Attractive Smile Research Articles

Aesthetic perception of gingival smiles

Abstract Introduction Dentists have shown interest in learning new techniques to create more attractive smiles, but with little concern for understanding the reasons why the patient is dissatisfied. Objective To evaluate the aesthetic perception of laypersons in dentistry in comparison with general practitioner dentists and periodontists regarding the gingival smile, and to compare this aesthetic perception between the male and female genders. Methodology A photograph of a standard smile was taken and was digitally modified to create the periodontal conditions of a gingival smile from 0.5 mm to 2.5 mm. The photographs were judged by 150 individuals (25-65 years of age), 81 female and 69 male, divided into three groups: 50 laypersons, 50 general practitioners and 50 periodontists. The evaluation was performed using a visual analog scale. The statistical evaluation tests used were the Pearson Chi squared test, Student's t-test, ANOVA and Newman-keuls. Result The aesthetic perceptions among the professionals are similar, and they observe more subtle changes in the aesthetics of the smile than the laypersons observe. The general practitioners and periodontists were similarly sensitive to changes generated in the gingival smile when these reached 1.5 mm, while laypersons only perceived them when these changes reached 2.5 mm. There was no significant difference in the aesthetic perception of male and female evaluators in any of the groups. Conclusion The aesthetic perception of the gingival smile between general practitioner dentists and periodontists was similar, and dental professionals were more demanding than the layperson. There was no difference between female and male aesthetic perceptions.

Influence of Lip Height and Inciso Gingival Height in Relation to Smile Aesthetics in Orthodontically Treated Individuals

Aim: To study on the influence of lip height and inciso gingival height in relation to smile aesthetics in orthodontically treated individuals. Materials and method: The study was conducted in Saveetha Dental College, Chennai. The participants were informed and their consent were obtained for this study, in order to displayed and used their image in the study. The participants were previously having orthodontic treatment in relation to smile aesthetics and free from any other smile aesthetics treatment. Total of 30 participants photographed were used in this study for assessment of their smile. A total of 10 general practitioners,10 orthodontists and 10 lay people were asked to be the evaluators panel. The smile of each participants were then analysed by using visual analogue scale (VAS) and scored for each categories in the questionnaire. Data were then collected and analysed. Results: The study was compromised of 30 dental students of post graduates and undergraduates with age range from 19 to 26 years old. The mean age of the evaluators was 20.07. It shown that 40.7%, 27.3%, 20.0% and 12.0% of the subjects had good, fair, very good and excellent smiles respectively after undergone orthodontics treatment. There were no definite difference on the frequency distribution of the smiles. According to the data of the comparison of the inciso gingival height in social smile and spontaneous smile of the study models, Chi-square test shown no significant differences between the two types of smile according to the visibility of the maxillary central incisors. The frequency distribution of the upper lip height also shown the same. In addition to this, 73% of the evaluators chose social smile as the most attractive smile in general, followed by spontaneous smile (17%) and commissure smile (10%). Conclusion: Both social and spontaneous smile may exhibits difference variance, but it is not too significant. Thus this study prove that the upper lip height and inciso gingival height have no effect on rating of smiles in social as well as spontaneous smile of the orthodontically treated people.

Aesthetic perception of the smile related to the vertical position of the lower anterior teeth by afro-descendent laypeople

Introduction: To evaluate the influence of the vertical position of the lower anterior teeth in the aesthetic perception of the smile of Afro-descendent laypeople from different age groups. Materials and Methods: A standard smile was constructed from intraoral photographs of an afro-descendent individual. The vertical position of the lower anterior teeth was gradually changed by moving the teeth up and down within the lip frame in 0.5 mm increments ranging from -1.5 mm to 2.0 mm, regarding point zero. Using a visual analog scale, 150 Afro-descendent Brazilian lay individuals from three different age groups (15-19, 35-44 and 65-74) rated the attractiveness in relation to 8 smiles with altered gingival exposure. Results: There were no significant differences (p>0.05) between male and female raters for the three groups. All the age groups assigned higher scores for the smiles with 0.5 mm coverage of the lower lip on the lower central incisors. However, for the less attractive smiles, there were differences in the opinions of the age groups (p<0,05).Conclusions: the age groups shared similar preferences regarding the most pleasant smile regarding the vertical positions of the lower anterior teeth.

笑顔への歯科からのアプローチ : 口唇周囲の変化からみた研究(大阪歯科大学大学院歯学研究科博士(歯学)学位論文内容要旨および論文審査結果要旨の公表)

笑顔への歯科からのアプローチ : 口唇周囲の変化からみた研究(大阪歯科大学大学院歯学研究科博士(歯学)学位論文内容要旨および論文審査結果要旨の公表)

Does the presence of unilateral maxillary incisor edge asymmetries influence the perception of smile esthetics?

Determine orthodontists and laypersons' perception of maxillary central and lateral incisor edge asymmetries in full-face and close-up smiles. Four smile photos were selected for this study: two full-face and two close-up smile photos of two male subjects, a white man and an Afro-descendant man. Both were considered pleasant smiles, following some principles of an ideal smile. Images were digitally altered to create tooth wear asymmetries on the maxillary left central and lateral incisor in 0.5 mm increments. Final images were arranged randomly into a photo album and were shown to 86 judges (43 orthodontists and 43 laypersons). Judges were asked to evaluate the attractiveness of the images according to a visual analog scale. Data were statistically analyzed using one-way analysis of variance (ANOVA) with the Tukey's post hoc test and the Student t test. There was no statistically significant difference in the mean esthetic scores of the full-face and close-up smile photos. The most attractive smiles were those without asymmetries and those with 0.5 mm wear in the lateral incisor, whereas the least attractive ones were those with 1.0-1.5 mm wear in the central incisors. Statistically significant difference was found in the mean scores given by the judges in most cases. The orthodontists were more critical and assigned lower scores than the laypersons. The presence of maxillary incisor asymmetries is a critical factor influencing the perception of smile esthetics. The most attractive smiles of the men investigated were those without asymmetry and those with 0.5 mm incisor edge asymmetry in the lateral incisor. The presence of incisal asymmetries (especially in maxillary central incisors) negatively influences smile esthetics, corroborating the clinical hypothesis that the closer to the facial midline, the greater the need for symmetry.

The approach to an attractive smile in dentistry : examination of changes in the distance around the mouth

The approach to an attractive smile in dentistry : examination of changes in the distance around the mouth

Influence of the Smile Line on Smile Attractiveness in Short and Long Face Individuals.

Objectives The study assessed the impact of facial height on attractiveness of smile, in association with the maxillary gingival display. This research was performed by dental professionals and laypersons. Materials and Methods Frontal extraoral photographs were captured for both short and long faces. The photographs were modified using software for image-processing and three rater groups (orthodontists, dentists, and laypersons) evaluated the smile attractiveness, with 30 subjects in each group. Differences in ratings of the different smiles among the different experimental groups were examined using the Kruskal-Wallis test. The Mann–Whitney U test was performed for pairwise comparisons between the experimental groups. Results Dentists and laypeople were most likely to agree. For the short face, laypeople and dentists both rated the +2 mm gingival display smile as the most attractive smile whilst orthodontists ranked the 0 mm gingival display smile as the most attractive smile. For the long face, laypeople and dentists ranked the 0 mm gingival display smile as the most attractive smile, whilst orthodontists ranked the +2 mm gingival display as the most attractive. Conclusion Smile line of both short and long face subjects was found to influence the smile attractiveness rating by the three rater groups.

A study to assess and compare facial and dental proportions in attractive smiles

A study to assess and compare facial and dental proportions in attractive smiles

Comparative Evaluation of Gingival Depigmentation by Tetrafluroethane Cryosurgery and Surgical Scalpel Technique. A Randomized Clinical Study.

Introduction:Importance of good smile cannot be underestimated in enhancement of beauty, self-confidence and personality of a person. Health and appearance of gingiva is an essential part of attractive smile. Gingival pigmentation gives rise to unesthetic smile line. In present world, with increasing awareness to esthetic, people have become highly concerned about black gums. Various treatment modalities like abrasion, scrapping, scalpel technique, cryosurgery, electrosurgery and laser are available for treatment of gingival pigmentation. The present study was conducted with an objective of comparing efficacy of gingival depigmentation by cryosurgery and scalpel technique.Method:A Randomized control split mouth study was conducted for 25 patients with gingival pigmentation. Gingival pigmentation Index (GPI) for pigmentation and Visual Analoug Scale (VAS) for pain was evaluated for both test (Cryosurgery) and control sites (Scalpel technique) at baseline, 1month, 3months and 6 months.Results:GPI score was 3 and 2 for 21/25 and 4/25 control sites and was 22/25 and 3/25 test sites respectively at baseline. Both the groups showed significant reduction in GPI score i.e., 0 at 1 and 3 months interval after treatment. GPI score increased to 1 for 5/25 sites treated with scalpel technique and 2/25 sites treated with cryosurgery at 6 months interval (P =0.0691). This indicates recurrence rate for pigmentation is higher after scalpel treatment. VAS Score was 3 for 10/25 sites treated with scalpel and was 2 for 12/25 sites treated with cryosurgery (P <0.001).Conclusion:It can be concluded that cryosurgery can be effectively and efficiently used for depigmentation by keeping patients acceptance and comfort in mind and also the long term results and ease of use when compared to scalpel technique.

Management of chronic periodontitis: an interdisciplinary approach

Objective: In recent years, advances in technique as well as a growing public interest in developing and maintaining a healthy and attractive smile, has resulted in a greater understanding of the interrelationships between periodontics and orthodontics. The primary objective of periodontal therapy is to restore and maintain the health and integrity of the attachment apparatus of teeth. In adults, the loss of teeth or periodontal support can result in pathological teeth migration involving either a single tooth or a group of teeth. This may result in the development of a diastema, incisal proclination, rotation with collapse of the posterior occlusion.Materials and methods: This case report is of a 32 year old female patient who reported with swollen gums, generalized spacing between the teeth and extruded upper anterior tooth. Periodontal therapy followed by fixed orthodontic therapy was planned.Results: At the end of 2 years a stable healthy periodontium was established that was both functional and esthetic.Conclusion: Adjunctive orthodontic therapy is often necessary for successful restoration of periodontal health. On the other hand, successful orthodontic treatment will depend on the periodontal preparation before and after treatment and the maintenance of periodontal health throughout all phases of mechano-therapy.

Subjective and objective evaluation of frontal smile esthetics in patients with facial asymmetry-a comparative cross-sectional study.

To analyze the relationship between subjective and objective evaluations of pre-treatment posed smiles in patients with facial asymmetry and to assess the influence of dentofacial structures involved in asymmetry on the perception of smile attractiveness. Thirty-five patients (25 males and 10 females) between 18 and 25 years of age with facial asymmetry were selected. Pre-treatment clinical photographs of posed smiles were subjectively evaluated by a panel of 20 orthodontists, 20 oral surgeons, and 20 laypersons. A customized Smile Mesh program was used for objective evaluation of the same smiles. Direct comparison among three smile groups (unattractive, slightly attractive, and attractive) for different Smile Mesh measurements was carried out using two-way anova test. Additionally, linear regression was performed to evaluate whether these measurements could predict the attractiveness of captured smiles. Patients with 'slightly attractive' smiles had a significantly greater distance between the incisal margin of the maxillary central incisor and the lower lip during smiling. The Smile Index was significantly greater in attractive smiles. However, based on the coefficients of linear regression, no objectively gathered measurement could predict smile attractiveness. Attractiveness or unattractiveness of smiles in patients with facial asymmetry could not be predicted by any measurement of Smile Mesh. The presence of facial asymmetry did not significantly influence the perception of smile esthetics.

Celebrity smile esthetics assessment: Smile angulation

Statement of problemWhether deviations in the angulation discrepancy between the intercanine and interpupillary line significantly affect attractiveness is unknown. PurposeThe purpose of this prospective study was to quantify dental and facial esthetics to determine whether smile angulation discrepancies in individuals identified as having attractive smiles are smaller than those in the average population. Material and methodsAn Internet search for “best smile” and “celebrity” identified 108 celebrities (Test group). Photographs showing smiles within 10 degrees of a frontal view were gathered. In mannequin testing, small head rotation (<10 degrees) was found not to affect the measurements. Photographs of dental students were used for the control group. The angulation discrepancy between the intercanine and interpupillary line was measured using computer software. Groups were compared using the Mann-Whitney U test (α=.05). ResultsUsable photographs were obtained for 94 celebrities (62 women, 32 men) and were compared with photographs of 97 dental students (54 women, 43 men). Significant (P<.01) differences in angulation discrepancy were found, with celebrities having smaller mean angulation discrepancies (0.97 degrees) than dental students (1.33 degrees). The differences between men and women were not statistically significant (P>.05). ConclusionsCelebrities identified as having “best smile” had significantly smaller mean angulation discrepancies than the control group.

The influence of varying maxillary incisor shape on perceived smile aesthetics

ObjectivesThis paper aims to determine the influence of varying the maxillary incisor shape of an individual on perceived smile aesthetics. MethodsA photograph of a female smile displaying maxillary teeth only was digitally altered to produce five different incisor shapes. They consisted of three basic shapes: square (S), ovoid (O), triangular (T) and two variations, tapered-ovoid (TO) and square-tapering (ST). The images were ranked from the most to the least attractive by 30 dentists, 30 technicians and 30 patients. ResultsThe TO maxillary incisor shape was perceived to be the most attractive smile overall (50%), and amongst dentists (70%), technicians (50%) and patients (30%). The O shape maxillary incisors were ranked the second most attractive overall (36.7%) and the most attractive amongst patients (56%). The S shape maxillary incisors were perceived as the least attractive overall (43.3%), and amongst dentists (47%), technicians (50%) and patients (33%). ConclusionsThe tapered-ovoid incisor tooth form for females is preferred to the square form, which corresponds with the findings in the dental literature. However, the results also suggest that there is not one ‘ideal’ incisor shape and that dental professionals are more critical than patients with respect to the shapes of maxillary incisors. Dental professionals should take the individual variability in patient response into consideration during treatment planning, to produce an aesthetic outcome that is acceptable for the patient. Clinical significanceAs a general rule, the tapered-ovoid tooth form is perceived to be more desirable than the square tooth form. The dental team should therefore keep this finding in mind and liaise with the patients accordingly, in order to help to produce desirable aesthetic clinical outcomes.

Oral health awareness amongst the medical student of Telengana, India

Background: Attractive smile is a sign of good health. Oral health plays an important role in individuals overall health. Majority of systemic diseases have oral manifestations.Methods: The cross sectional study was carried out amongst the medical students of an Medical college by using WHO ORAL SURVEY for adults, with aims and objectives of estimating the prevalence and severity of oral health problem in the study population, understand and analysis various determinants of diseases of oral cavity and to create awareness on oral health.Results: Out of the 250 repondents, 40% of respondent said, the condition of tooth is very good, which is a sign of good oral hygiene. 13% of the participant said they have never visited a dentist.23%of the participants said; they visited the dentist in last 6-12 months. 32% felt it is necessary to visit dentist regularly.Conclusions: Oral diseases have a significant impact on the quality of life of individuals, their participation in society and economic productivity as well as on health systems, making oral diseases a significant public health concern. Pain and discomfort from cavities, can affect the ability of an individual to chew and to obtain adequate nutrition, which, in turn, affects the immune response and the ability to fight disease.

A Study to evaluate Some of the Esthetic Factors determining Attractive Smile

ABSTRACTAimThe objective of the study is to evaluate some of the esthetic factors which will determine an attractive smile.Materials and methodsThis study was conducted with 214 students, between the age of 18 and 25 years, from Dharwad SDM College of Dental Sciences with natural dentition and who fulfilled the required criteria; the frontal photograph was taken of each individuals with smile displaying upper anterior teeth as well as gingiva. Each student's smile was compared, analyzed, and evaluated. Differences between smile types were determined statistically with Z-proportionality test.ResultsFive elements of smile were analyzed. The difference in smile type between men and women was statistically significant. Average smile was the most common with 48.13%, followed by high smile of 37.38%, and low smile was the least common with 14.49%. The downward curvature was the most common with 48.60% followed by straight curvature 42.88% and the lowest common was upward curvature with 8.88%. Straight curvature was the most common followed by parallel curvature and reverse curvature. Totally, 64.95% students showed lower lip touch of the maxillary teeth, and 22.43% showed lower lip not touching the teeth. And, 12.62% showed lower lip slightly covering teeth; 64.95% displayed till 2nd premolar; 32.24% displayed till the first molar; and 2.8% displayed till canine.ConclusionThe average smile was the most common with downward curvature, straight maxillary incisal curve with the lower lip, maxillary anterior teeth not touching the lower lip, and a number of teeth displayed till the second premolar. Smile analysis must be assessed in association with the face in order to define esthetic rehabilitation of smile. It will give guidelines for restoration of esthetics in anterior.How to cite this articleMeshramkar RD, Agarwal R, Pillai LK, Nadiger RK. A Study to evaluate Some of the Esthetic Factors determining Attractive Smile. Int J Prosthodont Restor Dent 2016;6(2):31-36.

Rejuvenating Smile with All-ceramic Crowns

ABSTRACTSmile enhancement for a patient instills self-confidence by rendering an attractive smile. All-ceramic restorations have the potential to replicate the natural esthetics close to natural dentition, i.e., lacking in metal ceramic restorations. A young female patient unhappy with her smile was rehabilitated with all-ceramic restorations; thereby, the beauty of an individual within the functional and physiological functions could be restored. The final outcome with regard to esthetics and function was found to be good.How to cite this articleGandhi KN, Ram SM, Shah NP. Rejuvenating Smile with All-ceramic Crowns. J Contemp Dent 2016;6(1):80-84.

Comparison of efficacy of depigmentation of gingiva in terms of ImageJ intensity values and surface area of repigmentation using scalpel and diode laser

Background: For an attractive smile, health and color of the gingiva are essential components. Hyperpigmented gingiva is considered unaesthetic and unsightly by many, and there is an increasing demand for depigmentation of gingiva from patients. Many techniques are available for gingival depigmentation. Aims and Objectives: To compare the effectiveness of scalpel and laser techniques for depigmentation in terms of patient comfort using visual analog scale (VAS) for pain, changes in ImageJ intensity values of gingival pigmentation, and to compare the frequency and area of repigmentation postoperatively between two groups up to a period of 3 months using Adobe Photoshop. sMaterials and Methods: The study was conducted in the Department of Periodontics, Indira Gandhi Institute of Dental Sciences. Fifty individuals, aged between 18 and 30 years, with an esthetic complaint of hyperpigmented gingiva were enrolled in the study. The study comprised two groups of 25 individuals each. One group was taken up for scalpel method of depigmentation and the other for laser depigmentation. Results: The difference between the mean pain scores of scalpel and laser group on day 1, day 4, and day 7 were recorded, with a P value of 0.123, 0.000, and 0.037, respectively. The difference in intensity values between baseline and 90 days for both scalpel and laser groups was highly significant, with a P value of 0.000. When surface area of repigmentation was compared between two groups, scalpel group (557.20 mm2) of patients had less repigmentation than laser group (737.08 mm2). Conclusion: The patient apprehension for anesthetic infiltration, bleeding during the procedures, and VAS scores for pain were less in laser group as compared to scalpel group. Efficiency of depigmentation and frequency of recurrence of gingival pigmentation were similar in both the groups. However, in terms of patient's comfort, laser appeared to have a significant advantage over scalpel.

Modern management of dental decay in children and adolescents - a review.

Health is a right that requires responsible individual actions. Oral health corresponds to an important part of general health, even if for a large majority of people healthy teeth are equal with beautiful teeth. For children and adolescents „having an attractive smile” is synonymous with social acceptance and success. Dental decay has a high incidence in children in our country and progress in decay prevention, diagnosis and treatment is not reflected in children and adolescents’ oral health. It is established by studies conducted by dentists and psychologists that dental decay can affect the quality of life by engendering specific eating behaviors, particular ways of speech or smile and unfortunately pain.The aim of this article is to emphasize the modern approach of dental decay in line with principles of non-invasive strategies. An important element to be considered - prophylactic methods - must be included in every treatment plan, in order to control individual caries risk. The time invested in prevention during childhood represents a real benefit for the future adult’s oral health. Many a dental problems can be avoided if dental decay management relies on the link between medical science and every day practice.

English

: The focus of this study was to test the hypothesis that the amount of buccal corridor associated with dolicofacial, mesofacial and brachyfacial facial patterns has no influence on smile evaluations by laypersons of different age groups. A photograph was constructed of a woman displaying a broad smile. Buccal corridors were modified digitally in increments of 5% and 10%, displaying from 0% to 30% buccal corridor compared with the inner commissural width. Using a visual analog scale(VAS), 150 laypersons divided into 3 groups(n=50) of age-ranges from 15-19, 35-44 and 65-74 years of age rated the attractiveness of five smiles with altered buccal corridors. Differences in the median esthetic scores were analyzed using the Kruskal-Wallis test ( P 0.05). There was significant difference between the groups from 15-19 and 65-74 years of age in evaluating the attractiveness of the smile with the size of the buccal corridor at 20% and 30% for the short( P =0.045, and P =0.035) and long ( P =0.029, and P =0.038) facial types, respectively. The hypothesis was rejected. Laypersons over the age of 65 years attributed higher scores. Irrespective of age, laypersons preferred broader smiles with a smaller buccal corridor, with 15% being the limit between the most and least attractive smile.

The perception of smile attractiveness among Saudi population.

Parameters of dental beauty change across time for varying reasons. Thus, an understanding of the factors that help or harm the attractiveness of a smile is an important step in creating attractive smiles. This study aimed to identify factors that affect smile perception and attractiveness among the Saudi population. A cross-sectional study was conducted among the Saudi population. Questionnaires were distributed to 130 dentists and final-year dental students, and to 130 laypersons. The questionnaire contained six smile photographs created by Photoshop® software. There was a statistically significant difference in scale ratings, based on participant background, for the “gummy” smile picture (P-value =0.003), diastema picture (P-value =0.000) and the “Reverse” smile picture (P-value =0.004). As for sex, males significantly underscored the gummy picture (P-value =0.009). Older people accepted the gummy smile less than did younger people, but diastema was considered as one of the variations that spoiled the attractiveness of the smile. “Dental background” participants significantly identified the ideal smile better than the “nondental” group. The perception of diastema as a sign of beauty among Saudi population in the past has definitely changed, according to the results of our study, where diastema and reverse smile received the lowest score in this survey.