{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:21:29Z","timestamp":1787764889257,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>This study aims to understand the relationship between midline deviations and the inherent asymmetry that can be observed in a human face.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted using a frontal smile photograph of a female which was altered on Adobe Photoshop software version 23.0 into eight different photographs by deviating the dental midlines by 2 mm, 4 mm, and 6 mm towards and away from the facial flow line (FFL). 4 mm of chin deviation was incorporated in all the pictures except for the first picture in which the midline and chin were kept symmetric. Orthodontic residents evaluated those photographs on an interrupted visual analogue scale (VAS) with 0 being the least attractive and 10 being the most. Simple linear regression was applied to observe factors associated with VAS score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Highest score was observed for picture with midline and chin on (MLCon) with a score of 9.4 \u00b1 0.7, followed by picture with midline on and chin deviated (MLon) 8.7 \u00b1 0.8. The deviations towards green zone received higher scores in comparison to deviations towards red zone. Linear regression revealed highly statistically significant differences between the constant and the rest of the pictures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The formation of green and red zones by the FFL influences the perception of midline deviation as judged by orthodontic residents. Midline when deviated towards the green zone, was judged to be more aesthetic than when shifted towards the red zones.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jos.jos_85_22","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T01:30:18Z","timestamp":1699234218000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Facial flow line and its effect on dental midline deviation on a female subject in an Asian population \u2013 A cross-sectional study"],"prefix":"10.4103","volume":"12","author":[{"given":"Muhammad","family":"Maaz","sequence":"first","affiliation":[{"name":"Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanza","family":"Tahir","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mubassar","family":"Fida","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashna H.","family":"Sukhia","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,11]]},"reference":[{"key":"R1-20240830","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.otc.2019.02.013","article-title":"Minimally invasive facial cosmetic procedures","volume":"52","author":"Devgan","year":"2019","journal-title":"Otolaryngol Clin North Am"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"421","DOI":"10.2319\/022107-85.1","article-title":"Asymmetry of the face in orthodontic patients","volume":"78","author":"Haraguchi","year":"2008","journal-title":"Angle Orthod"},{"key":"R3-20240830","first-page":"210","article-title":"The prevalence of facial asymmetry in preorthodontic treatment","volume":"4","author":"Anistoroaei","year":"2014","journal-title":"Int J Med Dent"},{"key":"R4-20240830","first-page":"171","article-title":"The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina","volume":"12","author":"Severt","year":"1997","journal-title":"Int J Adult Orthodon Orthognath Surg"},{"key":"R5-20240830","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.prosdent.2018.03.023","article-title":"The facial flow concept: An organic orofacial analysis\u2014The vertical component","volume":"121","author":"Silva","year":"2019","journal-title":"J Prosthet Dent"},{"key":"R6-20240830","first-page":"1","article-title":"Effect of variations in facial flow curves on the perceptions of smile esthetics by laypeople","volume":"1","author":"Koseoglu","year":"2021","journal-title":"J Prosthet Dent"},{"key":"R7-20240830","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/S1073-8746(98)80016-9","article-title":"Evaluation of dental midline position","volume":"4","author":"Beyer","year":"1998","journal-title":"Semin Orthod"},{"key":"R8-20240830","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.ajodo.2013.02.034","article-title":"Perceptions of midline deviations among different facial types","volume":"145","author":"Williams","year":"2014","journal-title":"Am J Orthod Dentofac Orthop"},{"key":"R9-20240830","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1093\/ejo\/21.5.517","article-title":"The influence of dental to facial midline discrepancies on dental attractiveness ratings","volume":"21","author":"Johnston","year":"1999","journal-title":"Eur J Orthod"},{"key":"R10-20240830","first-page":"91","article-title":"Are ratings of dentofacial attractiveness influenced by dentofacial midline discrepancies?","volume":"24","author":"Shyagali","year":"2008","journal-title":"Aust Orthod J"},{"key":"R11-20240830","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1093\/ejo\/cjq100","article-title":"Perceptions of Jordanian laypersons and dental professionals to altered smile aesthetics","volume":"33","author":"Abu Alhaija","year":"2011","journal-title":"Eur J Orthod"},{"key":"R12-20240830","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/j.1708-8240.1999.tb00414.x","article-title":"Comparing the perception of dentists and lay people to altered dental esthetics","volume":"11","author":"Kokich","year":"1999","journal-title":"J Esthet Restor Dent"},{"key":"R13-20240830","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2319\/040710-195.1","article-title":"Influence of orthodontic treatment, midline position, buccal corridor and smile arc on smile attractiveness: A systematic review","volume":"81","author":"Janson","year":"2011","journal-title":"Angle Orthod"},{"key":"R14-20240830","first-page":"359","article-title":"The effect of axial midline angulation on dental esthetics","volume":"73","author":"Thomas","year":"2003","journal-title":"Angle Orthod"},{"key":"R15-20240830","doi-asserted-by":"crossref","first-page":"45","DOI":"10.12968\/ortu.2009.2.2.45","article-title":"Orthodontics and the ideal occlusion\u2013A review","volume":"2","author":"Seehra","year":"2009","journal-title":"Orthod Update"},{"key":"R16-20240830","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1590\/2177-6709.21.6.051-057.oar","article-title":"Perception of midline deviations in smile esthetics by laypersons","volume":"21","author":"Ferreira","year":"2016","journal-title":"Dent Press J Orthod"},{"key":"R17-20240830","doi-asserted-by":"crossref","first-page":"e516","DOI":"10.4317\/medoral.18335","article-title":"Canting of the occlusal plane: Perceptions of dental professionals and laypersons","volume":"18","author":"Olivares","year":"2013","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"R18-20240830","first-page":"132","article-title":"Changes in smile parameters as perceived by orthodontists, dentists, artists, and laypeople","volume":"9","author":"Erum","year":"2008","journal-title":"World J Orthod"},{"key":"R19-20240830","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1590\/2177-6709.20.6.110-125.sar","article-title":"Facial asymmetry: A current review","volume":"20","author":"Thiesen","year":"2015","journal-title":"Dental Press J Orthod"},{"key":"R20-20240830","doi-asserted-by":"crossref","first-page":"e12235","DOI":"10.1111\/jicd.12235","article-title":"Esthetic perception of smile components by orthodontists, general dentists, dental students, artists, and laypersons","volume":"8","author":"Sadrhaghighi","year":"2017","journal-title":"J Investig Clin Dent"}],"container-title":["Journal of Orthodontic Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jos.jos_85_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:50:02Z","timestamp":1787763002000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jos.jos_85_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jos.jos_85_22","relation":{},"ISSN":["2278-1897","2278-0203"],"issn-type":[{"value":"2278-1897","type":"print"},{"value":"2278-0203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]},"assertion":[{"value":"2022-09-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}