Smile Esthetics Research Articles

Comparative Evaluation of Various Parameters of Spontaneous Smile Captured by Conventional Photographic Method, Video Clip Method, and Direct Biometric Method

Introduction: Facial and dental attractiveness can significantly impact one's life. As per Kiekens, smile esthetics contributed 25%–31% to facial attractiveness. Smile is one of the most effective means by which people convey their emotions. People have more positive acceptance and better behavior against attractive faces; this phenomenon is called “attractiveness halo”. The records needed for contemporary smile visualization and quantification can be static records (static photograph and/or lateral cephalogram), dynamic record (digital videography), and direct biometric/clinical measurements. Previous studies examining smile esthetics had used static photographs. Recently, a method of capturing and analyzing the smile using videography and computer software becomes need of an hour. Aim: Comparative evaluation of various parameters of spontaneous smile captured by conventional photography method (CPM), video clip method (VCM), and direct biometric method (DBM). Materials and Methods: The subjects were screened clinically and based on normal soft tissue profile angle in the profile photographs. Smile photographs of the subjects were obtained using conventional photography technique. VCM was used to capture spontaneous smiles of the subjects using the same camera. Finally, the parameters of the smile were directly measured on the subjects using Vernier calipers. Images were standardized and subjected to appropriate analyses to evaluate smile arc, buccal corridor, lower incisal display, upper gingival display, smile index, Morley's ratio, and smile line. Results: Measurements of smile arc, buccal corridor, lower incisal display, upper gingival display, smile index, Morley's ratio, and smile line on the photographs obtained from CPM showed statistically significant differences when compared to both VCM and DBM. Conclusion: As VCM is better able to capture and assess spontaneous smile when compared to CPM, it is the preferred method along with DBM as additional confirmation.

Evaluation of esthetic parameters of the face and components of smile in children with deciduous dentition

In the present era, esthetics has become an important dimension in dental practice as parents and children are equally self-conscious of their appearance. Children now desire to possess an aesthetically pleasing smile. Harmonizing an esthetic smile integrates facial and dental components. Since the scientific data on pediatric esthetics are limited, the aim of the study was to evaluate esthetic parameters of the face and components of smile in children with deciduous dentition.: After fulfilling inclusion criteria, 3 sets of facial photographs of 100 children were obtained, comprising of frontal at rest, frontal smile and profile at rest images under standardised photographic technique. Linear measurements of facial and dental parameters were assessed with the help of Adobe photoshop and static norms were obtained by taking the average value. Subjective evaluation was performed by a group of professionals using Q-sort technique to list the attractive features in children.Static norms were obtained for facial and dental parameters. Attractive children showed decreased facial height, anterior lower facial height, vermilion height and bigonial width. They also displayed decreased smile index and buccal corridor ratio along with parallel smile arc and more than 3/4th of crown height visibility during smiling. Attractive children presented facial and dental parameters variable from normative values. : The study results can be utilised during restorative and prosthetic rehabilitation among children to improve esthetics.

Prevalence of dental esthetic proportions and its correlation with Dentogenics in Maharashtrian population- A cross sectional study

Artistic and scientific principles play a vital role in esthetic smile designing. These principles can be established through data collected from patients, diagnostic models, dental research, scientific measurements and basic artistic concepts of beauty in nature. Various proportions have been identified by many authors and attempts have been made to apply those proportions in smile designing to improve the esthetic outcome of rehabilitation. This study aims to ascertain the most prevalent dental proportion existing in natural dentition based on photographic data, to be utilized in clinical application. 1. To investigate and compare the existence of Golden proportion, Recurring Esthetic Dental, Preston proportion and Golden Percentage in maxillary anterior teeth in dentate population using digital photographs and software analysis; 2. Correlation of the dental esthetic proportions with dentogenic concept.Fifty dentate individuals with full complement of maxillary anterior teeth were selected for the study. Digital photographs (frontal) were taken from a standardized distance. Mesiodistal width of individual tooth was taken at incisal contact with adjacent tooth and readings were tabulated. Ratio of adjacent teeth was calculated for evaluation of dental esthetic proportions. The width of each tooth was used to calculate the golden percentage and results obtained were subjected to statistical analysis.For Golden proportion, distribution of mean delta (difference between observed and reference data) for all parameters differs significantly from the reference standard (p-value<0.001 for all). For RED proportion, Preston proportion and Golden percentages,distribution of mean delta for the parameters did not differ significantly from the reference standard (p-value>0.05 for all). Mean overall absolute delta value for standards such as Golden percentage, RED proportion, Preston proportion and Golden proportion is 1.62, 7.42, 9.00 and 10.54 respectively. Distribution of mean overall delta for either ratios did not differ significantly across three demographic variables studied in the study group (p-value>0.05).Based on results, it was found that golden percentage was most prevalent for all age groups, irrespective of gender and difference in personality types. Other commonly occurring standards (in ascending order) based on delta value after Golden percentage are RED proportion, Preston proportion and Golden proportion respectively.

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

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

Smile makeover treatments.

The demand for aesthetic smile makeover treatments is increasing, especially with the rise in social media use. Historically, healthy tooth structure was sacrificed in order to achieve rapid results but this would invariably lead to compromise of the occlusion and a less-than-ideal result.Multi-disciplinary treatment planning, including the use of orthodontic treatment, is now routinely used in order to achieve optimal results. This paper aims to highlight the importance of a combined orthodontic-restorative planning process to allow a long-term aesthetic and functional result for our patients.

Reconstruction of Oronasal Fistula with Tongue Flap: A Cleft Palate Report.

Oronasal fistula can persist after conventional secondary alveolar bone graft surgery, which may lead to functional issues, such as regurgitation of fluids from the oral to the nasal cavity. This manuscript describes a clinical case of a patient with a bilateral cleft lip and palate that underwent tongue graft surgery for closure of an oronasal fistula after three failed local mucosa flap surgeries. The multidisciplinary treatment was comprised of orthodontic treatment, mucosa and alveolar grafts for palate closure and aesthetic rehabilitation of the anterior maxillary teeth. Smile aesthetics were noticeably improved, enhancing the patient’s self-perception and confidence.

Prevalence and influence of dental development anomalies in smile esthetics

Aim: To determine the prevalence of dental development anomalies and type of influence on the smile of adolescent students. Method: This was a cross-sectional and analytical study carried out in two public (A1) and two private (A2) schools chosen by lot in the city of Parnaíba-Piauí. The sample calculation was based on the target population: number of people enrolled in public and private schools between 15 and 19 years, in the city of Parnaíba-PI, which totaled 6209 students in 2020, according to a survey carried out by the Brazilian Institute of Geography and Statistics – IBGE. A questionnaire on epidemiological data and aesthetic self-perception of the smile was applied to 160 adolescents between 15 and 19 years old, from August 2020 to July 2021. The clinical examination was carried out under natural light, to check for the presence of anomaly(s) in the dental development. Students who presented only one pathology would be called group 1 (G1), those who presented two would be called group 2 (G2) and those who presented 3 or more would be called group 3 (G3). On the other hand, adolescents in whom no anomaly was evidenced would participate in the control group (CG), both in A1 and A2. Results: It was observed that 37.5% of the sample had only a type of dental anomaly, corresponding to 60 individuals. The most prevalent were enamel hypoplasia, fusion, transposition, agenesis, ectopic eruption, microdent and dens-in-dent. It was possible to verify a higher prevalence in the maxilla, private schools (76.6%) and females (86.6%). In 45% of adolescents with dental anomalies, embarrassment was observed when smiling. Conclusion: The prevalence was relatively high, highlighting the enamel hypoplasia, influencing the smile esthetics of a reasonable number of adolescents, whether for acquaintances, strangers or even for photographs.

Torque and vertical control of maxillary incisors for an esthetic smile using TSADs implanted in various areas: Biomechanical considerations

Esthetic smiles are an increasingly important focus of orthodontic treatment. Factors related to maxillary incisors, such as smile arc, maxillary gingival exposure, and maxillary crown torque, are related to esthetic smiles. It is very important to consider these factors during orthodontic treatment. However, with conventional orthodontic treatment using traditional anchorage, torque and vertical control of maxillary incisors, which are closely related to esthetic smile, were significant challenges, but with the introduction of temporary skeletal anchorage devices (TSADs), control of maxillary incisors has become easier to accomplish along with premolar extractions. Importantly, the various clinical applications and biomechanics of TSADs must be understood because of the variety of sites where the TSADs can be implanted. In general, the torque and vertical position of the maxillary incisors can be controlled by adjusting the line of action of force by changing the length of the lever arm and the vertical position of the TSADs. In this article, we classify TSADs for esthetic control of the maxillary incisors into anterior labial TSADs, posterior buccal TSADs, and palatal TSADs according to the implant sites, presenting various cases and discussing the biomechanics associated with them. Esthetic smiles are an increasingly important focus of orthodontic treatment. Factors related to maxillary incisors, such as smile arc, maxillary gingival exposure, and maxillary crown torque, are related to esthetic smiles. It is very important to consider these factors during orthodontic treatment. However, with conventional orthodontic treatment using traditional anchorage, torque and vertical control of maxillary incisors, which are closely related to esthetic smile, were significant challenges, but with the introduction of temporary skeletal anchorage devices (TSADs), control of maxillary incisors has become easier to accomplish along with premolar extractions. Importantly, the various clinical applications and biomechanics of TSADs must be understood because of the variety of sites where the TSADs can be implanted. In general, the torque and vertical position of the maxillary incisors can be controlled by adjusting the line of action of force by changing the length of the lever arm and the vertical position of the TSADs. In this article, we classify TSADs for esthetic control of the maxillary incisors into anterior labial TSADs, posterior buccal TSADs, and palatal TSADs according to the implant sites, presenting various cases and discussing the biomechanics associated with them.

The role of botulinum toxin A in the management of different types of excessive gingival display: a systematic review.

Background An aesthetic smile displays a symmetrical 2 mm or less of gingival tissue. A smile with over 3 mm of gingival display can be deemed socially unaesthetic, impacting on a patient's psychosocial status. This literature review aimed to explore the role of botulinum toxin A as a treatment modality for different types of excessive gingival display (EGD) and appropriate treatment protocols.Methods A systematic search of the literature dating from 1980 onwards was conducted using electronic databases (Medline, Scopus and Web of Science). The Fowkes and Fulton quality assessment was undertaken to review the level of bias.Results Nine prospective studies were assessed for the number and site of injections, the unit dosage, the reconstitution and the improvement of EGD. Guidelines for treatment of EGD were constructed for operator consideration.Conclusions The data from this study elucidated that botulinum toxin is an effective treatment for all types of EGD caused by hyperfunctional smile muscles. It can be regarded as a safe treatment that reversibly improves facial aesthetics in patients suffering from gummy smile due to hyperactive musculature. Botulinum toxin was confirmed to be useful as a diagnostic tool and palliative treatment, as well as an adjunctive therapy in the treatment of a gummy smile.

Prevalence of Maxillary Impacted Canine among Orthodontic Patients of Universal College of Medical Sciences, College of Dental Surgery, Bhairahawa, Nepal

INTRODUCTIONIn general, canines play an essential role in establishing a functional occlusion as well as serving as the foundation of an esthetic smile. With the exception of the third molars, impaction of the maxillary permanent canines is the most common form of tooth impaction and prevalence of impacted permanent canine has been reported in 1-5% of population. In this study, we aimed to determine the prevalence of maxillary canine impaction among orthodontic patients of Universal College of Dental Surgery, Bhairahawa, Nepal. METHODS A retrospective study was conducted on orthodontic patients at UCMS,CODS during august 2017 to august 2019. The study included clinical examination of 384 patients who visited Department of orthodontics and Dentofacial Orthopedics seeking orthodontic treatment. RESULTS This study reveals, a total of 22 (5.73%) patients having maxillary canine impaction, where 13 (59.09%) were females and 9 (40.90%) were males. Likewise 6 (27.27% ) palatal and 16 (72.72%) buccal maxillary canine impaction was found. CONCLUSIONMaxillary canines fulfill important esthetic and functional roles. Unfortunately, prevalence of impacted maxillary canine is approximately 5%, the second highest frequency behind that of third molar impaction. The prevalence of impacted maxillary canine is found to be (5.73%), where 13 (59.09%) were females and 9 (40.90%) were males. Likewise 6 (27.27% ) palatal and 16 (72.72%) buccal maxillary canine impaction was found.

Smile management: White esthetic, pink esthetic and facial attractiveness, a review of literature

A smile determines whether an individual is happy, pleasant, or laughing. A delicate or pleasant smile can boost the introductory impression in socializing, which consequently increases the approval of a person in the community. Therefore, it is considered a way of communication. Smile aesthetics can be described by many factors, including teeth surrounded by upper and lower lips, the sculpting of the tissue or gums, and the total of gaps and extra spaces. The formation of a perfect smile requires the interaction of many elements with different degrees of significance. Knowledge of the concepts that describe the equilibrium betwixt the dental care provider's knowledge related to aesthetic smile and the individual's perception is necessary. The major aim of this study was to describe various esthetics and methods that contribute to the formation of a perfect smile.

Electron-microscopic study on structural changes of mini-implants following fixed orthodontic treatment

In today's society, patients who turn to the orthodontist want final results in the shortest possible time, with maximum emphasis on smile aesthetics, dental alignment and facial harmony. In this regard, some procedures have emerged to accelerate the movement of teeth through the alveolar bone, thus shortening the duration of active treatment: corticotomy, application of mini-implants, etc. Of these methods, bone anchorage on mini-implants is increasingly popular among adult patients, as it is a versatile technique that ensures a stable, bony anchorage and more predictable final results. Compared to implantology in prosthodontics, which has a long history, mini- orthodontic implants emerged later in medical practice. In 1998, Shapiro and Kokich described for the first time the possibility of using dental implants for anchorage in orthodontic therapy. Odman J et al. (Upsala University, Sweden) applied implants to patients with partial edentulousness. The results were favorable, leading the authors to recommend the technique for adult partial edentulousness. Kanomi (1997) showed that a 1.2 mm diameter titanium mini- implant provides anchorage for the intrusion of the lower front teeth. After 4 months, the mandibular incisors were intruded by 6 mm without root resorption. Birte Melsen et al. (1998) introduced the use of zygomatic ligatures as anchorage in patients with partial edentulousness. To this they attached nickel-titanium springs for intrusion and retraction of maxillary incisors. Hugo de Clerk (2008) used 4 mini-implants (Bollard type) inserted into the infra-zygomatic crest in patients with Angle class III anomalies. He used 2 mini-implants with hooks in the chin area, and patients wore Class III 150 grams elastics on each side. This direct anchorage also has orthopedic effects, with clinicians achieving upper jaw advancement and correction of mandibular prognathism.

Perception of Smile Aesthetics and Attractiveness among Saudi Females

Smile aesthetic, known as the static and dynamic relationship of the dentition and supporting structures to the facial soft tissues, is one of the most important elements of facial attractiveness. The objective of the study was to assess the perception of smile aesthetics and attractiveness through digital image manipulation of aesthetic variables and to compare those perceptions according to diverse sociodemographic data among female Saudi laypeople attending the dental clinic. A crosssectional study of 193 female Saudi participants were randomly selected and consented to answer the study questionnaire. Nine smile photograph images were created to compare different smile aesthetic perceptions. Two groups were recruited: 120 participants in the first group (under 30 years old) and 73 participants in the second group (30 years old or above). All participants in both groups were asked to choose the attractiveness of each smile image using multiple-choice options. A statistically significant finding showed that normal buccal corridors were chosen as the most attractive smile by 42.5% of the participants in the younger group and by a significantly higher ratio of the participants with a bachelor’s degree or higher level of education at 49% (p &lt; 0.05). Laypeople’s preferences regarding smile attractiveness vary, but a normal appearance was the ideal choice for the majority. Orthodontic treatment should consider the general sociocultural understanding of smile perception.

Assessment of Golden Proportion among Natural Maxillary Anterior Teeth of Global Population: A Systematic Review

The purpose of this systematic review was to analyze studies, identify the existence of golden proportion between the perceived widths of the maxillary anterior teeth among the different geographical populations, and evaluate the range of dental proportion that exists regionally. An electronic search was conducted using PubMed, Medline, EMBASE, Scopus, Science Direct, Web of Science, and the Cochrane Library. The focused question was, “Does golden proportion exist in natural, aesthetically pleasing smiles among different populations around the world?” The search conducted included studies from January 2000 to September 2020, identifying articles in English with the specific combination of MeSH and other related terms. The title search yielded eight hundred and ninety-eight articles, and seventy-five articles were selected for full-text analysis. However, only fifty-two full-text articles were included in the systematic review. The mean predicted dental ratios were either larger or smaller than the successive widths of maxillary natural anterior teeth. Golden proportions were not found consistently among anterior teeth in different populations observed in the systematic review. The golden proportion is still a useful tool for the reconstruction of lost or damaged anterior tooth widths; however, it is not the only standard for restoring esthetic smiles worldwide, and anterior tooth proportions differ among populations based on their geographic, ethnic, and racial background. Moreover, consideration should also be given to an individual’s dentofacial variations in restoring anterior teeth.

Subjective and Objective Evaluation of the Symmetry of Maxillary Incisors among Residents of Southwest Poland

Dental aesthetics is an essential factor affecting people’s psychosocial wellbeing. One of the most critical components of an aesthetic smile is symmetry within the dentition. Dentists and orthodontists, unlike laypersons, are critical in assessing dental aesthetics. This study aimed to evaluate the accuracy of patients’ assessment of the symmetry of their maxillary incisors and some factors that influence it. The study was conducted on 83 participants aged from 11 to 39 years. First, the participants filled out a questionnaire to obtain patients’ opinions of the symmetry of their upper incisors. This stage was followed by an intraoral examination, during which we used a digital caliper to measure the width of four maxillary incisors. The data were entered into STATISTICA v. 13.3. The following conclusions were drawn from the study. First, the respondents were generally able to determine the asymmetry of the incisors. Second, among the maxillary incisors, the participants defined the symmetry of maxillary central incisors more accurately than the maxillary lateral incisors. The cut-off value for incisor asymmetry noticeable to a layperson is 0.2 mm for maxillary medial incisors and 0.55 for maxillary lateral incisors. Third, we found no dependence of the accuracy of the assessment of incisor asymmetry on the age of the subjects; however, in our study group, the age range (spread) was not significant, so further studies are recommended. Finally, results concerning the relationship with gender showed that males assess the level of symmetry of their maxillary incisors more accurately than females.

Does the current generation’s smile esthetics hinge on social media and cosmetic makeover? A questionnaire-based study

: Smile esthetics for today’s generation is an absolute necessity. It has been etched in people’s minds to present their best selves to gain acceptance from their peers. Social media with its filter/lens feature, photo editing options, and circulation of idealized celebrity photos have left a deep scar on the self-image of people. This has made individuals resort to cosmetic makeovers as a coping mechanism. 2 previously validated questionnaires were used. Specific items from both questionnaires were taken up which would fit the questionnaire while maintaining its essence. The final questionnaire was divided into 2 domains to understand the influence of social media and smile makeover individually. It comprised of 10 questions which were circulated via google form. 100 responses were received for the circulated questionnaire. For the social media domain, majority did not compare their smiles with that of others; were not very confident when it came to showing their smile on social media; often noticed the smile of others; and felt they had a good smile of their own. There was an even distribution when asked if they were conscious of their smile. For the cosmetic makeover domain, majority didn’t feel the need to get cosmetic procedures and were not influenced by social media into getting one.Results showed social media to have a big influence on improving smile esthetics. However, the same cannot be said for the desire of getting a cosmetic makeover as the majority didn’t feel the need for it.

Impact of Gingival Margin Asymmetries on the Smile Esthetic Perception of Dental Specialists, Doctors of Dental Medicine, Students, and Laypeople: a Comparative Pilot Study.

ObjectiveTo evaluate the perceptions of altered incisor gingival position among dental specialists, dentists, dental students, and laypeople.Materials and methodsFour digital smile photographs with altered gingival margin position of the right maxillary incisor (0, 1, 2, and 3 mm) were presented to a sample of 232 respondents (71.1% female; 28.9% male): 42 dental specialists, 63 dentists, 33 dental students (1st to 3rd year), 38 dental students (4th to 6th year) and 56 laypeople. The questionnaire consisted of four randomly displayed photographs, administered via Google Form, and respondents were asked to rate the images on a scale from 1 to 5, from the least attractive to the most attractive. A statistical analysis was performed using the TIBCO Statistica program (v. 13.3. 0, TIBCO Software Inc., Palo Alto, CA, USA; 2017). According to the Shapiro- Wilk's test, the data were not distributed normally. The Kruskal-Wallis test with post hoc multiple comparisons with the Bonferroni adjustment were used to compare group esthetic scores and to determine the threshold levels of deviation at which each group was discriminated between esthetic and non-esthetic situations.ResultsMedian values of esthetic scores decreased in all groups as the gingival asymmetries increased. Dental professionals were significantly more critical of esthetics than laypeople in all levels of asymmetry. The greatest difference was found for 2 mm of gingival asymmetry (p=0.002).ConclusionFrom the results of our study, we can conclude that the perception of gingival asymmetries in the esthetic zone of smile differs among dental specialists, doctors, students, and laypeople. Dental specialists, doctors, and clinical students were more critical of these asymmetries, while preclinical students and laypeople noticed only 2 mm or more of gingival asymmetry of central incisors.

Impact of severity of malocclusion and self-perceived smile and dental aesthetics on self-esteem among adolescents

The psychological impact of malocclusion, social acceptance, self-esteem, and the development of personality traits are considerations that can affect the demand for orthodontic treatment. The aim of this study was to assess the effect of malocclusion severity and self-perceived smile and dental aesthetics on self-esteem among adolescents in Lagos, Nigeria. This analytical cross-sectional study was performed among 393 adolescents (210 females and 183 males) at a university teaching hospital in Nigeria. The need for orthodontic treatment was assessed using the Dental Aesthetic Index, whereas self-esteem was measured using the Rosenberg Self-Esteem Scale. Smile analysis was performed on photographs of posed smiles, whereas photographs of posed smiles and intraoral frontal view with teeth in centric occlusion were rated with the Visual Analog Scale for self-perception of smile and dental aesthetics. A comparison of variables among self-esteem groups was made using the ANOVA and Tukey post hoc tests, whereas an association among all variables was examined using the correlation coefficient. Stepwise regression analysis examined the effects of independent variables on self-esteem. A significant correlation was found between self-esteem and self-perceived smile (r=0.294; P < 0.001) and dental aesthetics (r=0.212; P < 0.001). Adolescents with high self-perceived smile (mean ± standard deviation, 7.66 ± 2.20) and dental aesthetics (6.68 ± 2.58) had higher self-esteem than participants with low self-perceived smile (4.75 ± 2.73) and dental aesthetics (4.36 ± 2.29). Self-perceived smile aesthetics had the most predictive impact on self-esteem. The results showed that self-perception of smile and dental aesthetics is a significant factor that influences self-esteem among adolescents.

A systematic diagnostic scheme for excessive gingival display “gummy smile”

Achieving a harmonious smile has become an integral part of orthodontic treatment. Excessive gingival display or a gummy smile (GS) negatively affects smile esthetics and often prompts patients to seek orthodontic treatment. The manifestation of GS can be due to various etiologic factors that may be present separately or simultaneously in variable degrees. Differentiating the underlying etiologies for each patient with a GS is essential for making an accurate diagnosis and a predictable treatment plan. This article aims to present a comprehensive diagnostic scheme of GS comprising seven sequential steps to identify and quantify the potentially responsible etiologies. A diagrammatic diagnostic chart for a sample case with GS is presented, along with a comprehensive table template of the recommended measurements and their ideal values. • A sequential diagnostic scheme for gummy smile analysis is presented. • The contributions of various etiologic factors in a gummy smile are evaluated. • Diagnostic steps in the form of a diagrammatic chart are illustrated. • The scheme can help clinicians to select the most suitable treatment modality.

Smile Aesthetic Evaluation on Videographs: An Intra-Rater and Inter-Rater Agreement Study.

The aim of this study was to assess on videographs the intra- and inter-rater reproducibility of the Smile Esthetic Index (SEI) that has been previously validated on photographs. Smile videographs were obtained using a smartphone associated with the Smile Lite MDP mounted on a tripod. They were then randomized and evaluated twice consecutively at a 1-week interval by three periodontists according to the SEI based on 10 variables. Cohen’s Kappa and Fleiss’ Kappa tests were performed to measure intra- and inter-rater agreement. Sixty-five smile videographs of 24 men and 41 women (mean age 33 ± 11.3 years) were scored. A mean intra-rater agreement of 0.68 (0.64–0.73) was obtained, representing substantial agreement. The inter-rater agreement calculated for each variable ranged from 0.31 for the variable “absence of visible excessive gingiva” to 0.90 for the variable “absence of diastema and/or missing inter-dental papilla.” Within the limits of this study, we have demonstrated that it was possible to use videographs to reproducibly evaluate an aesthetic score (SEI) previously validated on photographs.