journal article·2024-09-04Open access

The Potential of AI-Powered Face Enhancement Technologies in Face-Driven Orthodontic Treatment Planning

Juraj Tomášik, Márton Zsoldos, Kristína Majdáková, Alexander Fleischmann, Ľubica Oravcová, Dominika Sónak Ballová, Andrej Thurzo

Applied Sciences· Volume 14· Issue 17

Abstract

Improving one’s appearance is one of the main reasons to undergo an orthodontic therapy. While occlusion is important, not just for long-term stability, aesthetics is often considered a key factor in patient’s satisfaction. Following recent advances in artificial intelligence (AI), this study set out to investigate whether AI can help guide orthodontists in diagnosis and treatment planning. In this study, 25 male and 25 female faces were generated and consequently enhanced using FaceApp (ver. 11.10, FaceApp Technology Limited, Limassol, Cyprus), one of the many pictures transforming applications on the market. Both original and FaceApp-modified pictures were then assessed by 441 respondents regarding their attractiveness, and the pictures were further compared using a software for picture analyses. Statistical analysis was performed using Chi-square goodness of fit test R Studio Studio (ver. 4.1.1, R Core Team, Vienna, Austria) software and the level of statistical significance was set to 0.05. The interrater reliability was tested using Fleiss’ Kappa for m Raters. The results showed that in 49 out of 50 cases, the FaceApp-enhanced pictures were considered to be more attractive. Selected pictures were further analyzed using the graphical software GIMP. The most prominent changes were observed in lip fullness, eye size, and lower face height. The results suggest that AI-powered face enhancement could be a part of the diagnosis and treatment planning stages in orthodontics. These enhanced pictures could steer clinicians towards soft-tissue-oriented and personalized treatment planning, respecting patients’ wishes for improved face appearance.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Orthodontics and Dentofacial Orthopedics · Facial Rejuvenation and Surgery Techniques · Body Image and Dysmorphia Studies

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Orthodontics, Regenerative and Forensic Dentistry, Faculty of Medicine, Comenius University in Bratislava, 81102 Bratislava, Slovakia

Department of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary

Faculty of Medicine, Masaryk University in Brno, 62500 Brno, Czech Republic

Department of Mathematics and Descriptive Geometry, Faculty of Civil Engineering, Slovak University of Technology in Bratislava, 81005 Bratislava, Slovakia

Funding

Kultúrna a Edukacná Grantová Agentúra MŠVVaŠ SR (KEGA) · Vedecká Grantová Agentúra MŠVVaŠ SR a SAV (VEGA) · Agentúra na Podporu Výskumu a Vývoja (APVV)

References (100+)

Show source-provided references
1. What Was the First “Art”? How Would We Know?10.1073/pnas.2117561118 ↗
3. Proffit, W.R., Fields, H.W., Larson, B., and Sarver, D.M. (2018). Contemporary Orthodontics, Mosby. [6th ed.].
4. Cultural and Psychologic Influences on Treatment Demand10.1053/sodo.2000.90511 ↗
5. Cosmetic Surgery and the Diversity of Cultural and Ethnic Perceptions of Facial, Breast, and Gluteal Aesthetics in Women: A Comprehensive Review10.2147/CCID.S410621 ↗
6. Background Considerations to Facial Aesthetics10.1093/ortho/28.2.159 ↗
7. Expectations of Treatment and Satisfaction with Dentofacial Appearance in Orthodontic Patients10.1067/mod.2003.84 ↗
8. Yao, J., Li, D.-D., Yang, Y.-Q., McGrath, C.P.J., and Mattheos, N. (2016). What Are Patients’ Expectations of Orthodontic Treatment: A Systematic Review. BMC Oral Health, 16.10.1186/s12903-016-0182-3 ↗
9. Patients’ and Parents’ Expectations of Orthodontic Treatment10.1179/14653120723247 ↗
10. Creativity Is Intelligence10.4103/0976-237X.169836 ↗
11. (2024, March 03). John Ray Quotes. Available online: https://www.brainyquote.com/quotes/john_ray_119945.
12. Smile Prevails over Other Facial Components of Male Facial Esthetics10.1016/j.adaj.2018.03.019 ↗
13. Sarver, D.M. (2020). Dentofacial Esthetics: From Macro to Micro, Quintessence Publishing Co, Inc.. [1st ed.].
14. A Qualitative Study of Teenagers’ Decisions to Undergo Orthodontic Treatment with Fixed Appliance10.1093/ortho/29.3.197 ↗
15. Changes in Esthetic Standards since 194010.1016/j.ajodo.2009.10.029 ↗
16. Esthetic Preferences of Laypersons of Different Cultures and Races with Regard to Smile Attractiveness10.4103/0970-9290.207795 ↗
17. Nanda, R. (2015). Chapter 1-Individualized Orthodontic Diagnosis. Esthetics and Biomechanics in Orthodontics, W.B. Saunders. [2nd ed.].10.1016/B978-1-4557-5085-6.00001-1 ↗
18. Morphological, Functional and Aesthetic Criteria of Acceptable Mature Occlusion10.1093/ejo/23.4.373 ↗
19. Occlusion: An Orthodontic Perspective
20. The Six Keys to Normal Occlusion10.1016/S0002-9416(72)90268-0 ↗
21. Naini, F.B. (2013). Facial Aesthetics: Concepts & Clinical Diagnosis, Wiley-Blackwell.
22. Nanda, R. (2015). Chapter 13-Class II Correction with an Intermaxillary Fixed Noncompliance Device: Twin Force Bite Corrector. Esthetics and Biomechanics in Orthodontics, W.B. Saunders. [2nd ed.].
23. The Enigma of Facial Beauty: Esthetics, Proportions, Deformity, and Controversy10.1016/j.ajodo.2005.09.027 ↗
24. New “Golden” Ratios for Facial Beauty10.1016/j.visres.2009.11.003 ↗
25. Correlation between Facial Attractiveness and Facial Components Assessed by Laypersons and Orthodontists10.1016/j.jds.2020.07.012 ↗
26. Chrapla, P., Paradowska-Stolarz, A., and Skoskiewicz-Malinowska, K. (2022). Subjective and Objective Evaluation of the Symmetry of Maxillary Incisors among Residents of Southwest Poland. Symmetry, 14.10.3390/sym14061257 ↗
27. Tasman, A., Riba, M.B., Alarcón, R.D., Alfonso, C.A., Kanba, S., Ndetei, D.M., Ng, C.H., Schulze, T.G., and Lecic-Tosevski, D. (2020). The Physician–Patient Relationship. Tasman’s Psychiatry, Springer International Publishing.10.1007/978-3-030-42825-9 ↗
28. The Soft Tissue Paradigm in Orthodontic Diagnosis and Treatment Planning: A New View for a New Century10.1111/j.1708-8240.2000.tb00198.x ↗
29. AI and Face-Driven Orthodontics: A Scoping Review of Digital Advances in Diagnosis and Treatment Planning10.3390/ai5010009 ↗
30. Subramanian, A.K., Chen, Y., Almalki, A., Sivamurthy, G., and Kafle, D. (2022). Cephalometric Analysis in Orthodontics Using Artificial Intelligence—A Comprehensive Review. BioMed Res. Int., 2022.10.1155/2022/1880113 ↗
31. Artificial Intelligence and Machine Learning for Automated Cephalometric Landmark Identification: A Meta-Analysis Previewed by a Systematic Review
32. Accuracy of Automated 3D Cephalometric Landmarks by Deep Learning Algorithms: Systematic Review and Meta-Analysis10.1007/s11547-023-01629-2 ↗
33. Thurzo, A., Urbanová, W., Novák, B., Czako, L., Siebert, T., Stano, P., Mareková, S., Fountoulaki, G., Kosnáčová, H., and Varga, I. (2022). Where Is the Artificial Intelligence Applied in Dentistry? Systematic Review and Literature Analysis. Healthcare, 10.10.3390/healthcare10071269 ↗
34. Applications of Artificial Intelligence and Machine Learning in Orthognathic Surgery: A Scoping Review10.1016/j.jormas.2022.06.027 ↗
35. Development and Accuracy of Artificial Intelligence-Generated Prediction of Facial Changes in Orthodontic Treatment: A Scoping Review10.1631/jzus.B2300244 ↗
36. Differences in Hard and Soft Tissue Profile after Orthodontic Treatment with and without Extraction10.4103/njcp.njcp_1562_21 ↗
37. Zhou, Q., Gao, J., Guo, D., Zhang, H., Zhang, X., Qin, W., and Jin, Z. (2023). Three Dimensional Quantitative Study of Soft Tissue Changes in Nasolabial Folds after Orthodontic Treatment in Female Adults. BMC Oral Health, 23.10.1186/s12903-023-02733-5 ↗
38. Deep Learning-Based Prediction of the 3D Postorthodontic Facial Changes10.1177/00220345221106676 ↗
39. Ryu, J., Lee, Y.-S., Mo, S.-P., Lim, K., Jung, S.-K., and Kim, T.-W. (2022). Application of Deep Learning Artificial Intelligence Technique to the Classification of Clinical Orthodontic Photos. BMC Oral Health, 22.10.1186/s12903-022-02466-x ↗
40. Li, S., Guo, Z., Lin, J., and Ying, S. (2022). Artificial Intelligence for Classifying and Archiving Orthodontic Images. BioMed Res. Int., 2022.10.1155/2022/1473977 ↗
41. Volovic, J., Badirli, S., Ahmad, S., Leavitt, L., Mason, T., Bhamidipalli, S.S., Eckert, G., Albright, D., and Turkkahraman, H. (2023). A Novel Machine Learning Model for Predicting Orthodontic Treatment Duration. Diagnostics, 13.10.20944/preprints202306.2096.v1 ↗
42. Artificial Intelligence in Medico-Dental Diagnostics of the Face: A Narrative Review of Opportunities and Challenges10.1007/s00784-022-04724-2 ↗
43. Ruz, G.A., Araya-Díaz, P., and Henríquez, P.A. (2022). Facial Biotype Classification for Orthodontic Treatment Planning Using an Alternative Learning Algorithm for Tree Augmented Naive Bayes. BMC Med. Inform. Decis. Mak., 22.10.1186/s12911-022-02062-7 ↗
44. Mladenovic, R., Kalevski, K., Davidovic, B., Jankovic, S., Todorovic, V.S., and Vasovic, M. (2023). The Role of Artificial Intelligence in the Accurate Diagnosis and Treatment Planning of Non-Syndromic Supernumerary Teeth: A Case Report in a Six-Year-Old Boy. Children, 10.10.3390/children10050839 ↗
45. Ryu, J., Kim, Y.-H., Kim, T.-W., and Jung, S.-K. (2023). Evaluation of Artificial Intelligence Model for Crowding Categorization and Extraction Diagnosis Using Intraoral Photographs. Sci. Rep., 13.10.1038/s41598-023-32514-7 ↗
46. Jha, N., Lee, K.-S., and Kim, Y.-J. (2022). Diagnosis of Temporomandibular Disorders Using Artificial Intelligence Technologies: A Systematic Review and Meta-Analysis. PLoS ONE, 17.10.1371/journal.pone.0272715 ↗
47. Almășan, O., Leucuța, D.-C., Hedeșiu, M., Mureșanu, S., and Popa, Ș.L. (2023). Temporomandibular Joint Osteoarthritis Diagnosis Employing Artificial Intelligence: Systematic Review and Meta-Analysis. J. Clin. Med., 12.10.3390/jcm12030942 ↗
48. Xu, L., Chen, J., Qiu, K., Yang, F., and Wu, W. (2023). Artificial Intelligence for Detecting Temporomandibular Joint Osteoarthritis Using Radiographic Image Data: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy. PLoS ONE, 18.10.1371/journal.pone.0288631 ↗
49. Comparison of Individualized Facial Growth Prediction Models Based on the Partial Least Squares and Artificial Intelligence10.2319/031723-181.1 ↗
50. Jeong, Y., Nang, Y., and Zhao, Z. (2023). Automated Evaluation of Upper Airway Obstruction Based on Deep Learning. BioMed Res. Int., 2023.10.1155/2023/8231425 ↗
51. Tsolakis, I.A., Kolokitha, O.-E., Papadopoulou, E., Tsolakis, A.I., Kilipiris, E.G., and Palomo, J.M. (2022). Artificial Intelligence as an Aid in CBCT Airway Analysis: A Systematic Review. Life, 12.10.3390/life12111894 ↗
52. Fountoulaki, G., and Thurzo, A. (2022). Change in the Constricted Airway in Patients after Clear Aligner Treatment: A Retrospective Study. Diagnostics, 12.10.20944/preprints202207.0454.v1 ↗
53. Amen, B. (2015, January 21–26). Sketch of Big Data Real-Time Analytics Model. Proceedings of the Fifth International Conference on Advances in Information Mining and Management, Brussels, Belgium.
54. Gulum, M.A., Trombley, C.M., Ozen, M., Esen, E., Aksamoglu, M., and Kantardzic, M. (2024). Why Are Explainable AI Methods for Prostate Lesion Detection Rated Poorly by Radiologists?. Appl. Sci., 14.10.3390/app14114654 ↗
55. Thakur, G.S., Sahu, S.K., Swamy, N.K., Gupta, M., Jan, T., and Prasad, M. (2023). Review of Soft Computing Techniques in Monitoring Cardiovascular Disease in the Context of South Asian Countries. Appl. Sci., 13.10.3390/app13179555 ↗
56. Xiao, Q., Lee, K., Mokhtar, S.A., Ismail, I., Pauzi, A.L.b.M., Zhang, Q., and Lim, P.Y. (2023). Deep Learning-Based ECG Arrhythmia Classification: A Systematic Review. Appl. Sci., 13.10.3390/app13084964 ↗
57. DeepGrading: Deep Learning Grading of Corneal Nerve Tortuosity10.1109/TMI.2022.3156906 ↗
58. Chen, T., Tachmazidis, I., Batsakis, S., Adamou, M., Papadakis, E., and Antoniou, G. (2023). Diagnosing Attention-Deficit Hyperactivity Disorder (ADHD) Using Artificial Intelligence: A Clinical Study in the UK. Front. Psychiatry, 14.10.3389/fpsyt.2023.1164433 ↗
59. Remote Sensing Image Scene Classification Using Bag of Convolutional Features10.1109/LGRS.2017.2731997 ↗
60. Surovková, J., Haluzová, S., Strunga, M., Urban, R., Lifková, M., and Thurzo, A. (2023). The New Role of the Dental Assistant and Nurse in the Age of Advanced Artificial Intelligence in Telehealth Orthodontic Care with Dental Monitoring: Preliminary Report. Appl. Sci., 13.10.3390/app13085212 ↗
61. Psychobiology of Facial Attractiveness
62. Mogilski, J.K., and Welling, L.L.M. (2018). The Relative Contribution of Jawbone and Cheekbone Prominence, Eyebrow Thickness, Eye Size, and Face Length to Evaluations of Facial Masculinity and Attractiveness: A Conjoint Data-Driven Approach. Front. Psychol., 9.10.3389/fpsyg.2018.02428 ↗
63. Facial Attractiveness10.1016/S1364-6613(99)01403-5 ↗
64. Impact of Face Proportions on Face Attractiveness10.1111/jocd.12783 ↗
65. Shen, H., Chau, D.K.P., Su, J., Zeng, L.-L., Jiang, W., He, J., Fan, J., and Hu, D. (2016). Brain Responses to Facial Attractiveness Induced by Facial Proportions: Evidence from an fMRI Study. Sci. Rep., 6.10.1038/srep35905 ↗
66. Image Enhancement Methods: A Review10.9734/BJMCS/2014/10332 ↗
67. (2024, March 05). Gemini–Chat to Supercharge Your Ideas. Available online: https://gemini.google.com.
68. (2024, March 06). Top 10 Best AI Face Apps Review 2024. Available online: https://topten.ai/face-apps-review/.
69. Sha, A. (2024, March 06). 8 Best AI Photo Enhancers in 2024 (Free and Paid). Available online: https://beebom.com/best-ai-photo-enhancers/.
70. InterFace Experiments: FaceApp as Everyday AI
71. Sudmann, A. (2019). The Democratization of Artificial Intelligence: Net Politics in the Era of Learning Algorithms, transcript.10.1515/9783839447192 ↗
72. The Nooscope Manifested: AI as Instrument of Knowledge Extractivism10.1007/s00146-020-01097-6 ↗
73. Perceptual Bias and Technical Metapictures: Critical Machine Vision as a Humanities Challenge10.1007/s00146-020-01058-z ↗
74. Orhan, K., and Jagtap, R. (2023). Artificial Intelligence in Dentistry, Springer International Publishing.10.1007/978-3-031-43827-1 ↗
75. (2024, August 24). Generated Photos|Unique, Worry-Free Model Photos. Available online: https://generated.photos.
76. (2024, August 24). FaceApp: Face Editor. Available online: https://www.faceapp.com/.
77. Cox, D.R. (2000). Karl Pearson and the Chisquared Test. Goodness of Fit Tests and Model Validity, Birkhäuser.
78. Wickham, W. (2016). Ggplot2: Elegant Graphics for Data Analysis, Springer.10.1007/978-3-319-24277-4_9 ↗
79. R Core Team (2021). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing.
80. Measuring Nominal Scale Agreement among Many Raters10.1037/h0031619 ↗
81. Gamer, M., Lemon, J., Fellows, I., and Singh, P. (2024, July 01). Irr: Various Coefficients of Interrater Reliability and Agreement; Version 0.84.1. Available online: https://CRAN.R-project.org/package=irr.
82. The Importance of Beta, the Type II Error and Sample Size in the Design and Interpretation of the Randomized Control Trial10.1056/NEJM197809282991304 ↗
83. (2024, August 24). GIMP. Available online: https://www.gimp.org/.
84. (2024, August 24). GPT-4. Available online: https://openai.com/index/gpt-4/.
85. Goffman, E. (1959). The Presentation of Self in Everyday Life, Doubleday.
86. Ozimek, P., Lainas, S., Bierhoff, H.-W., and Rohmann, E. (2023). How Photo Editing in Social Media Shapes Self-Perceived Attractiveness and Self-Esteem via Self-Objectification and Physical Appearance Comparisons. BMC Psychol., 11.10.1186/s40359-023-01143-0 ↗
87. Facial Attractiveness: Beauty and the Machine10.1162/089976606774841602 ↗
88. A Machine Learning Predictor of Facial Attractiveness Revealing Human-like Psychophysical Biases10.1016/j.visres.2007.11.007 ↗
89. Gründl, M. (2013). Determinanten Physischer Attraktivität–Der Einfluss von Durchschnittlichkeit, Symmetrie Und Sexuellem Dimorphismus Auf Die Attraktivität von Gesichtern. [Ph.D. Thesis, Universität Regensburg].
90. Influence of Lower Facial Height Changes on Frontal Facial Attractiveness and Perception of Treatment Need by Lay People10.2319/032509-176.1 ↗
91. Changes in Soft Tissue Variable of Lips Following Retraction of Anterioir Teeth-A Cephalometric Study10.4103/jpbs.jpbs_478_22 ↗
92. Dibot, N.M., Tieo, S., Mendelson, T.C., Puech, W., and Renoult, J.P. (2023). Sparsity in an Artificial Neural Network Predicts Beauty: Towards a Model of Processing-Based Aesthetics. PLoS Comput. Biol., 19.10.1371/journal.pcbi.1011703 ↗
93. Applications of Artificial Intelligence and Machine Learning in Orthodontics: A Scoping Review10.1186/s40510-021-00361-9 ↗
94. Gao, J., Wang, X., Qin, Z., Zhang, H., Guo, D., Xu, Y., and Jin, Z. (2022). Profiles of Facial Soft Tissue Changes during and after Orthodontic Treatment in Female Adults. BMC Oral Health, 22.10.1186/s12903-022-02280-5 ↗
95. Ethical, Legal, and Social Considerations of AI-Based Medical Decision-Support Tools: A Scoping Review10.1016/j.ijmedinf.2022.104738 ↗
96. Murphy, K., Di Ruggiero, E., Upshur, R., Willison, D.J., Malhotra, N., Cai, J.C., Malhotra, N., Lui, V., and Gibson, J. (2021). Artificial Intelligence for Good Health: A Scoping Review of the Ethics Literature. BMC Med. Ethics, 22.10.1186/s12910-021-00577-8 ↗
97. The Ethics of AI in Health Care: A Mapping Review10.1016/j.socscimed.2020.113172 ↗
98. Medical Ethics Considerations on Artificial Intelligence10.1016/j.jocn.2019.03.001 ↗
99. The Ethics of AI Ethics—An Evaluation of Guidelines10.1007/s11023-020-09517-8 ↗
100. Artificial Intelligence and Ethics in Dentistry: A Scoping Review10.1177/00220345211013808 ↗