Female Smile Research Articles

Influence of symmetric and asymmetric alterations of maxillary canine gingival margin on the perception of smile esthetics among orthodontists, dentists, and laypersons.

Esthetics is one of the major concerns among people seeking orthodontic treatment, and its perception varies from person to person. Our objective was to determine the differences in the perception of smile esthetics among orthodontists, general dentists, and laypersons with respect to alteration in the maxillary canine gingival margin in close-up smile analyses. Close-up photograph of an ideal Indian female smile was selected. The images were digitally altered to create symmetrical images with the gingival margin levels of maxillary canine matching the central incisors. Twelve alterations were created in the gingival margin of the canine with discrepancies of 1, 2, and 3 mm in relation to the most superior point on the labial gingival margin of patient's central incisor and divided under four groups. Finally, close-up images of the smile were assessed by orthodontist, general dentist, and layperson who indicated the level of attractiveness of each smile on a visual analogue score. The data collected were then statistically analyzed by one-way analysis of variance followed by Newman-Keul's range test. Most evaluators considered all the three components, i.e., lips, teeth, and gingiva while assessing the smile's attractiveness. Statistically significant differences were observed between different evaluator groups when considering bilateral increase in crown height by 2 and 3 mm. The perceptions of asymmetries in the gingival margin levels of the maxillary canines were 1.0 mm for orthodontists and 2.0 mm for laypersons. The result of this study suggested that the orthodontists were more critical than dentist and layperson in evaluating smile esthetics.

Effects of Three Types of Digital Camera Sensors on Dental Specialists' Perception of Smile Esthetics: A Preliminary Double-Blind Clinical Trial.

The effect of image quality or dental specialties on the subjective judgment of facial beauty has not been evaluated in any study. This study assessed the effect of digital sensors and specialties on the perception of smile beauty. In the first phase of this double-blind clinical trial, 40 female smile photographs (taken from dental students) were evaluated by a panel of three prosthodontists, six orthodontists, and three specialists in restorative dentistry to select the most beautiful smiles. In the second phase, the 20 students having the most appealing smiles were again photographed in standard conditions, but this time with three different digital sensors: full-frame 21.1-megapixel, half-frame 18.0-megapixel, and compact 10.4-megapixel. The same panel judged smile beauty on a visual analog scale. The referees were blinded to the type of sensors, and the images were all coded. The data were analyzed using two-way ANOVA, Kruskal-Wallis, and Mann-Whitney U tests (α = 0.05 and 0.0167). The mean scores for full-frame, half-frame, and compact sensors were 6.70 ± 1.30, 4.56 ± 1.29, and 4.40 ± 1.39 [out of 10], respectively (Kruskal-Wallis p < 0.0001). The differences between the full-frame and the other sensors were statistically significant (Mann-Whitney p < 0.01); however, the difference between the half-frame and compact sensors was not statistically significant (p > 0.1). Sensors (ANOVA p < 0.00001) but not specialties (p = 0.687) affected the perception of beauty. According to the results of this study, image quality affected the perception of smile beauty. The full-frame sensor produced consistently better results and was recommended over half-frame and compact sensors. Dentists of different specialties might have similar standards of smile beauty, although this needs further assessment.

The effects of camera lenses and dental specialties on the perception of smile esthetics.

Background and Aim:The purpose of this study was to investigate whether different camera lenses and dental specialties can affect the perception of smile esthetics.Methods:In the first phase of this study, 40 female smile photographs (taken from dental students) were evaluated by six orthodontists, three specialists in restorative dentistry, and three prosthodontists to select the most beautiful smiles. The 20 students with the best smile ranks were again photographed in standard conditions, but this time with two different lenses: Regular and then macro lenses. Each referee evaluated the beauty of the smiles on a visual analog scale. The referees were blinded of the type of lenses, and the images were all coded. The data were analyzed using two-way analysis of variance (ANOVA), Kruskal–Wallis and Mann–Whitney U-tests (alpha = 0.05, alpha = 0.0167).Results:The lenses led to similar scores of beauty perception (Mann–Whitney P = 0.8). There was no difference between subjective beauty perception of specialties (Kruskal–Wallis P = 0.6). Two-way ANOVA indicated no significant role for lenses (P = 0.1750), specialties (P = 0.7677), or their interaction (P = 0.7852).Conclusion:The photographs taken by a regular lens and then digitally magnified can be as appealing as close-up photographs taken by a macro lens. Experts in different specialties (orthodontics, prosthodontics, and restorative dentistry) showed similar subjective judgments of smile beauty.

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 +/

A comparison between laypeople and orthodontists in evaluating the effect of buccal corridor and smile arc on smile esthetics

ObjectiveThe purpose of this study was to investigate the effects of buccal corridor space (BCS) and smile arc (SA) on smile esthetics as judged by laypeople and orthodontists, and to identify the threshold where these smile variables became esthetically displeasing. MethodsA color photograph of a female smile was digitally modified to produce six smile images with BCS ranging from 0% to 25% and three smile images with altered smile arcs (consonant, flat, and reverse). These images were shown to 104 laypeople and 52 orthodontists who were asked to rate the attractiveness of each smile on a scale of 1 to 10. Perceptions were compared between laypeople and orthodontists using t-test analysis. A one-way ANOVA post hoc Duncan test was used to establish the threshold at which BCS was considered unattractive by each group. ResultsThe results showed that orthodontists seemed to detect changes in BCS more readily than did laypeople. They rated images with 15% to 25% BCS as significantly less attractive than did laypeople. The threshold at which BCS was considered significantly unattractive by the laypeople and orthodontists was 25%. The most attractive smile as judged by orthodontists and laypeople was the broadest and consonant smile. The image with a reverse smile arc was rated as the least attractive by both groups. ConclusionsIt is advisable to take into consideration the smile arc during orthodontic treatment, because flattening the smile arc has been perceived as more unattractive than small variations in the BCS.

The influence of maxillary central incisor height-to-width ratio on perceived smile aesthetics

To determine the influence of varying the width-to-height ratio of maxillary central incisors on perceived smile aesthetics. Cross-sectional study. Postgraduate dental teaching hospital. A posed female smile was digitally modified using Adobe Photoshop(®). Three images were created; central incisors with normal form, tooth wear and delayed apical migration. For each image the length of the teeth was altered to create a set of nine images with normal form (66% to 96% width-to-height ratios), and sets of five images with tooth wear and with delayed apical migration (78% to 96% ratios). The images in each set were ranked in order of most to least attractive by 32 dentists, 32 technicians and 32 patients. An 82% width-to-height ratio was perceived as the most attractive for normal central incisors although there is variability in the responses. There is a definite trend towards the extremes of very long or very short teeth being less attractive. The very long central incisors, and those with tooth wear were perceived as unattractive. The patients rated fewer images from the tooth wear and delayed apical migration sets as unattractive compared to the dentists and technicians. The width-to-height ratios perceived as most attractive correspond with the higher end of ideal ratios proposed in the dental literature (75-80% width-to-height ratio). Significant differences exist between the aesthetic perceptions of dentists, technicians and patients and there is lack of agreement within each group, in particular within the patient group. The individual variability in patient response should be taken into account during treatment planning.

Attractiveness of variations in the smile arc and buccal corridor space as judged by orthodontists and laymen.

To evaluate changes in attractiveness on the basis of computerized variations of smile arcs and buccal corridors for male and female smiles judged by orthodontists and laypersons. Using a visual analog scale in a Web-based survey, orthodontists and laypersons rated the attractiveness of nine digitally altered smile arc and buccal corridor variations of male and female smiles. The variations were accomplished in a clinically relevant manner and based on standards set by experienced orthodontists in a pilot web-based survey. The results indicate that both laypersons and orthodontists prefer smiles in which the smile arc parallels the lower lip and buccal corridors are minimal. Significantly lower attractiveness ratings were found for smiles with flat smile arcs and excessive buccal corridors. Flattening of the smile arc overwhelms the deleterious effects of excessive buccal corridors on attractiveness ratings. On the basis of the results of this study, care should be taken not to produce an excessively flat smile arc during orthodontic treatment.

Impact of dental asymmetries on the perception of smile esthetics

The purpose of this study was to evaluate the impact of anterior tooth asymmetries on the perception of smile esthetics. Three pleasant female smiles were digitally altered to simulate several degrees of asymmetry of the gingival margin of a maxillary central incisor, wear of a maxillary canine cusp, and a dental midline shift. Three groups of 50 raters--laypersons, orthodontists, and prosthodontists--evaluated the original and the altered images and used a visual analog scale to score smile esthetics. The threshold of the orthodontists and the prosthodontists for asymmetry of the gingival margin of a maxillary central incisor was 0.5 mm; the threshold for laypersons, who were less perceptive, was 2.0 mm. Wear of a maxillary canine cusp had no esthetic impact for any group of raters. Midline shifts became perceptible when equal to or greater than 1.0 mm for orthodontists and 3.0 mm for prosthodontists; laypersons saw no alteration. Laypersons, orthodontists, and prosthodontists have different perceptions of attractiveness when evaluating gingival margin height of a maxillary central incisor and a dental midline shift. These findings might help dental specialists to consider the patient's esthetic expectations when planning treatment.

The influence of varying maxillary lateral incisor dimensions on perceived smile aesthetics

The aim of this study was to determine the influence of varying the dimensions of the maxillary lateral incisors on perceived smile aesthetics. Clinical study. Postgraduate dental teaching hospital. A photograph of a female smile displaying only the lips and teeth was digitally altered. First, the width of the maxillary lateral incisors, in proportion to the central incisor, was altered at 5% intervals to produce six images (52%, 57%, 62% [the 'golden proportion'], 67%, 72% and 77%). In a second group, the length of the lateral incisor was altered at 0.5 mm increments to produce five images with the lateral incisor 0.5 mm, 1 mm, 1.5 mm, 2 mm and 2.5 mm shorter than the adjacent central incisor. The photos were ranked from 'most attractive' to 'least attractive' by 41 hypodontia patients, 46 non-hypodontia 'control' patients and 30 dentists. The 67% followed by the 72% lateral-to-central width proportions were the 'most preferred' by all groups. A maxillary lateral incisor that is 1-1.5 mm shorter than the central incisor was the 'most popular' maxillary lateral incisor length. The very short and very long maxillary lateral incisor was consistently perceived as 'least attractive'. There is no evidence to suggest that the golden proportion should be considered the ideal aesthetic standard when creating space for the replacement of missing lateral incisors.

Esthetics: patients' perceptions of dental attractiveness.

The importance of dentofacial attractiveness to the psychosocial well-being of an individual has been well established. Very little information is available regarding dental patient perceptions of a pleasing esthetic image. The purpose of this study was to identify factors distinctive to attractive smiles versus unattractive smiles, as perceived by patients. Standardized format photographs (5 x 7 in, matte finish, at f-32 and 1:2 magnification) of eight male and eight female smiles, framing only lips and teeth, were viewed by 297 subjects. The smiles exhibited differences in symmetry, tooth shade, number of teeth displayed, and height of maxillary lip line, and included both restored and unrestored teeth. Respondents ranked the photographs in order from most to least appealing appearance. Respondents viewed each series of photographs in a similar lighting and time period. A questionnaire identified the respondent's age, sex, race, education, income, and home town. Twenty-five demographic groups were established from the information in the questionnaire. Data were analyzed using stepwise discriminant analysis to determine the combination of smile characteristics that best predicted the ranking. The same female smile was chosen as the most attractive by 24 of the 25 demographic groups. This smile is characterized by natural teeth having light shade, high lip line, a large display of teeth, and radiating symmetry. Two female smiles typified by darker shade and asymmetry were rated by all groups as being least attractive. Two male smiles were judged equal as the most pleasing esthetically. Respondents favored those smiles characterized by light shade, a moderate display of teeth, moderate lip line, and a symmetrical arrangement of teeth. One male smile characterized by darker shade was rated as least attractive. In all cases, tooth shade was the most important factor, followed in sequence by unrestored natural teeth and number of teeth displayed. No correlation was found to exist between specific demographic groups and smile variables.