Buccal Corridor Space Research Articles

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.

The buccal corridor as a possible morphological risk indicator for sleep disordered breathing.

To explore a possible morphological relationship between buccal corridor, gingival display, transpalatal molar width, palatal height, and a cephalometric measurement (PV-A Line) as a risk indicator for sleep-disordered breathing. Thirty subjects were enrolled. Full face maximum smile images and CBCT scans were taken. A Pearson correlation coefficient was used to identify any relationships between the variables. No correlations were identified between any of the variables investigated in this study as they relate to risk factors for sleep-disordered breathing. The amount of buccal corridor space in relation to a patient's smile and the amount of gingival display does not appear to be a reliable metric in identifying certain morphological risk factors for sleep-disordered breathing. Assessing the amount of buccal corridor space in relation to a smile does not appear to be a reliable predictor of morphological risk for certain risk factors of sleep-disordered breathing. In addition, utilizing the amount of gingival display in a patient's maximum smile does not appear to relate directly to risks in sleep-disordered breathing. Other tests and discovery may be necessary to identify these types of patients.

Perception of smile attractiveness among laypeople and orthodontists regarding the buccal corridor space, as it is defined by the eyes. An innovated technique.

To investigate whether there is a relationship between the distance between the iris and pupil with the ideal size of buccal corridors. A full-portrait image of a male Caucasian was used to create a set of 11 digitally modified images with different buccal corridor space. A web-based cross-sectional study was designed and distributed via an online survey to 200 laypeople and 200 orthodontists to assess image attractiveness, using a Visual analogue scale. For the statistical analysis, Wilcoxon signed-rank and Mann-Whitney U tests were used. The significance level was set at p < 0.05. The response rate for laypeople was 70% (n=139), while the rate for orthodontists was 73% (n=146). For the layperson group, the maximum smile attractiveness score was 10% of buccal width reduction, compared to the iris-pupillary distance, while for the orthodontists, it was 20%. The attractiveness of the smile was significantly reduced in both groups when the buccal corridor width was increased in comparison to the iris-pupillary distance. The length between the mesial part of the iris and the distal of the pupil, may constitutes a landmark for the estimation of the desired width of the buccal corridor. Inter iris-pupillary distance can be the starting point in the smile designing process, in order to perform a facial driven selection of buccal corridor size.

Perception of Smile Attractiveness Associated with Buccal Corridor Space Among Orthodontists and Laypersons Visiting de’ Montmorency College of Dentistry in Lahore, Pakistan

OBJECTIVE: To determine the frequency based on the acceptance of absent, presence or excessive buccal corridor space that maybe required for a smile to be apprehended as attractive among orthodontists and laypersons visiting de' Montmorency College of Dentistry in Lahore, Pakistan. METHODOLOGY: A descriptive cross sectional design was conducted to assess the perception of smile attractiveness among orthodontists and laypersons visiting de' Montmorency College of Dentistry in Lahore, Pakistan from July 2019 to January 2020. Both male and female participants with age ranging between 25 - 50 years were included in the study. Each participant was shown 6 digitally altered images of a female patient after which they were asked to rate whether the portrayed smile among the images was acceptable or not. All the collected information was entered and analyzed using the SPSS version 20.0 software. RESULTS: A combined total of 220 participants (110 Orthodontist and 110 Laypersons) who met the inclusion and exclusion criteria were registered in this study. Among the orthodontists the mean age was 28.58±5.96 years and for the layperson was 23.38 ± 2.96 years. The mean total score for orthodontists was 33.28±7.08 and for layperson was 33.50±7.29. A statistically insignificant difference was found between the two study groups when stratified according to gender, however a significant difference was seen upon stratifying on acceptance of smile i.e. p-value = &lt; 0.005 CONCLUSION: Both orthodontists and layperson do perceive that the buccal corridor space does have an impact on smile attractiveness and its acceptance. KEYWORDS: Esthetics, Dental*, Orthodontists, Perception, Smiling

Perception and Characterization of Posed Smile: A Photographic Study

Aims of the Study:The aims of the study are: (a) to compare the perceptions of dental specialists and laypeople regarding smile esthetics; (b) to compare male and female smile parameters; (c) to find influence of smile parameters on esthetics of smile.Materials and Methods:The study was conducted on 60 subjects (30 males and 30 females) of age 18 to 25 years. Frontal posed photographs of all subjects were taken using a digital camera and rated on a visual analog scale by 10 dental specialists and 10 laypersons. Measurements made on photographs were used to analyze various parameters of smile, such as buccal corridor space, smile arc, modified smile index, anterior height of smile, most posterior maxillary tooth visible, and midline relationship of central incisors to philtrum.Results:Visual analog scale values showed that 6 photographs were rated as very good (3 males, 3 females), 29 as good (11 males, 18 females), 21 as average (13 males, 8 females), and 4 photographs were rated as bad (3 males, 1 female). A high correlation was observed between ratings of dental specialists and layperson’s ratings for both male and female smiles. Most of the subjects had non-consonant smile arc, and a high correlation was found between buccal corridor space on right and left sides in both males and females. Most of the male and female smiles had an average anterior height of smile; permanent maxillary first molar was the last tooth visible during smile (73.3% females, 66.7 males); and 55% subjects had coincident midline relationship of central incisors to philtrum.Conclusion:There was no significant difference in perception of dental specialists and laypersons regarding esthetics of smile. Smile arc and anterior height of smile influenced the esthetics of smile. No significant difference was found between male and female smile parameters except modified smile index.

Effect of class II extractions and functional appliance treatment on smile esthetics.

Class II malocclusion is routinely observed in orthodontics. Its treatment usually revolves around the growth modification or the extractions of the teeth. Identifying treatment that leads to the greatest improvement can aid clinicians in providing the desired smile esthetics. The aim of the study was to compare smile esthetics between treatment groups by measuring various smile variables and the esthetic perceptions of 3 panels of raters. A cross-sectional study was performed on 66 patients equally divided into the functional appliance (FA) and upper first premolar extraction (UPE) groups. Eight smile variables were measured on post-treatment photographs using the Adobe Photoshop® software. Ten orthodontic residents, general dentists and laypersons performed the subjective evaluations of smiles using the visual analog scale (VAS). The Mann-Whitney U-test was applied to compare smile variables between the groups. The Kruskal-Wallis test was used to compare esthetic scores (ES) among the raters. The simple linear regression analysis, followed by the multiple linear regression analysis was applied to determine the smile variables associated with the ES values. Statistically significant differences were found between the FA and UPE groups for the buccal corridor ratio (BCR) (p = 0.046), the visible dentition width ratio (VDWR) (p = 0.019) and the arch form index (AFI) (p < 0.001). The Kruskal-Wallis test showed significant differences in ES among the raters for the FA (p < 0.001) and UPE (p = 0.004) groups. The simple linear regression analysis showed significant associations between ES and the patient's age (p = 0.002), BCR (p = 0.020) and VDWR (p = 0.006). The multiple linear regression analysis showed that age (p = 0.008) and VDWR (p = 0.021) were significantly associated with the ES values. The FA group had narrower buccal corridor spaces, a greater visible dentition width and a wider arch form in their smiles. The UPE group showed an increase in the buccal corridor width. Each panel rated the FA appliance group as superior.

Are buccal corridors and smile width relating to smile esthetics? - A Photometric Study

The present photometric study investigated the correlation of buccal corridor and smile width to an esthetic smile and the influence of the facial form on it. Standardized photographs of posed smile of 60 subjects in the age range of 17-25 years were taken. Among those 60 subjects, 3 groups were divided as 20 subjects each in leptoprosopic facial form, mesoprosopic facial form and euryprosopic facial form (according to morphological facial index given by Martin and Saller in 1957). Frontal smile photographs were taken and measurements of maximum smile width, right and left buccal corridor spaces were done according to methodology proposed by Johnson and Smith (1995) using software Corel DRAW X7. As separate evaluation done by orthodontists and lay persons and both of them presented with no differences of buccal corridor width and the total smile width in the esthetic smiles from comparing the percentage between the study groups. Remarkable finding was that the buccal corridor width and total smile width does not alter with the 3 types of facial form and broad faces have a tendency for broader buccal corridor and narrow faces have smaller buccal corridor.

Smile attractiveness of Persian women after orthodontic treatment

Achieving a balanced, attractive smile is an important goal in contemporary orthodontics. This study aimed to assess the smile attractiveness of Persian women after orthodontic treatment. In this descriptive-analytical study, frontal-view photographs were taken of posed smiles of 100 Persian women 3months after completion of their orthodontic treatment. A total of 153 laypeople aged over 15years were requested to score each smile in terms of attractiveness using a visual analogue scale (1-10). Next, 25 photographs that acquired the lowest score (group A) and 25 photographs that acquired the highest score (group B) were chosen and evaluated by 3 orthodontists regarding parameters related to an attractive smile. Data were analyzed using SPSS version18. The mean buccal corridor space in group A was significantly greater than that in group B (P=0.004). The correlation of lip line and study group was significant such that 60% of patients in group B had a moderate lip line (P=0.005). The difference in other parameters was not significant between the 2 groups (P>0.05). The buccal corridor space and lip line are important factors affecting smile attractiveness of Persian women. According to the opinion of the laypeople, smaller buccal corridor space and moderate lip line yield a more attractive smile. Thus, these parameters should be taken into account in the orthodontic treatment of Persian women.

Effect of buccal corridors on smile esthetics

Effect of buccal corridors on smile esthetics - IJODR- Print ISSN No: - 2581-9356 Online ISSN No:- 2581-9364 Article DOI No:- 10.18231/j.ijodr.2020.003, IP Indian Journal of Orthodontics and Dentofacial Research-IP Indian J Orthod Dentofacial Res

Smile Aesthetics among Late Adolescents: Perspective of Adolescents, General Dentists and Orthodontists

Introduction: An adolescent’s personal experiences, peer influences and social environment can affect their preference towards smile aesthetics and have influence apart from the opinion of their orthodontists. Aim: To evaluate and compare the preferences regarding smile arc, gingival display, midline symmetry, shape and size of incisor teeth, buccal corridor space and smile index of adolescent subjects between late adolescents, general dentists and orthodontists. Materials and Methods: A total of 52 orthodontists, 111 general dentists and 275 adolescents (156 females, 119 males) had participated in this cross-sectional study from 1st September 2019 to 31st January 2020. Each participant was shown a photo album consisting of 5 sets of photographs of male and female adolescent subjects and was asked to rate them on 7 selected variables. The data obtained was subjected to comparison between the groups using Chi-square test. Results: While assessing smile of the female subject, other than the incisal edge position, the intergroup comparisons of gingival display (p=0.0001), midline symmetry (p=0.0001), shape of incisor teeth (p-value=0.0001), buccal corridor space (p=0.001), ratio of central: lateral incisor (p=0.016) and smile index (p=0.0001) were statistically significant. While assessing smile of the male subject, the intergroup comparisons of incisal edge position (p=0.0001), gingival display (p=0.001), midline symmetry (p=0.007), shape of incisor teeth (p-value=0.0001), buccal corridor space (p=0.0001), ratio of central: lateral incisor (p=0.0001) and smile index (p=0.0001) were statistically significant. Orthodontists’ accepted gingival display of 0-2 mm, midline deviation up to 2 mm and buccal corridor space of upto 5 mm and upto 25% increase in smile index in both genders. Conclusion: The Orthodontists and dentists have more similarities than differences in comparison to adolescents with respect to the smile preferences of adolescent subjects.

Perception of Buccal Corridor Space on Smile Aesthetics among Specialty Dentist and Layperson.

Objectives:The aim of this study was to assess and compare the perception of smiles with and without buccal corridor spaces (BCSs) among prosthodontists, orthodontists and laypersons on smile aesthetics.Materials and Methods:Smiling photographs of subjects with wide BCSs were collected and digitally manipulated to eliminate the BCSs. Digitally altered and unaltered photographs were placed together and assessed for aesthetic appeal using visual analog scale of one to ten by prosthodontists, orthodontists, and laypersons. One-way analysis of variance (ANOVA) and two-way ANOVA were applied to evaluate the collected data using the Statistical Package for the Social Sciences (SPSS 22), Epi Info 6.0, and GraphPad Prism, version 6.0.Results:The total mean value scores of smiles with BCSs were significantly higher than those of smiles without BCSs (P < 0.001). Orthodontists and prosthodontists significantly appreciated BCSs and graded the smiles with BCSs to be much more attractive (P > 0.005). Laypersons rated the smiles with BCSs with greater mean values, but the difference in mean values of smiles with and without BCSs was not significant (P < 0.005). No significant difference was found between the perceptions of prosthodontists and orthodontists.Conclusion:The results of this study reveal that the smiles with BCSs were notably more desirable than the smiles without BCSs. Laypersons, orthodontists, and prosthodontists evaluated smiles differently. The smiles with BCSs were appraised much more pleasing by prosthodontists and orthodontists. Laypersons could not significantly appreciate BCSs, but rated smiles with BCSs as more acceptable.

Perception of general dentists and laypersons towards altered smile aesthetics.

OBJECTIVES:This study aimed to evaluate how dental practitioners and laypersons differ in their perception of altered smile aesthetics based on viewing images of a digitally manipulated smile.MATERIALS AND METHODS:A photograph with close to ideal smile characteristics was selected and digitally manipulated to create changes in buccal corridor space (BCS), midline diastema, gingival display, and midline shift. These altered images were rated by two groups: dental practitioners and lay persons using a visual analogue scale. The mean ± standard deviation (SD) of both groups were calculated and the Student's t-test was used to identify any statistically significant differences between the groups. Data analysis was done using the Statistical Package for Social Science (version 23.0; SPSS Inc., Chicago, Illinois, USA).RESULTS:The dentists were more sensitive to changes in the midline shift than laypeople and provided lower scores. There were no significant differences between the two groups when the gingival display alteration was ≤3 mm. However, for gingival display of 4 mm and 5 mm, there was significant difference between the two groups, with dentist rating them poorer as compared with the laypeople (P < 0.001). Dentists were more sensitive than the laypeople for midline diastema of 2 mm and 3 mm (P < 0.001 and P = 0.005 respectively). Changes in the BCS had minimal impact on the overall esthetic score for both the groups.CONCLUSIONS:Perception of smile esthetics differed between dentists and laypersons.

Comparison of the influence of dental and facial aesthetics in determining overall attractiveness

Orthodontic treatment aims at improving the perceived aesthetics; hence knowing which characteristics play a significant role in determining aesthetics is an important orthodontic objective. The aim of this study was to evaluate among laypersons, general dentists and orthodontists the importance of dental versus facial aesthetics. Frontal face smile photographs of eight volunteers (4 males & 4 females), age group ranging from 16 to 24 years were used for the study. One hundred and fifty evaluators (50-lay people, 50 general dentists and 50 orthodontists) were asked to select which face they found most attractive-an aesthetically pleasing face with a malocclusion evident in their smile or an average face with an aesthetic smile. A questionnaire method was followed. There was a statistical significant difference in the perception of the faces among the group of the evaluators. Crowding and midline diastema have more of an effect on the perception of attractiveness by laypersons than gumminess or increased buccal corridor space. Facial attractiveness is the dominating factor compared to dental aesthetics in cases where the malocclusion is less noticeable.

Smile attractiveness related to buccal corridor space in 3 different facial types: A perception of 3 ethnic groups of Malaysians

Statement of problemBuccal corridor space and its variations greatly influence smile attractiveness. Facial types are different for different ethnic populations, and so is smile attractiveness. The subjective perception of smile attractiveness of different populations may vary in regard to different buccal corridor spaces and facial patterns. PurposeThe purpose of this study was to determine esthetic perceptions of the Malaysian population regarding the width of buccal corridor spaces and their effect on smile esthetics in individuals with short, normal, and long faces. Material and methodsThe image of a smiling individual with a mesofacial face was modified to create 2 different facial types (brachyfacial and dolicofacial). Each face form was further modified into 5 different buccal corridors (2%, 10%, 15%, 22%, and 28%). The images were submitted to 3 different ethnic groups of evaluators (Chinese, Malay, Indian; 100 each), ranging between 17 and 21 years of age. A visual analog scale (50 mm in length) was used for assessment. The scores given to each image were compared with the Kruskal-Wallis test, and pairwise comparison was performed using the Mann-Whitney U test (α=.05). ResultsAll 3 groups of evaluators could distinguish gradations of dark spaces in the buccal corridor at 2%, 10%, and 28%. Statistically significant differences were observed among 3 groups of evaluators in esthetic perception when pairwise comparisons were performed. A 15% buccal corridor was found to score esthetically equally within 3 face types by all 3 groups of evaluators. The Indian population was more critical in evaluation than the Chinese or Malay populations. In a pairwise comparison, more significant differences were found between long and short faces and the normal face; the normal face was compared with long and short faces separately. ConclusionsThe width of the buccal corridor space influences smile attractiveness in different facial types. A medium buccal corridor (15%) is the esthetic characteristic preferred by all groups of evaluators in short, normal, and long face types.

Smile esthetics: Evaluation of long-term changes in the transverse dimension.

ObjectiveTo analyze the long-term changes in maxillary arch widths and buccal corridor ratios in orthodontic patients treated with and without premolar extractions.MethodsThe study included 53 patients who were divided into the extraction (n = 28) and nonextraction (n = 25) groups. These patients had complete orthodontic records from the pretreatment (T1), posttreatment (T2), and postretention (T3) periods. Their mean retention and postretention times were 4 years 2 months and 17 years 8 months, respectively. Dental models and smiling photographs from all three periods were digitized to compare the changes in three dental arch width measurements and three buccal corridor ratios over time between the extraction and nonextraction groups. Data were analyzed using analysis of variance tests. Post-hoc multiple comparisons were made using Bonferroni correction.ResultsSoft-tissue extension during smiling increased with age in both groups. The maximum dental width to smile width ratio (MDW/SW) also showed a favorable increase with treatment in both groups (p < 0.05), and remained virtually stable at T3 (p > 0.05). According to the MDW/SW ratio, the mean difference in the buccal corridor space of the two groups was 2.4 ± 0.2% at T3. Additionally, no significant group × time interaction was found for any of the buccal corridor ratios studied.ConclusionsPremolar extractions did not negatively affect transverse maxillary arch widths and buccal corridor ratios. The long-term outcome of orthodontic treatment was comparable between the study groups.

Influence of masseter muscle thickness on buccal corridor space and craniofacial morphology: A correlative study

Purpose: The present study was designed to evaluate the influence of masseter muscle thickness on buccal corridor space and underlying craniofacial morphology. Materials and Methods: Forty-six young adults (23 males and 23 females) in the age group of 18–23 years having intact dentitions and Class I molar relationship were included in the study. Masseter muscle thickness was measured using ultrasonography in relaxed, smiling, and contracted states. Posed smile photographs were taken to measure the buccal corridor space. Standardized frontal and lateral cephalograms were taken to determine craniofacial morphology in all three dimensions. Results: The mean masseter muscle thickness was 10.54 (±1.92) mm, 12.00 (±2.06) mm, and 14.04 (±1.99) mm in relaxed, smiling, and contracted states, respectively. Statistically significant correlation also was noted between masseter muscle thickness, during contracted state and buccal corridor width ratio. There was a strong association of masseter muscle thickness on both vertical as well as transverse craniofacial morphologies. Conclusions: Masseter muscle thickness is positively correlated with the buccal corridor width and influences both vertical as well as transverse facial dimensions.

An Evaluation Of The Attractiveness Of A Posed Smile With Computerised Variations Of The Smile Parameters

A study was conducted to evaluate the changes in the attractiveness and acceptance of a posed smile with computerised variations of the smile parameters and head types. Two adults, one male and one female were selected. Their posed smile photographs were taken, which were morphed into different images [by using Adobe Photoshop Version 7 and Adobe Photoshop CS2 soft wares] . The judges in our study were educated and uneducated males and females and dental professionals. Results of our study showed that, the smile parameter acceptable for a particular head type was more or less acceptable to the other head types. The overall acceptance of smile parameters showed that an acceptable smile should have minimum buccal corridor space, an upper lip that elevates till the marginal gingiva and a lower lip that is coincident with the upper incisaledges.

Perception of Smile Attractiveness by Laypeople–influence of Profession and Treatment Experience

Aims: To assess the influence of profession, treatment experience, age and gender on the perception of smile aesthetics with different buccal corridors and smile arcs, and to identify the threshold where bucca l corridor space becomes aesthetically displeasing. Study Design: A questionnaire-based descriptive study on the assessment of attractiveness ratings by laypeople. Place and Duration of Study:Amman/Jordan, University of Jordan Hospital; Faculty of Dentistry, Division of Orthodontics, from 2010 -2011. Methodology: A coloured photograph of a female smile was digitally modified to produce six smile images with buccal corridor spaces (BCSs) ranging from 0% to 25% and three smile images with altered smile arcs (consonant, flat and reverse). These images were shown to 104 laypeople who were asked to rate the attractiveness of each smile on a scale of one to ten. Analysis of variance was used to study the effect of age, gender, profession and treatment experience on smile attractiveness rating. A one -way ANOVA post hoc Duncan test was used to establish the threshold where BCS was considered unattractive. Results: The most attractive smile was the broadest and consonant smile (7.42 +/

Factors affecting buccal corridor space in Angle′s Class II Division 1 malocclusion

Background and Objectives: Buccal corridor space has been thought of primarily in terms of maxillary width, but there is also evidence that they are heavily influenced by the antero-posterior position of maxilla. The present study was undertaken with an aim of evaluating and comparing the dental and skeletal factors related to buccal corridor space in individuals having Class I and Class II Division 1 malocclusions. Materials and Methods: A total of 80 subjects of which 40 were males and 40 were females in the age group of 20-30 years were selected as per inclusion criteria and were grouped as Group I having Class I malocclusion and as Group II having Class II malocclusions based on angle ANB. 12 linear and 2 angular cephalometric measurements and 4 study cast measurements were used to correlate with the buccal corridor linear ratio (BCLR), calculated on smile photograph using the Adobe Photoshop 7.0 software (Adobe Systems Inc., San Jose, California, USA). The data obtained was statistically evaluated using independent t-test and multiple linear regression analysis. Result: Buccal corridor space is larger in individuals with Class II Division 1 malocclusion when compared with individuals with Class I malocclusions. There exists a significant difference in buccal corridor space between males and females. Conclusion: The present study helps in establishing the correlation between certain factors and the amount of buccal corridor space in individuals having skeletal Class II pattern.

Improvement in smile esthetics following orthodontic treatment: A retrospective study utilizing standardized smile analysis

To quantify smile esthetics following orthodontic treatment and determine whether these changes are correlated to the severity of the initial malocclusion. A standardized smile mesh analysis that evaluated nine lip-tooth characteristics was applied to two groups of successfully treated patients: group 1 (initial American Board of Orthodontics Discrepancy Index [DI] score<20) and group 2 (initial DI score>20). T-tests were used to detect significant differences between the low-DI and high-DI groups for baseline pretreatment measurements, baseline posttreatment measurements, and changes from pre- to posttreatment. A Spearman correlation test compared the initial DI values with the changes in the nine smile measurements. Five of the smile measurements were improved in both groups following orthodontic treatment. Both groups demonstrated improved incisor exposure, an improved gingival smile line, an increase in smile width, a decreased buccal corridor space, and an improvement in smile consonance. Spearman correlation tests showed that initial DI value was not correlated to changes in any of the individual smile measurements. Smile esthetics is improved by orthodontic treatment regardless of the initial severity of the malocclusion. In other words, patients with more complex orthodontic issues and their counterparts with minor malocclusions benefitted equally from treatment in terms of their smile esthetics.