Assessment of perceived orthodontic appliance attractiveness

Introduction: To date, no studies have been published in the literature evaluating the esthetics of orthodontic appliances. The purpose of this study was to assess appliance variables, including appliance type, brand, wire, and ligature tie, for their relative attractiveness. Demographic factors were also evaluated. Methods: Appliances were placed in an adult, and digital images were captured, standardized, and incorporated into a computer-based survey. Subjects (n = 200) rated each image for attractiveness on a visual analog scale. The attractiveness ratings were analyzed by using factorial analysis of variance with repeated measures. Post-hoc testing was done with the Tukey-Kramer test (overall alpha < .05). Results: For all demographic factors, attractiveness ratings were significantly different between alternative ( clear trays and simulated lingual appliances), ceramic, and all self-ligating/stainless steel appliances. No differences between brands in each appliance type were found. Ratings of some ceramic appliances were significantly affected by archwire and ligature tie, depending on several demographic interactions. Conclusions: Orthodontic appliance attractiveness varies by the following hierarchy of appliance types: alternative > ceramic > all stainless steel/self-ligating. Wire and tie selection can affect the appearance of ceramic appliances but have no impact on stainless steel or self-ligating appliances. Certain demographic factors have variable effects on attractiveness ratings.