Smile Images Research Articles

Perceptions of dental professionals and laypersons to altered dental esthetics: Asymmetric and symmetric situations

Previous studies evaluated the perception of laypersons to symmetric alteration of anterior dental esthetics. However, no studies have evaluated the perception of asymmetric esthetic alterations. This investigation will determine whether asymmetric and symmetric anterior dental discrepancies are detectable by dental professionals and laypersons. Seven images of women's smiles were intentionally altered with a software-imaging program. The alterations involved crown length, crown width, midline diastema, papilla height, and gingiva-to-lip relationship of the maxillary anterior teeth. These altered images were rated by groups of general dentists, orthodontists, and laypersons using a visual analog scale. Statistical analysis of the responses resulted in the establishment of threshold levels of attractiveness for each group. Orthodontists were more critical than dentists and laypeople when evaluating asymmetric crown length discrepancies. All 3 groups could identify a unilateral crown width discrepancy of 2.0 mm. A small midline diastema was not rated as unattractive by any group. Unilateral reduction of papillary height was generally rated less attractive than bilateral alteration. Orthodontists and laypeople rated a 3-mm distance from gingiva to lip as unattractive. Asymmetric alterations make teeth more unattractive to not only dental professionals but also the lay public.

Body Image and Televised Images of Thinness and Attractiveness: A Controlled Laboratory Investigation

Body Image and Televised Images of Thinness and Attractiveness: A Controlled Laboratory Investigation

Buccal and labial extensions from the lingual arch (clinic)

In this study, we aimed to investigate the effect of buccolingual inclinations of the maxillary canines and premolars on the perceived attractiveness of the smile when viewed from the frontal perspective.A smiling frontal photograph was taken of a man. A 3-dimensional digital dental model of this subject was constructed within which the buccolingual inclinations of the canines and premolars could be altered relative to the occlusal plane. Three-dimensional models of the altered digital models were then printed in resin and mounted on articulators. Frontal photos of the mounted models were taken and transferred to the smile image. A series of images was produced with the canines and premolars inclined buccally or lingually by different degrees. The smile images were assessed by 2 panels, orthodontists and laypeople.There was a broad range of esthetic acceptability for the buccolingual inclinations of the maxillary canines and premolars. The range of preferred inclinations was not as broad. Smile esthetics was significantly compromised (P <0.01) when the canines were lingually inclined more than −12°, or the premolars were lingually inclined more than −15°, as perceived by orthodontists and laypersons. Buccally tipping the canines more than 6° also made the smile esthetics less satisfying (P <0.01).It could be esthetically satisfying to position the teeth within the ranges of 0° to −7° of inclination for the canines and −3° to −11° of inclination for the premolars, as assessed by the orthodontists, or of 3° to −10° of inclination for the canines and 5° to −11° of inclination for the premolars, as assessed by the laypersons. Clinicians could exercise flexibility within this range, when compromising tooth positions for transverse jaw discrepancies.