Buccal Corridor Research Articles

Non-Surgical Modification of Buccal Corridor in Different Facial Types

Non-Surgical Modification of Buccal Corridor in Different Facial Types

Clinical audit of an artificial intelligence (AI) empowered smile simulation system: a prospective clinical trial

Smile aesthetics is an important factor to consider during orthodontic treatment planning. The aim of the present study is to assess the predictability of Invisalign SmileView for digital AI smile simulation in comparison to actual smile treatment outcomes, using various smile assessment parameters. A total of 24 adult subjects (12 females and 12 males; mean age 22 ± 5.2 years) who chose to be treated using Invisalign were prospectively recruited to have their pretreatment smiles captured using the Invisalign SmileView to simulate their new smiles before treatment was started. Patients were then treated using upper and lower Invisalign aligners with average treatment time of 18 ± 6 months. Full post-treatment records were obtained and full smile frame images of simulated smile and actual final smile of each subject were evaluated by an independent examiner using an objective assessment sheet. Ten smile variants were used to assess the characteristics of the full smile images. Significance level was set at P < 0.05. The ICC for the quantitative parameters showed that there was an overall excellent & good internal consistency (alpha value > 0.7 & > 0.9). The Independent t test was performed amongst the quantitative variables. The P value was not significant for all except maxillary inter canine width (P = 0.05), stating that for the five variables namely; philtrum height, commissure height, smile width, buccal corridor and smile index, actual mean values were similar to the simulation mean values. For the qualitative variables, the Kappa value ranged between 0.66 and − 0.75 which showed a substantial level of agreement between the examiners. Additionally, the Chi square test for the qualitative variables, revealed that the P value was found to be significant in all except lip line. This implies that only the lip line values are comparable. More optimal lip lines, straighter smile arcs and more ideal tooth display were achieved in actual post treatment results in comparison to the initially predicted smiles. Five quantitative smile assessment parameters i.e., philtrum height, commissure height, smile width, buccal corridor, and smile index, could be used as reliable predictors of smile simulation. Maxillary inter canine width cannot be considered to be a reliable parameter for smile simulation prediction. A single qualitative parameter, namely the lip line, can be used as a reliable predictor for smile simulation. Three qualitative parameters i.e., most posterior tooth display, smile arc, and amount of lower incisor exposure cannot be considered as reliable parameters for smile prediction.Trial Registration number and date: NCT06123585, (09/11/2023)

Assessment of mini-aesthetics in Class I malocclusion subjects who underwent orthodontic treatment with or without extraction of four premolars – A prospective study

Smile and facial attractiveness are strongly correlatedThis study aimed to assess the effect of extraction or non-extraction orthodontic treatment on mini-aesthetics in patients with Class I malocclusion by measurement of the smile variables.A total of 56 subjects were selected and grouped as Group 1- treated non-extraction, Group 2A-treated with extraction of first premolars and groups 2B- treated with extraction of second premolar teeth. Each subject was photographed with a posed smile and NHP using DSLR camera. The images were then imported into a computer software and the following smile parameters were assessed: gingival display, smile index, maxillary incisor display on smile and buccal corridor ratio.The mean measured maxillary incisor display was 1.39±0.34, 2.31±0.50 and 0.90±0.19mm in Group 1, Group 2A and Group 2B. The mean measured gingival display on smiling was 0.07±0.07, 0.38±0.65 and 0.07±0.15mm in Group 1, Group 2A and Group 2B. The mean measured smile index was 0.15±0.68, 1.20±0.22 and 0.95±0.41 in Group 1, Group 2A and Group 2B. The mean measured buccal corridor ratio was 0.83±0.39, 1.59±0.26 and 1.26±0.31 in Group 1, Group 2A and Group 2B. There was an increase in maxillary incisor display after fixed Orthodontic treatment in the non-extraction group and a decrease in first premolar extraction group while second premolar extraction group showed no changes. Smile index was increased post-treatment in first premolar and second premolar extraction group while non-extraction group showed no significant difference. Buccal corridor ratio decreased in first premolar and second premolar extraction groups while non-extraction group showed no changes.

An Appraisal of Age and Sex-related Changes in Selected Smile Parameters in North Indian Population

Objective To evaluate the changes in buccal corridor and smile index, with respect to age and gender, in a randomly selected sample of the North Indian population. Materials and Methods Perioral musculature of 195 subjects (divided into three age groups) was recorded using standardized videographic method. The frame representing subject’s “widest posed smile,” was selected and analyzed to evaluate selected smile parameters. Results Buccal corridor decreased significantly for overall as well as female sample population, whereas it was fairly unchanged for males. No significant variation was noted for smile index. Conclusions As a person ages, the smile gets narrower vertically as well as transversely, with the change being greater in the transverse dimension. Age-related changes must be considered for delivering long-lasting orthodontic results.

Successful completion of orthodontic therapy in a patient with osteopetrosis: Case Report.

Orthodontic therapy in patients with osteopetrosis (OP) of the jaws has typically been contraindicated owing to the presence of poorly perfused and extremely compact bone, and the potential risk for infection and osteomyelitis. As such, completed orthodontic cases in association with OP have rarely been published. A patient aged 14 years 6 months, with no known diagnosis of OP, sought orthodontic assessment for anterior crowding. The patient exhibited a straight facial profile and increased mandibular facial height, competent lips, shallow mentolabial sulcus with mild mentalis strain, flat/reverse smile arc and wide buccal corridors on smiling. The patient had a Class I incisor relationship on Class I skeletal bases with bilateral Class I molars and Class II canine relationships. This was complicated by a crossbite involving the lateral incisors and a Bolton discrepancy due to small maxillary lateral incisors. A radiologic assessment revealed polyostotic OP of the oromaxillofacial complex. Treatment consisted of maxillary and mandibular fixed orthodontic therapy, bite turbos and elastics to level and align the dentition. Extractions of permanent teeth were not needed. At the conclusion of treatment, there was a slight left Class II malocclusion, with incomplete intercuspation on the left side due to tooth size discrepancy, possibly attributed to inadequate elastics compliance and the presence of osteopetrotic bone. The treatment was completed in 3 years, 1 year longer than anticipated. This report represents the second published account of a patient with OP successfully managed with comprehensive orthodontic care and without osseous complications. Obtaining cephalometric measurements on OP-affected patients may be imprecise owing to the presence of extremely dense bone and difficulty to identify bony landmarks. To reduce osteopetrotic sequelae, attending clinicians should consider reduced exertional orthodontic forces and closely monitor patients for adverse alveolar events.

Dental Aesthetic Perception of Dentistry Students: A Literature Review

The appearance of a smile has increasingly become a factor that significantly impacts an individual's self-esteem and social context. Consequently, there is a growing desire for changes in the oral region to achieve what is considered an ideal smile, particularly in light of new beauty standards, where white and aligned teeth are deemed highly relevant. However, the concept of beauty is highly subjective, and sometimes dental standards do not align with patients' aesthetic desires. This study aims to evaluate the dental aesthetic perception of dentistry students through an integrative review. For the reference framework, we searched articles from the PubMed and Lilacs databases from the past five years, using the keywords "Dental esthetic," "dental student," and "Smiling," with the Boolean operator "and." After a thorough reading of all the articles, nine studies were selected. This review showed that the level of education and gender presented differences in the perception of dental aesthetics. However, students generally agree that aesthetics must be associated with the health and naturalness of the smile, following dental anatomy, dental alignment, buccal corridor, level of gingival exposure, and color.

Indonesian orthodontists and laypeople’s perception of the four components of smile analysis in individuals with various vertical skeletal patterns

Objectives: The objective of this study was to analyze the difference towards orthodontists’ and laypeople’s perceptions of four smile analysis components in individuals with various vertical skeletal patterns. Material and Methods: Each of the 100 orthodontists, and laypeople aged 26–65 years old were asked to complete an online questionnaire about four smile analysis components in individuals with various vertical skeletal patterns. The questionnaire consists of 36 modified photos according to various smile curves, buccal corridors, gingival displays, and incisor displays in normal, hypodivergent, and hyperdivergent skeletal patterns. Perceptions were assessed using a visual analog scale. Results: Significant differences were found in straight and parallel smile curve, maximum buccal corridor, and gingival display 4 mm components in all vertical skeletal patterns. Additionally, differences were also found in the medium buccal corridor in hypodivergent skeletal pattern, gingival display 2 mm in normal and hypodivergent skeletal patterns. Moreover, significant differences were also observed in the 100% incisor display in normal vertical skeletal pattern, and 50% incisor display in hyperdivergent skeletal pattern Conclusion: Orthodontists and laypeople have similar perceptions toward the most esthetic components (parallel smile curve, minimum buccal corridor, gingival display 0 mm, and incisor display 75%) in all vertical skeletal patterns.

A Comparative Analysis of Arch Widths in Class I and Class II Malocclusion: Extraction vs. Non-extraction Treatment.

This study aimed to assess and compare dental arch widths in the anterior and posterior regions among patients undergoing extraction and non-extraction treatments for Class I and Class II malocclusions. A total of 40 patients were selected, with 10 in each of the categorized groups based on malocclusion type and treatment status. Dental arch widths were meticulously measured using a digital Vernier caliper at the canine and molar regions to ensure precise data collection. Statistically significant differences were noted when comparing mean inter-canine and molar widths between pre- and post-treatment periods among extraction cases in Class I malocclusion (p < 0.001). Conversely, there were no significant changes observed in arch widths among non-extraction cases in Class I malocclusion. Similarly, significant changes were observed in both extraction and non-extraction cases of Class II malocclusion when comparing mean inter-canine and molar widths between pre- and post-treatment periods (p < 0.05). After treatment, both Class I and Class II extraction cases showed an increase in inter-canine arch width, while intermolar arch width remained unchanged, suggesting that the treatment did not significantly alter the buccal corridor. Additionally, there were no notable changes in inter-canine arch widths between pre- and post-treatment in Class I non-extraction cases. However, the Class II non-extraction group exhibited increased upper and lower inter-canine arch widths after treatment.

Laypersons’ perception of smile esthetics from different backgrounds

Background: Smile esthetics can be subjective. This study aims to assess the effect of culture/geographic location on judging smile esthetics by comparing the perception of smile characteristics between American laypersons (Western culture) and Iranians (Eastern). Materials and Methods: One hundred residents from each country were recruited for this analytical cross-sectional study. A frontal picture of a posed smile with standard norms which are mentioned in the Contemporary Orthodontics textbook by William R. Proffit was selected. Adobe Photoshop 7 was used to alter midline diastema, gingival display (GD), maxillary midline-to-face discrepancy, buccal corridor (BC), and smile arc. Images were given to groups to determine the most attractive and acceptable smile. Data were analyzed by Chi-square, Mann–Whitney, and Spearman correlation coefficient in SPSS-22 (α =0.05). Results: Americans were less critical in judging diastema (P &lt; 0.001), GD (P = 0.013), and BC (P = 0.004) for smile attractiveness than Iranians. No difference was between the two groups in choosing the acceptability threshold and determining the most attractive smile except for BC (P = 0.002). Conclusion: Overall, Americans were more tolerant of variations in smile characteristics than Iranians. Both groups agreed on most smiles. Therefore, it seems that it is reasonable to use similar standards for smile characteristics while considering the small differences.

Attractive combinations of female gingival displays, buccal corridor sizes, and facial heights according to orthodontists, dentists, and laypeople of different ages and sexes: a psychometric study

IntroductionEsthetics plays a crucial role in orthodontics and many other dental and medical fields. To date, no study has assessed the combined effects of the 3 facial features ‘facial height, gingival display (GD), and buccal corridor size (BC)’ on facial/smile beauty. Therefore, this study was conducted for the first time.MethodsIn this psychometric diagnostic study, beauty of 27 randomized perceptometric images of a female model with variations in facial heights (short, normal, long), gingival displays (0, 2, 4, 6 mm), and buccal corridor sizes (2%, 10%, 15%, 20%, 25%) were evaluated by 108 judges (36 orthodontists, 36 dentists, 36 laypeople) using a 5-scale Likert scale (1 to 5). Combined effects of facial heights, GDs, BCs, judges’ sexes, ages, and jobs, and their 2-way interactions were tested using a mixed-model multiple linear regression and a Bonferroni test. Zones of ideal features were determined for all judges and also for each group using repeated-measures ANOVAs and the Bonferroni test (α=0.05).ResultsJudges’ sex but not their age or expertise might affect their perception of female beauty: men gave higher scores. The normal face was perceived as more beautiful than the long face (the short face being the least attractive). Zero GD was the most attractive followed by 4 mm; 6 mm was the least appealing. BCs of 15% followed by 10% were the most attractive ones, while 25% BC was the worst. The zone of ideal anatomy was: long face + 0mm GD + 15% BC; normal face + 2mm GD + 15% BC; long face + 2mm GD + 15% BC; normal face + 0mm GD + 15% BC.ConclusionsNormal faces, zero GDs, and 15% BCs may be the most appealing. Facial heights affect the perception of beauty towards GDs but not BCs.

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.

Buccal corridor and gummy smile treatment with MARPE and gingivoplasty: A 2-year follow-up case report

The advent of Mini-screws assisted rapid palatal expansion (MARPE) has introduced a simpler in-office procedure that enables the translation of the alveolar process in adults. This case report showed the combination of MARPE, orthodontic treatment, and gingivoplasty to correct malocclusion and enhance smile aesthetics. A 20-year-old woman expressed concerns about excessive buccal corridors and a gummy smile. She exhibited skeletal class I malocclusion, with buccal corridors exceeding 4 mm, a gummy smile, and lingual tipping of the lower posterior segments. The treatment plan involved utilizing the MARPE appliance, a Nitinol wire, gingivoplasty to address the gummy smile. Retention evaluations demonstrated the stability of MARPE in transversal skeletal discrepancies. There was notable improvement in incisor inclination and soft tissue profile, particularly evident in the E-line and nasolabial angle. Cephalometric analysis confirmed these changes, showing a decrease of 5.9 degrees in the inclination of the maxillary incisors. After a 2-year follow-up, the results remain stable, and the patient expresses satisfaction with the outcome. MARPE can be considered as an effective tool for managing buccal corridors, complemented by fixed orthodontic treatment employing labial appliances and gingivoplasty to correct malocclusion and enhance smile aesthetics. The treatment showed positive long-term outcomes.

An evaluation and comparison of smile characteristics of female adults in high angle, medium angle and low angle skeletal types – An observational study

To evaluate and compare the smile characteristics of female adults in high angle, medium angle and low angle skeletal types. Frontal photograph at posed smile of 45 adult females were taken with the help of Canon 1500D camera. These photographs were standardized and uploaded on to the Medit Link software. Various smile characteristics like upper lip length, upper lip thickness, lower facial height, lower lip thickness, lower lip length, chin height, incisor display, buccal corridors, gingival display and smile width were measured. Descriptive statistics were carried out for the data and ANOVA test was done for comparison among the types. P-value more than 0.05 was taken to be significant. It was seen significant for gingival display and chin height in high angle types. The mean for gingival display was 2.26 mm in high angle types (P=0.000531). The mean for chin height was 34.84 mm in high angle types (P=0.016198). Smile width also showed significant results in low angles types. The mean for smile width was 63.88 mm in low angle types. The significant differences were seen to be in gingival display and chin height in high mandibular females, showing longer chin and more gingival display. In low mandibular angle females, it was seen that they have a broader smile. No significant angle wise differences were seen in other parameters.

Analysis of Different Vertical and Horizontal Smile Characteristics

BACKGROUND: Improving smile aesthetics is the main reason patients seek different treatments. AIM: This study aimed to evaluate some of the smile characteristics in patients with completed orthodontic treatment and patients with different types of dentoalveolar malocclusion using the method of photogrammetric analysis. MATERIALS AND METHODS: The sample consisted of 52 young adults aged 16–35 years. A standardized smile analysis was used to evaluate ten smile characteristics. Two frontal digital photographs were taken for each individual, one at rest and the other with a posed smile. RESULTS: A student’s t-test was used to evaluate the differences between the mean values of the smile characteristics of each type of malocclusion in untreated and treated patients. Comparing the characteristics of the smile in the study groups of treated and untreated patients with a subgroup of Class I and Class III malocclusion, no significant difference was observed in the mean values of the studied parameters. A statistically significant difference was observed only in the mean values of upper incisor exposure and left buccal corridor between untreated and treated patients with class II malocclusion. CONCLUSION: Knowledge of the correlation between hard and soft-tissue anatomy and smile esthetics has important clinical significance; therefore, the components of the smile should be considered as a guide to assist in orthodontic diagnosis and treatment planning.

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.

A Comparative Analysis of the Effect of Individualistic, Unique Hard- and Soft-tissue Parameters of the Face on Buccal Corridors in Adolescents and Adults with Angle’s Class I and Angle’s Class II Division 1 Malocclusion

Background and Objectives: This study was designed to determine the relationship between the parameters: buccal corridor, buccal corridor linear ratio (BCLR), upper intercanine width, intermolar width, and premolar basal arch width on a posed smile in adolescents and adults. The buccal corridor affects smile esthetics; hence, it is important to see its correlation with intercanine width. In addition, the study aimed to determine if the buccal corridor changes adversely in Class I and Class II Division 1 malocclusion patients and during growth. Materials and Methods: Posed smile and standard full-front face photographs of 150 patients were taken. Group A consisted of 50 adolescent patients between the ages of 11 and 14 years, divided equally based on malocclusion type. Group B consisted of 100 young adults between the ages of 18 and 25 years, divided equally into Class I and Class II Division 1 malocclusion. The parameters calibrated in the photographs were: upper intercanine distance, intercanthal distance, intercommisure width, difference between intercanthal and intercommisure width, distance between the last visible teeth in the maxilla, and BCLR. Results: The results of this study were analyzed using one-way ANOVA and Chi-square tests. The analysis showed a significant correlation between BCLR, intercanine width, distance from the last visible teeth, intercanthal distance, and intercommisure width, and their difference varied significantly among males and females, with P &lt; 0.05. Conclusion: This study concluded that the buccal corridor and intercanine width vary with age and gender. The buccal corridor is usually wider in young adults than in adolescent children.

Changes in the arch width and buccal corridor after fixed orthodontic treatment with Damon self-ligating system: premolar extraction vs. non-extraction.

Extraction vs. non-extraction is a crucial decision in orthodontic therapy. The aim of the present study was to investigate the changes in the dental arch width and buccal corridor after orthodontic treatment using extraction and non-extraction therapy with Damon self-ligating system. This retrospective study consisted of 35 patients (20 female and 15 male patients with median age of 12.5 years), treated by extracting 4 or 2 premolars, and 37 patients (16 female and 21 male patients with the median age of 12.8 years), treated without premolar extraction. Both groups were treated with Damon self-ligating system. Plaster models before (T0) and after (T1) treatment were measured, and the arch width values were determined at the level of the first molars, second premolars, canines and palatal rugae. Buccal corridor width was measured using the extraoral images at T0 and T1. Paired t-test was used for the analysis of the normally distributed data, and Wilcoxon Mann-Whitney U test was used for the data with non-normal distribution. Values of p<0.05 were set as statistically significant. The upper intercanine width increased significantly in both groups (p<0.01). In the non-extraction group, the arch width increased significantly in the maxillary second premolar and first molar region (p<0.01) as well as in the region of the canines (p=0.04), second premolars (p=0.01) and first molars (p<0.01) of the mandible. The buccal corridor decreased significantly in the non-extraction group (p<0.01). Premolar extraction in combination with Damon self-ligating system did not lead to reduction of the dental arch width in the maxilla, nor did it increase the size of the buccal corridors.

Smile esthetic

Most patients require orthodontic treatment to improve the esthetics of their smile. Orthodontists must consider how some parameters of mini-esthetics can influence the patient’s esthetic perception. Methods: A photograph of the smile of a young female was taken and some modifications were made to the buccal corridor, gingival exposure, smile arc and midline position to assess the influence of these variables on smile attractiveness. Two hundred examiners were selected from four groups: orthodontists (O), dental students (DS), orthodontic patients (OP) and surgical-orthodontic patients (SOP). Each examiner was asked to complete the questionnaire with an approval rating from 1 to 10. Significant level was set at P ≤ 0.05. Results: Only orthodontists considered buccal corridors of 4mm and midline deviation of 1mm as non-esthetic; all other examiners considered gingival exposures ≥3 mm and midline angulation as non-esthetic. All examiners assigned higher satisfaction values to the photo with the concordant smile arc and defined as non-esthetic the covered smile and the reverse smile arc. Patients perceived as non-esthetic only midline deviations of 4mm. The surgical orthodontic patients assigned lower values to the photos and showed greater attention to evaluating the esthetics of the smile than the orthodontic patients. Conclusion: Smile arc, gingival exposure and midline angulation influence smile esthetics; the role of buccal corridors and midline deviation is dependent on the type of examiner.

Effect of Clark’s twin block appliance and upper premolar extraction treatment modality on smile aesthetics in skeletal class II malocclusion: a retrospective cross-sectional study

ABSTRACT Introduction Treatment undertaken during growth has various advantages over camouflage treatment including an improved profile and treatment stability. The objective of this study was to compare pre- and post-treatment smile variables in class II malocclusion population treated via functional appliance or upper first premolar extraction. Materials and methods A cross-sectional study was conducted at a tertiary care hospital that included frontal closeup smile (FCS) pictures of 40 patients treated with Clark’s twin block (CTB) appliance and upper premolar extraction (UPE). Smile ratios were calculated, and improvement in smile aesthetics were scored on a visual analogue scale (VAS) by a panel of raters of laypersons, general dentists and orthodontists with 20 subjects in each panel. Friedman and Wilcoxon signed rank tests were used to determine differences between pre-, mid- and post-treatment smile variables. Independent t-test was used to measure differences in improvement of smile aesthetic scores, while simple and multiple linear regression analyses were used to determine any associations between smile aesthetic scores and variables. Results CTB group showed highly statistically significant differences for smile index (SIR), interlabial gap ratio (IGR), visible dentition width ratio (VDWR), archform ratio (AFR), mandibular incisal show ratio (MnIR) and smile arc ratio (SAR). On comparison of post-treatment smile variables between the two treatment groups, statistically significant differences were observed for buccal corridor ratio (BCR) (p = 0.01) and AFR ratios. Conclusions Higher smile improvement scores were seen with CTB treatment with orthodontists rating it higher than UPE. Improvement in maxillary incisal ratio causes an increase in smile aesthetic scores.

The Psychological Effects of a Perfect Smile on Adults: A Survey

Purpose: To investigate the psychological impact of dental aesthetics, specifically the effect of a perfect smile, on adults.&#x0D; Methodology: A random cross-sectional research was conducted on 200 adult patients who attended the dentistry facilities at Riyadh Elm University. To determine patient satisfaction with their overall dental look, an online questionnaire will be used. This cross-sectional research included REU patients and dentistry students. Adults over the age of 18 were all included in the study.&#x0D; Findings: On visible teeth numbers majority selected the second option, on the buccal corridor was option 2 and 3 equally, on smile lip line was first while on lower lip touching again was 2 and 3r equally. The majority of them never had any problem because of mouth or teeth in word pronunciations, in the sense of taste. However, the majority have painful aching in the mouth occasionally. The majority of participants never felt embarrassed and irritable because of any teeth problem. The majority of participants never had difficulty in their usual job doing, less satisfy and unable to function because of any teeth problem.&#x0D; Unique Contribution to Theory, Policy and Practice: The paper provides unique insights into the psychological impact of a perfect smile on adults, highlighting its role in enhancing self-esteem and quality of life. It suggests that aesthetic dentistry is not just about physical health but also mental well-being. These findings can guide policy development and practice in dentistry, emphasizing holistic patient care.