2019s judgement. The protocol was approved by the local Ethics Committee. Nine-hundred and ten questionnaires were collected. Treated subjects showed a larger improvement of facial attractiveness compared to controls. A significant effect of gender on the observer\u2019s ratings was observed. Some observers showed incoherent judgement, which had a significant effect on the regression model. In conclusion, early treatment with functional appliances seems to improve patients\u2019 facial aesthetics. This improvement is perceived equally by dental professionals and laypeople.<\/jats:p>","DOI":"10.1038\/s41598-021-93343-0","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T10:04:51Z","timestamp":1625652291000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Effect of Class II functional treatment on facial attractiveness, as perceived by professionals and laypeople"],"prefix":"10.1038","volume":"11","author":[{"given":"Federica","family":"Santori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Masedu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Ciavarella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Staderini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Chimenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Tepedino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,7]]},"reference":[{"key":"93343_CR1","first-page":"177","volume":"51","author":"JA McNamara","year":"1981","unstructured":"McNamara, J. 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