Attractive Smile Research Articles

STRATEGIES TO MINIMIZE TOOTH SENSITIVITY IN PATIENTS UNDERGOING TOOTH WHITENING: An integrative review

Teeth whitening is one of the most sought-after aesthetic procedures in modern dentistry, providing patients with a whiter and more attractive smile. However, one of the most common side effects associated with this treatment is tooth sensitivity, which can cause significant discomfort and even discourage patients from proceeding with the procedure. Due to the occurrence of this problem, this study aimed to investigate and evaluate strategies to minimize tooth sensitivity after whitening procedures. This study refers to an integrative review, which was guided by the following research question: "What are the most effective strategies for reducing post-bleaching sensitivity?" To achieve the proposed objective, inclusion criteria were applied to select articles from the Google Scholar, PubMed, and BVS databases, published in Portuguese and English between 2014 and 2023, that are relevant to the study. Various approaches were examined, including the use of desensitizing agents and modifications to clinical protocols. Among the evaluated methods, some were found to be ineffective, such as oral medications, anti-inflammatory drugs, analgesics, corticosteroids, and certain specific toothpastes, while others, such as the use of specific toothpastes and the combination of GLUMA with laser, demonstrated effectiveness in reducing post-whitening sensitivity. he results indicate that sensitivity can be reduced with the application of appropriate strategies, improving patient acceptance and satisfaction with the treatment. Each case should be individually considered, with the evaluation of other factors that may influence the response to the treatment.

An In-Vitro Study on the Impact of Light-Emitting Diode (LED) and Laser-Activated Bleaching Techniques on the Color Change of Artificially Stained Teeth at Varying Time Intervals.

Introduction Tooth color is a key factor in the perception of an attractive smile, making bleaching a widely sought-after cosmetic dental procedure. Valued for its minimally invasive approach, this technique effectively lightens teeth to achieve desired aesthetic outcomes. As the desire for immediate results grows among patients, various bleaching agents, and energy sources have been developed to expedite the bleaching process. The study aims to evaluate and compare the efficacy of 35% hydrogen peroxide activated by light-emitting diode (LED) and laser on artificially stained teeth, assessing color changes at different time intervals. Methodology Sixty maxillary central incisors with intact crowns were selected for the study. An artificial staining solution was prepared, and the samples were immersed in it for 15 days to simulate staining. After this period, the teeth were removed from the solution, rinsed with water, and dried. Baseline photographs of each tooth were taken for comparison. The teeth were then divided into two groups, one treated with LED activation and the other with laser activation of 35% hydrogen peroxide as the bleaching agent. The color changes were measured and recorded at different time intervals. Data were presented as mean and standard deviation, with statistical analysis conducted using independent sample t-test and repeated measures ANOVA to compare the efficacy of the two methods. Results Both LED and laser activation of 35% hydrogen peroxide demonstrated significant color changes in the stained teeth. The initial color improvement was noticeable in both groups, with LED and laser treatments producing comparable whitening effects. The mean color change values indicated that both activation sources were effective in enhancing the bleaching process, providing immediate and substantial results. Statistical analysis showed no significant difference between the two methods, suggesting their equivalency in clinical efficacy for tooth bleaching. Conclusion The study concludes that both LED and laser activation of 35% hydrogen peroxide are efficient methods for in-office tooth bleaching, providing immediate and enhanced whitening effects. The comparable results between the two energy sources indicate that can be effectively used to meet the increasing demand for rapid aesthetic improvements in a clinical setting. This finding supports the adoption of both LED and laser bleaching techniques as viable options for dental practitioners aiming to achieve optimal patient satisfaction with minimal invasiveness.

Smile aesthetics in Pakistani population: dentist preferences and perceptions of anterior teeth proportion and harmony

BackgroundThis study aimed to evaluate dentist perceptions of attractive smiles in the Pakistani population, considering different dental proportions.MethodsMaxillary casts and digital images were used to create symmetrical representations of anterior teeth. dentists’ preferences for good and bad teeth proportions, width/height ratios, and various dental proportions (golden, recurring esthetic dental (RED), golden percentage, Preston, and local/observed) were assessed using one sample and paired t-test. The Chi-square test was used to determine the gender disparities and factors affecting smile attractiveness. A p-value of ≤ 0.05 was taken as significant.ResultsThe RED proportion emerged as the preferred choice for normal-sized teeth, with specialists and general dentists favoring it over the golden proportion. For tall teeth, the golden proportion was predominantly preferred. The golden percentage received limited preference for aesthetic smile construction.ConclusionsThe smiles created using the principles of RED proportion were opted as the most attractive by local dentists. Factors such as tooth arrangement, color, and midline were highlighted as essential considerations in aesthetic smile construction.

Relationships between perception of black triangles appearance, personality factors and level of education

This analytical cross-sectional study evaluated the perception of black triangles (BT) and examined the relationships between the perception of BT, personality factors, different educational backgrounds and demographic factors. 435 participants were included and divided into four groups: dentists, clinical (4th and 5th year) dental students, pre-clinical (3rd year) dental students, and laypeople. Participants’ perception of the attractiveness of smile profiles of maxillary and mandibular anterior dentition with BT was rated using a ten-point VAS scale with 0 being the least, and 10 being the most attractive smile profile. The personality was assessed using the NEO-FFI personality questionnaire. The smile profile with multiple large BT was rated the least attractive for the maxillary (mean = 3.6) and mandibular (mean = 3.9) tested profiles. The smile profile without BT was rated the most attractive for the maxillary (mean = 9.1) and mandibular (mean = 8.8) tested profiles. The dental professionals perceived the maxillary smile profile with multiple large BT as less attractive than the non-dental participants (t = − 2.715, P = 0.007). Being a male, having dental education, having lower Neuroticism scores, as well as having higher Openness, Agreeableness, Conscientiousness, and Extraversion scores predicted and contributed more towards perceiving various tested smile profiles as more attractive. These findings show that black triangles negatively impacts the perception of smile attractiveness, and that personality traits and having dental education impact the perception of smile attractiveness for smiles with black triangles.

Changes in smile parameters after surgical-orthodontic treatment for skeletal Class III malocclusion

Background/purposeMany patients pursue attractive smiles, and surgical-orthodontic treatment is a common method. We aimed to analyze the changes in smile parameters after surgical-orthodontic treatment in patients with skeletal Class III pattern and identify factors influencing postoperative outcomes. Materials and methodsThis retrospective study comprised 34 patients with skeletal Class III malocclusion and pure mandible prognathism who received surgical-orthodontic treatment. Hard and soft tissue parameters were assessed through lateral cephalometry, and smile esthetics were evaluated through extraoral photography. Postoperative changes in smile parameters and between-parameter correlations were analyzed. Random forest and decision tree deep learning models were used to identify factors influencing postoperative changes. ResultsSubstantial postoperative changes were observed in the buccal corridor, upper lip height, and smile index. Significant between-sex differences were noted in the upper midline and right chelion. Strong, positive correlations were found between upper lip height and upper lip ratio and between lower lip height and lower lip ratio. By contrast, strong negative correlations were observed between lower teeth exposure and smile index and between interlabial gap and smile index. The highest degrees of postoperative changes were noted in asymmetry-associated smile parameters: lower lip area, interlabial gap, smile index, buccal corridor, and arc ratio. ConclusionConsiderable changes were noted in skeletal, dental, and soft tissue parameters after surgical-orthodontic treatment. However, the changes in smile esthetics were less prominent from the frontal view. As for chin asymmetry, the most to least prominent changes were in the lower lip area, interlabial gap, smile index, buccal corridor, and arc ratio, respectively.

Evaluation of Smile Characteristics of Attractive Smile in Various Growth Patterns

Objective: To investigate the dynamic aspect of attractive smile and smile parameters in different growth patterns. Methods: Participants ranging in age from 17 to 25 years were randomly selected and videographic records of smile were obtained. A panel of two orthodontists, two prosthodontists, and two laypersons were involved in the selection of attractive smile. Inter-examiner variability was also assessed. The final sample of 84 participants with attractive smile were grouped into three categories based on clinical FMA into average, horizontal, and vertical growth pattern. Upper lip length = ULL-R, Lower lip length = LLL-R were measured on rest photographs. Upper lip length = ULL-S, Lower lip length = LLL-S, Upper lip thickness = ULT, Lower lip thickness = LLT, Maxillary incisal display = MID, Interlabial gap = ILG, Outer inter commissural width = ICW, Buccal corridor space = BC were measured on smile photographs. Pearson’s Chi-square test was done for the perception of attractiveness of smile. Differences among the three groups was subjected to one-way analysis of variance and Tukey’s post hoc test. Results: Highly significant correlation was observed among orthodontists, prosthodontists, and laypersons in assessing attractiveness of smile. Vertical parameters such as upper lip length at rest, upper lip length during smile, lower lip length at rest, lower lip length during smile, and lower lip thickness (LLT) were significantly increased in the vertical pattern when compared with the average and horizontal growth pattern, whereas buccal corridor space was the least in horizontal growth pattern. Conclusion: Growth patterns appear to have an influence on perception of smile esthetics and smile parameters. This suggests that care should be taken while framing treatment goals considering the significant differences among growth patterns. Strong correlation was observed among orthodontists, prosthodontists, and laypersons in assessing attractiveness of smile. ULL-R, ULL-S, LLL-R, LLL-S, and ΔULL show a significantly higher value in vertical growth pattern when compared to average and horizontal growth pattern. The buccal corridor space (BC) among the participants was the least in horizontal growth pattern.

Full Arch Distalisation using Infrazygomatic Crest and Buccal Shelf Implants

This article reports the successful use of Infrazygomatic crest and buccal shelf implants in the maxilla and mandible to treat a female patient of age 13‐years. The patient had a skeletal Class I pattern and Angles class I malocclusion. Temporary anchorage devices (TADs) in the posterior dental region between maxillary and mandibular second premolar and first molar teeth on both sides were used as anchorage for full arch distalization. The patient received a satisfactory occlusion and an attractive smile. This technique requires minimal compliance and is particularly useful for correcting bimaxillary protrusion cases. Keywords: Class I Malocclusion, Distalization, Temporary Anchorage Devices

Influence of gingival display on smile attractiveness assessed by Saudi Arabian laypersons and dental professionals

This study was undertaken to evaluate the influence of changes in the gingival display of the maxillary teeth on smile attractiveness assessed by Saudi Arabian dental professionals and laypeople. A total of 138 dental professional and 182 laypeople rated the attractiveness of male and female smiles in a computerized survey. A smiling photograph of a male and a female dental students were selected and digitally manipulated to create changes the amount of gingival display from 4 mm of gingival display to 4mm of gingival covered by the upper lip in 1 mm increments. Each photo was accompanied by a visual analog scale (VAS) for rating. Among dental professionals, 61% rated the female photo with a 1-mm low lip line as the most attractive smile (VAS score ± SE, 7.3 ± 3.18), while 52.7% of laypeople considered the smile with a 2-mm low lip line as the most attractive (6.7 ± 3.4). Regarding male smile photos, 61.6% of dental professionals found the 1-mm low lip line the most attractive (7.3 ± 3.18). The same rating was given by 48.3% of laypeople (6.1 ± 3.6) (p ≤ 0.009). The least attractive smile photo was the smile showing 4 mm of gingiva for male and female smiles. More than half of the laypeople believed that an attractive smile highly affects social life and communication. The Saudi Arabian population appears to be sensitive to the amount of gingival display. The difference in female smile assessment between dental professionals and laypeople highlights the importance of dentist-patient consensus regarding decisions for esthetic treatments. Esthetic treatment is of a major concern for both dentist and patient. The careful assessment of smile pillars including gingival display must be tailored to each patient.

Pink Esthetic Score Around Single-Tooth Implant Crowns After Socket-Shield Technique: A Prospective Cohort Study.

Esthetics is important for any dental implant but crucial for implants in the anterior region. Restorations in this region are demanding, and the goal of re-establishing an attractive smile without revealing differences from the natural teeth is difficult to achieve. The aim of this study was to examine the clinical success of the socket-shield technique regarding soft tissue stability and overall esthetic outcome. Pink esthetic scores (PESs) were collected at two time points (T1: 6 months; T2: 6 years) by three different specialists. This prospective cohort clinical study involved 30 patients (7 women and 23 men) with a mean age of 42.3 years. There were no significant differences in PES values assessed by the oral surgeon and prosthodontist (P > .05) at either of the assigned time points. The periodontist found differences in PES values between T1 and T2 (P < .05), but they were modest in value. Analyses of each individual variable at given time intervals revealed significant differences in the shape of the distal papillae (χ2 = 6.182; P < .05) and soft tissue margin level (χ2 = 6.507; P < .05). The final results suggest that the socket-shield technique is promising for implant placement in the esthetic zone.

Mini Implants in Orthodontics: Unveiling Hazards and Complexities

In the last two decades, advances in digital and 3D printing technology, a rise in interest in cosmetic orthodontics, particularly among adults, and manufacturer marketing on a global scale have all contributed to clear aligners becoming a staple in modern orthodontic practise. Clear aligners have seen numerous improvements since they were first introduced with the goal of making orthodontic treatment less obvious. Like many other orthodontic tools, transparent aligners are used to move teeth for alignment and to create healthy, attractive smiles, but they are far more comfortable and aesthetically pleasing. The success of the treatment depends on the therapists' expertise and experience with the aligners, careful case selection, and patients' adherence to the prescribed treatment plans.

Tampilan gigi insisivus maxillaris dan koridor buccal pada senyum

Smile is one of the important things that would be noticed when communicating with someone; therefore, the aesthetics and appearance of a smile are important for both men and women. Smile analysis will assist the dentist in making a diagnosis and planning treatment depending on the balance and alignment of the smile components. The maxillary incisor display and the buccal corridor are two components that need attention to get an aesthetic and attractive smile.

Lengkung Senyum dan Tampilan Gingiva Pada Senyum

A smile is a form of one's facial expression that is widely used and easy to see. Having an aesthetic and attractive smile can make a person more confident when interacting socially in their environment. There are eight main components that are assessed in a smile, two of which are the smile arc and gingiva display. Both have received a lot of attention because they are known to have a major influence on an aesthetic smile.The harmony of the smile arc and gingival display will produce an attractive smile. A consonant smile and a moderate smile line are considered the ideal smile arc and gingival display.

Evaluation of the effect of gingival margin and incisal edge locations of maxillary anterior teeth on the perception of smile esthetics

ABSTRACT Purpose It is important to be aware of patients’ esthetic needs to create an attractive smile, because their aesthetic perception might differ from that of clinicians. This study was undertaken to determine the effect of the vertical position of maxillary central incisors and the mesiodistal position of the gingival zenith of maxillary incisors on the esthetic perception of the smile. Materials and methods A close-up, frontal view photograph of a smiling young adult Iranian woman was selected for the present study. The photos were randomly placed in an album and shown to 75 referees who assessed the attractiveness of the photos using VAS. The data were analysed with one-way ANOVA and post hoc LSD tests. Results There were no significant differences in the smile esthetic scores of VP photos given by the laypersons. The laypersons gave the least VAS smile esthetic scores to the photo in which the incisal edges of the central and lateral incisors were at the same level. The specialists gave the highest smile esthetic scores to the GZ photo in which the gingival zeniths of central incisors were 1 mm distal to the vertical axis and the gingival zenith of lateral incisors on the central vertical axis. Conclusion Laypersons were less sensitive than dental specialists in evaluating the esthetic smile of VP photos. However, in evaluating the smile attractiveness of GZ photos, restorative dentistry specialists exhibited more critical opinions than orthodontists and laypersons.

Smile Attractiveness and Treatment Needs of Maxillary Midline Diastema with Various Widths: Perception among Laypersons, Dental Students, and Dentists in Malaysia.

Smile attractiveness and the need for treatment of maxillary midline diastema with various widths are perceived differently between dentally trained and nondentally trained individuals of different sociodemographic backgrounds. This study aims to evaluate how laypersons, dental students, and dentists in Malaysia differ in their perceptions on smile attractiveness and treatment needs of maxillary midline diastema. A smiling photograph with well-aligned maxillary central incisors with proportionate width-to-height ratio and healthy gingival tissues was selected and digitally manipulated to create maxillary midline diastema with 0.5, 2.0, and 4.0 mm widths. The smile attractiveness and the perceived need for treatment of varying widths of maxillary midline diastemas were rated by laypersons, dental students, and dentists using the Likert scale via a single set of self-administered questionnaires. The impact of sociodemographic variables on aesthetic perception of different gap widths was tested using univariate analysis followed by a multiple linear regression model. A total of 158 laypersons, 118 dental students, and 138 dentists participated in this study. Both laypersons and dentists showed significantly higher mean aesthetic scores for 0.5 mm maxillary midline diastema, lower mean aesthetic scores, and hence higher mean treatment needs scores for 4.0 mm maxillary midline diastema as compared with dental students (p < 0.05). In general, female respondents perceived a gap width of up to 2.0 mm as aesthetically pleasing. Higher educational group and the Malay ethnicity had tolerance threshold of 0.5 mm gap width. The older group considered 4.0 mm gap width as aesthetically unpleasing. In conclusion, both laypersons and dentists accepted a 0.5 mm maxillary midline diastema as an attractive smile but considered 4.0 mm maxillary midline diastema as unpleasing smile which required treatment. Perceptions of laypersons and dentists were significantly different from dental students. Educational level, gender, ethnicity, and age were significantly associated with smile attractiveness of maxillary midline diastema at different investigated widths.

A case report: Surgical esthetic crown lengthening procedure for gummy smile treatment

Background: In modern society, a harmonious smile is considered a symbol of beauty. An attractive smile can improve appearance so that a person is more easily accepted in society. In planning dental treatment to be carried out, aesthetic considerations are very relevant because of the relationship between smile and facial beauty. Purpose: The purpose of writing this article is to describe a crown lengthening accompanied by bone reduction to correct an excessive gingival display in a patient with altered passive eruption (APE) of the maxillary anterior teeth. Case: A 28-year-old female patient came to the Periodontology Specialist Polyclinic at RSGM Airlangga University with complaints that the gums on the upper front teeth looked more dominant. The patient did not have problems with the periodontal tissue and had no history of systemic diseases such as diabetes, high blood pressure, and had no history of allergies to food and drugs. Case Management: After analyzing the periodontal tissue, the choice of crown lengthening with bone reduction was chosen to treat this case. Conclusion: procedures Crown lengthening have been performed as a viable option to facilitate restorative therapy or improve esthetic appearance.

Perceptual difference of smile aesthetics between 2-dimensional photographs and 3-dimensional dentofacial images: a cross-sectional study

BackgroundThe aim of this study was to compare the perceptual difference of smile aesthetics between 2D photographs and 3D dentofacial images as perceived by orthodontists and graduate students.MethodsForty-eight subjects finished orthodontic treatment were recruited with 2D photographs of frontal, oblique and lateral views as well as 3D dentofacial images. Twelve senior orthodontists and 13 postgraduate students were asked to rate the 2D and 3D smile simulations based on visual analog scale (VAS) and to vote for smile features that affect the attractiveness of smile. At the end, they completed a questionnaire about their views on different smile simulations. Wilcoxon signed-rank, Bland–Altman analysis, and multiple linear regression were used to compare the ratings and votes of smile perception between raters and between records.ResultsOrthodontists and postgraduate students rated smile consistently with 2D photographs, while orthodontists tended to give a higher rate for unattractive smiles and a lower rate for attractive smiles with 3D dentofacial images. The 3D dentofacial images were rated significantly lower than 2D photographs and the voting of most of the smile features showed significant negative main effect on VAS scores, while the effect of demographic characteristics of raters, voting on visible width of upper dentition and buccal corridor was not significant. In addition, a significant negative main effect of commissure and facial profile was found on the rating discrepancy between 2D and 3D images.ConclusionsSenior orthodontists tend to perceived 3D images more conservatively in smile evaluation. 3D dentofacial images were rated lower than 2D photographs and most of the smile features affect the aesthetic perception of smile. The perceptual difference of commissure and facial profile contributed to the lower ratings in 3D dentofacial images.

Influence of Lip Appearances and Tooth Shade on Smile Attractiveness Perception.

This study determined the effect of lip thickness, lipstick color, and tooth shade on the smile attractiveness perceptions of dentists, laypersons, dental students, and other faculty students. A set of 27 smile photographs was prepared with different lip thicknesses (Tk, thick; M, medium; and Tn, thin), lipstick shade (R, red; P, pink; and O, orange), and tooth shades (0M1, 0M3, and A1). A total of 212 Thai participants in four rater groups (dentists, laypersons, dental students, and other faculty students) rated smile attractiveness using a visual analog scale (VAS). Statistical analyses were performed using the Kruskal-Wallis test and pairwise analysis at a 0.05% level of significance. Tk or M lip thickness was associated with more smile attractiveness than Th lip thickness. The R lipstick is more attractive than the P and O lipsticks. The 0M1 tooth shade appeared to be the most attractive for laypersons and other faculty students, whereas tooth shades (0M1, 0M3, or A1) did not influence the smile attractiveness perception of dentists and dental students. The smile attractiveness perception was influenced by the lip appearance and tooth shade for each rater group, which are essential for an attractive smile design.

The Influence of Gingival Exposure on Smile Attractiveness as Perceived by Dentists and Laypersons.

Background and Objectives: Smile is an important mark of beauty, and smile attractiveness can be influenced by various factors, one of these being the amount of gingival exposure. The aim of this research was to evaluate the perception of an ideal gingival exposure in smile in a sample of Romanian dentists and laypersons, and to find out what is the most important aspect that influences the smile perception for the respondents included in the study sample. Materials and Methods: An online survey was conducted between 3 February 2020 and 31 October 2020. The authors developed a short questionnaire consisting of 7 items. The first four items investigated the respondents’ age, gender, profession and whether or not they underwent an orthodontic treatment in the past. For items 5 and 6, participants had to choose the most and the least attractive amount of gingival exposure, and for the last item they had to choose the factor that mostly influences the smile attractiveness in their opinion. Results: 235 questionnaires remained in the study. The sample consisted of 194 women and 41 men, 162 laypersons and 73 dentists. The average value for the most attractive amount of gingival exposure was −0.57 ± 2.407 mm, with a median value of 0 mm while the average value for the least attractive amount of gingival exposure was 1.43 ± 3.785 mm, with a median value of 4 mm. The differences between the most or least attractive gingival exposure perceived by the participants were not significant according to gender or professional category (p > 0.05), but, when compared between having or not having an orthodontic treatment in the past the differences were statistically significant (p < 0.05). As such, participants who had an orthodontic treatment in the past perceived a significantly higher value for the most attractive gingival exposure, and a significantly higher value for the least attractive gingival exposure (p = 0.026) than the participants who didn’t have an orthodontic treatment in the past. As for the factor that mainly influences smile attractiveness, laypersons chose significantly more frequent white teeth or aligned teeth (96%, 71.7%) while dentists chose significantly more frequent a gingival exposure between 0–3 mm (70.4%) as smile factors for an aesthetic smile (p < 0.001). Conclusions: In this study sample, the respondents considered that the most attractive smile involved a covering of 0.57 mm (in average) of the upper incisors by the upper lip. Although smile attractiveness did not appear to be influenced by gender or profession in this study population, it was influenced by previous orthodontic treatment. The participants’ roles of dentist or layperson influenced the factors chosen for an aesthetic smile.

Bioactivity in compound resin resistance and polibility: a clinical case report

Concern about appearance and the importance of an attractive smile is well established in modern society. A healthy aesthetic standard satisfies anyone regardless of sex, age, or social class. The growing interest of patients for a better aesthetic appearance, associated with the significant development of new restorative materials and wide dissemination in the media of this concept of beauty, led to changes in the concepts of dental treatment. This work aimed to demonstrate through a clinical case how biotechnology can help in treatments in a minimally invasive way. For this, a total of 34 articles were analyzed in full, however, 17 were included and discussed in this study. The literature reviews used and the observation of random studies was from the Bireme, PubMed, SciElo, and LILACS databases. It can be concluded in this clinical case that the success of aesthetic treatment is closely linked to the correct indication and knowledge of the dental surgeon in different products on the market, in addition to using it correctly, taking into account the patient's desire.

Smile Characteristics in Orthodontics: A Concept Review

It is important for orthodontists to make every effort to develop a harmonious balance that will produce the most attractive smile possible for each patient treated. A smile usually translates a common man emotional intelligence and expresses his feeling in a unique fashion Thus, he seeks the orthodontist to improve the esthetics and especially the smile. The success of smile design is determined by the patient’s profile and the orthodontist’s esthetic goals and skill so as to re-establish patients’ expectations. This article enlights the overview few characteristics for a balanced smile.