DIFFERENCE IN PERCEPTION OF LIP LINE CANTING: A COMPARATIVE EVALUATION AMONG ORTHODONTISTS, GENERAL DENTISTS AND PATIENTS

Abstract

Objective: To determine the sensitivity to and perception threshold for treatment of lip-line canting (LLC) among orthodontists, general dentists and patients and the influence of age or gender on the detection of LLC.

Study Design: Analytical cross-sectional study.

Study Site and Duration: Department of Orthodontics, AFID, Rawalpindi, Pakistan from April 2025 to September 2025.

Methodology: A standardized frontal facial photograph was digitally altered to produce eight graduated LLC images (1°–8°). Using stratified sampling, 399 evaluators were recruited comprising 133 orthodontists, 133 general dentists, and 133 patients. Each evaluator was asked to review the images twice: once to identify when LLC became detectable (Category I) and then again to determine when LLC required treatment (Category II). Demographic information was obtained. All the statistical analyses were performed using SPSS version 23.

Results: There was no significant association between age and gender with Category I or II scores (p > 0.05). Significant differences among the different evaluator groups were found. Orthodontists had the lowest mean Category I score of 2.37 ± 0.89 and the highest Category II score of 4.46 ± 0.95, thus showing the greatest sensitivity and strictest treatment thresholds. Patients showed the highest tolerance to LLC, with the lowest Category II score of 3.60 ± 1.23 (p = 0.001 and p < 0.001).

Conclusion: Orthodontists are significantly more sensitive to mild LLC and recommend intervention at lower degrees compared with general dentists and patients. Professional training, rather than age or gender, is the prime factor influencing LLC perception.