Smile Photographs Research Articles

The relationship of tooth shade and skin tone and its influence on smile attractiveness in native South Indians: A web-based cross sectional survey

ObjectivesThis study aimed to investigate the influence of tooth shade and skin tone on smile attractiveness among native South Indians. The primary research question was whether there is a significant relationship between these variables and perceived smile attractiveness. Materials and methodsA web-based cross-sectional survey was conducted with approval from the Institutional Review Board of (Thai Moogambigai Dental College and Hospital, Chennai). Standardized smile photographs of two South Indian models (one male and one female) were digitally modified to display four different tooth shades and four different skin tones, resulting in 32 images. These images were incorporated into a Google Form along with a questionnaire and a Visual Analog Scale (VAS) for attractiveness rating. The survey was distributed to 1200 participants, including both dental professionals and the general population, with 1000 valid responses recorded. Statistical analysis was performed using IBM SPSS Statistics, employing parametric tests to evaluate the data. ResultsThe study found that lighter tooth shades were consistently rated higher in attractiveness for both genders. Lighter tooth shades such as FS1T1 and FS2T1 scored means of 6.88 and 7.27 respectively for females, while darker shades like FS1T4 scored lower with a mean of 4.95. Similarly, males showed a preference for lighter tooth shades with MS1T1 and MS2T1 scoring means of 5.57 and 5.78 respectively compared to darker shades like MS1T4 with a mean of 3.63. Significant differences were noted across age groups and genders, with younger participants and females showing a stronger preference for lighter tooth shades. ConclusionsThe study concludes that both tooth shade and skin tone significantly influence smile attractiveness, with a clear preference for lighter tooth shades among the surveyed population. These findings suggest the importance of considering these factors in aesthetic dental treatments to enhance patient satisfaction and achieve optimal results. Clinical relevanceThe results underscore the necessity for dental practitioners to take into account both tooth shade and skin tone when planning aesthetic dental treatments. This approach will help in achieving a more harmonious and natural appearance, ultimately improving patient satisfaction with the treatment outcomes. Future research should continue to explore the cultural and individual factors that contribute to these preferences in dental aesthetics.

Influence of dental midline deviation with respect to facial flow line on smile esthetics-A cross-sectional study.

A contemporary concept states that dental midline deviation towards the direction of facial flow line (FFL) can mask the compromised smile esthetics. This study aimed to identify a range of midline deviations that can be perceived towards or away from the FFL influencing smile esthetics. A cross-sectional study was conducted using a frontal smile photograph of an adult female. The photograph was altered on Adobe Photoshop software into six different photographs by deviating the dental midlines towards and away from the FFL. A constant deviation of chin towards the left side was incorporated in all the photographs. Forty-three laypersons (LP) and dental professionals (DPs) evaluated those photographs. Independent t-test was used to compare the perception of dental midline deviation between LP and DPs. Simple linear regression was run to identify the factors associated with the scoring. A statistically significant difference was observed for picture two with 4 mm towards FFL in the perception of midline deviation between LP and DPs. LP could not perceive the midline deviations up to 4 mm while DPs were able to perceive deviations above 2 mm. The greater the age the better the scores were and female raters had a greater inclination towards poor scores. From 2 to 4 mm of midline deviation towards the FFL can be tolerated by LP and DPs. These findings underscore the importance of considering facial symmetry in orthodontic and cosmetic dental treatments to optimize smile esthetics.

Assessment and Correlation of Dentofacial Morphology and Lateral Cephalometric Parameters with Smile Characteristics in Lateral and Oblique View: Short Study

Aim: This study evaluated and established correlations between the dentofacial morphology of Angle’s Cl II and Cl I malocclusions, lateral cephalometric parameters, and smile characteristics assessed through lateral and oblique smile views. Methods: A sample of 20 random patients (>15 years, with prior orthodontic treatment) were selected for this study according to their arrival at the department. The selected individuals were grouped according to Angle’s classification of malocclusion, i.e., Angle’s Cl I and Angle’s Cl II malocclusion. Pretreatment records were taken for the study, including lateral cephalogram and extra-oral smile photographs (one lateral smiling and one oblique smiling). In the lateral cephalogram, skeletal, dental, and facial parameters were recorded, and in lateral and oblique smile views, lateral smile index, commissure angle, and incisal displays were recorded. Results: The results showed no significant difference in most cephalometric parameters except for UFH/LFH, which was higher in Angle’s Cl II. Additionally, smile analysis revealed significant differences between the two groups. In addition, significant differences were found in the incisal display, which was greater in Angle’s Cl II malocclusion. Conclusion: Smile characteristics differ between Angle Cl I and Cl II malocclusions. There was a significant difference in lateral and oblique smile parameters when Angle’s malocclusions classified as Cl I and Cl II were evaluated. Lateral and oblique smile index decreased from Cl I to Cl II malocclusion, whereas lateral and oblique smile commissure angle and lateral smile incisor display increased in Cl II malocclusion.

A Comparison of the Smile Esthetic Understanding of Periodontists, Orthodontists, General Dentists, and Dental Students

Objective: The aim of this study was to evaluate smile esthetics among periodontists, orthodontists, general dentists, and dental students. Methods: The study consisted of five groups: periodontists, orthodontists, general dentists, fifth-year dental students, and fourth-year dental students. The evulaters used the Smile Esthetics Index (SEI) consisting of 10 items to analyze the natural smile photographs of 15 different individuals. One-way ANOVA was performed for the comparison of group means. The Duncan multiple comparison test was also used to identify different groups. Non-linear principal component analysis was performed to determine the configuration of the relationship between categories of variables in two-dimensional space. Results: The group with the highest reliability coefficient among the groups was the fourth-year dental students (Cronbach's Alpha = 0.89). This was followed by general dentists, periodontists, fifth-year dental students, and orthodontists. According to the evaluation of the total score averages of the fifteen pictures, a statistically significant difference was observed between the groups (p = 0.041). Accordingly, the fourth-year dental students (5.78 ±1 .13) had a lower total score than the fifth-year dental students (6.56 ± 0.88), and this difference was statistically significant. However, no significant difference was observed between the fourth-year dental students and the general and specialized dentists and between the fifth-year dental students and graduated and specialized dentists in terms of the total score given to the pictures. Conclusion: It was observed that the reliability coefficient was high in all groups evaluated with SEI. It can be concluded that esthetic perception is formed by actively performing the profession of dentistry, and this situation does not change according to specialization.

Smile attractiveness in patients treated with or without 4 premolar extractions: A 36-year follow-up

This study aimed to assess the smile attractiveness in patients treated with or without 4 premolar extractions at a 36-year follow-up. The sample comprised 52 patients with Class I and II malocclusion divided into 2 groups. Group 1 consisted of 15 patients treated without extractions (10 females and 5 males), with a mean pretreatment, posttreatment, and long-term posttreatment (T3) age of 13.2, 15.1, and 49.8 years, respectively. The mean treatment time was 1.9 years, and the mean long-term follow-up period was 34.7 years. Group 2 consisted of 37 patients (25 females and 12 males) treated with 4 premolar extractions, with a mean pretreatment, posttreatment, and long-term posttreatment age of 13.3, 15.7, and 53.6 years, respectively. The mean treatment time was 2.3 years, and the mean long-term follow-up period was 37.9 years. The mean retention time was 2 years for both groups. Frontal smiling photographs were obtained at long-term follow-up. Smile attractiveness was evaluated in an online questionnaire in which the evaluator could rate the smiling photographs with a 10-point scale. The randomly selected evaluator sample consisted of 62 laypeople, 33 dentists, and 89 orthodontists. Independent t tests, 1-way analysis of variance, and Tukey tests were used for intergroup comparisons at P<0.05. The smile attractiveness on the long term was similar in the groups treated with 4 premolar extractions (4.70 ± 1.35) or without extractions (4.51 ± 1.46). Women and orthodontists were more critical in assessing smile attractiveness than men, dentists, and laypeople. After long-term posttreatment, the smile attractiveness was similar in patients treated with 4 premolar extractions or without extractions.

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 STUDY ON THE INFLUENCE OF GINGIVAL ESTHETICS ON THE ESTHETIC PERCEPTION OF WIDE SMILE

Aim: To examine the influence of gingival esthetics on the esthetic perception of wide smile; as when the subject smiles more openly exposing the gingiva and how it is esthetically appreciated by the common people and to correlate the gold standard criteria (Gingival zenith alignment is considered gold standard here) with the manipulated gingival esthetics. Materials &amp; Methods: 50 clinical and 50 nonclinical students, a total of 100 students were involved in the study to score the esthetics of the smile photographs shown to them. Results: clinical and non clinical students were not able to find all the manipulated smiles as unesthetic smile. Conclusion: Gold standard factors like Gingival zenith doesn’t always play an important role in determining esthetic smile.

A Photographic Assessment of Smile by Modifying Crown Height, Width and Angulation of Maxillary Lateral Incisor among Orthodontic Patients of Karachi, Pakistan

Abstract: Background: Smile aesthetics vary culturally, influenced by media and the Golden Proportion in dental beauty. Challenges arise with missing lateral incisors, treated through composite build-up or canine substitution, highlighting the importance of crown dimensions and the need for clinician expertise in personalized treatments. Objectives: The objective of the study is to evaluate the influence of altering height, width and angulation of maxillary lateral incisors on the perception of smile. Materials and Methods: This cross-sectional study was conducted at OPD of Jinnah Medical and Dental College, Karachi from January 2020 to June 2020, on 120 orthodontic patients (44 males and 76 females) aged between 15 and 35 years. Photoshopped photographs of an ideal smile were shown to the participants. In an ideal smile photo, the width of lateral incisor was 62% of the width of maxillary central incisors. The pictures showed to the participants had modifications in terms of crown heights, width and angulation of only maxillary lateral incisor without doing any changes to the other maxillary teeth. The responses of the participants were graded on the basis of perception of attractiveness. Result: Mean score for height, width and angulation changes were obtained. The highest score by males was given to lateral incisor whose length was increased by 1mm (6.87±2.21) and in females; the highest score was given to lateral incisor which is modified by adding 0.5 mm increment (6.98±1.05). Both males and females preferred narrow lateral incisors as esthetically attractive. The mean highest scores for the decrease in width given by males were 6.52±2.52 and 6.8±2.217 by females, respectively. Both males (6.37±2.18) and females (6.64±1.81) preferred 10 degrees of mesial angulation of lateral incisor as more esthetically pleasing. Changes in distal angulation of more than 5 degrees are considered unattractive by both genders. Mean values were 6.04±2.15 for males and 6.00±1.99 for females. Conclusion: In conclusion females are more concerned to the change in height, while in terms of width both genders preferred narrower maxillary lateral incisors over wider ones. Both genders perceived a 10 degree mesially angulated lateral incisor as more attractive.

Influence of orthodontic bracket prescription on smile attractiveness in patients with different sagittal skeletal patterns: A 3-dimensional cross-sectional study

The objective of this study was to evaluate the influence of orthodontic bracket prescription on smile attractiveness. Three women were chosen according to their sagittal skeletal pattern: skeletal Class I, II, or III malocclusion. For each, 3 smiling pictures were taken in frontal, oblique, and lateral views. The maxillary arch was then scanned, and a 3-dimensional digital model was constructed on the OrthoAnalyzer software. The information of 3 orthodontic prescriptions, namely Roth, MBT, and Ricketts, was simulated after the virtual placement of orthodontic brackets on 10 maxillary teeth. The simulations were then superimposed on the smile photographs in the 3 views, creating a total of 27 images. Groups of orthodontists, dentists, and laypeople rated the attractiveness of each smile using the visual analog scale. This study included 167 evaluators: 54 orthodontists, 54 dentists, and 59 laypersons. In terms of orthodontic prescription, MBT esthetic scores were 4% lower than Roth scores (P<0.001), and Ricketts scores were 13.6% lower than Roth scores (P<0.001). In terms of skeletal pattern, Class II and III scores were 15.0% and 16.4% lower than Class I scores, respectively (P<0.001). Regarding the smiling view, oblique view scores were 3.1% lower than frontal view scores (P= 0.031), whereas lateral view scores were 8.4% lower than frontal view scores (P<0.001). In contrast to gender and age, the specialty of the evaluators significantly affected the esthetic rating of the smiles. The attractiveness of a smile is affected by the prescription of the brackets. The Roth prescription tends to obtain the most favorable esthetic scores, especially in sagittal smiling images. Profile smiles with excessively proclined incisors are considered unattractive. Different views of the same smile do not get similar esthetic scores because sagittal views are rated the most severely.

Increased Occlusal Vertical Dimension and Its Influence on Lip Position at Smile in Dentulous Adults

Introduction: Increasing occlusal vertical dimension (OVD) is often indicated in complex prosthodontic rehabilitations to gain restorative space and improve the occlusal relationship and esthetics. However, any alterations made in OVD will also influence the lip position mainly during rest and smile. This study aims to determine the influence of the vertical dimension of occlusion on lip positions at a smile. Methods: 30 samples between the age group of 20 - 30 years were included in this study meeting the selection criteria. The acrylic splint of varying thicknesses of +2mm, +4mm, +6mm, +8mm was prepared on the dental stone cast of a patient that was articulated in a semi-adjustable articulator after tentative facebow transfer. Smile photograph of each individual at the occlusal vertical dimension of +0mm, +2mm, +4mm, +6mm, +8mm was taken using a DSLR camera mounted on a tripod using the prepared acrylic splints. Digital measurements were done in photographs using the Adobe Photoshop software. Results: The study's results demonstrate that increasing the OVD significantly affects the inter labial distance, incisal edge to lower lip distance, and the display zone area. However, the study found no notable alterations in the distance from the incisal edge to the upper lip or in the intercommissural width with the same increased OVD. These findings demonstrate on how changes in OVD can influence various orofacial measurements. Conclusion: Within the limitation of this study, it can be concluded that with the increase in the OVD, inter labial distance, incisal edge to lower lip distance, and display zone area are increased. But upper lip position and inter commissural width should not be expected to be changed with increased OVD.

The relationship between different levels of facial attractiveness and malocclusion perception: an eye tracking and survey study

IntroductionThe aim of this study was to investigate the relationship between levels of facial attractiveness and the perception of different types of malocclusion.MethodsA preliminary questionnaire was used to assign photographs of three female patients to low, moderate, and high facial attractiveness designations. Seven modified photographs for each smile photograph of each of these three patients were created. The evaluated photographs were as follows: P0: at rest position, P1: ideal smile, P2: − 2-mm (low) smile line, P3: + 4-mm gummy smile, P4: + 6-mm gummy smile, P5: maxillary anterior crowding, P6: median diastema, P7: polydiastema. An eye tracking device and a questionnaire were used to collect data from orthodontists, dentists, orthodontic patients, and laypeople.ResultsTotal fixation duration varied depending on the type of malocclusion, the level of facial attraction, and the participants’ occupations. In general, orthodontists and dentists had higher total fixation duration scores than orthodontic patients and laypersons. The maxillary anterior crowding photograph had the lowest visual analysis scale score at each attractiveness level (low, medium, and high). Visual analysis scale scores became similar at each attractiveness level only in the P4 photographs, and thus the difference in facial attractiveness disappeared.ConclusionWhile a worsening of the ideal smile had a smaller impact on aesthetic perceptions in an individual with low facial attractiveness, it had a significant negative impact on a person with high facial attractiveness. Anterior crowding and diastema had a more negative impact on facial attractiveness than low or high smile lines.

Comparison of pleasant and unpleasant smile characteristics in the perception of the laypeople in an Iranian population

This study aimed to compare the characteristics of pleasant and unpleasant smiles from the perception of laypeople. Two-hundred posed smile photographs were obtained from adult participants with no anomaly, restoration, or severe crowding and spacing in anterior teeth. Photographs were shown to 26 judges to give each photograph a score for attractiveness. Upper and lower quartiles for the most and least rated smiles were determined, and variables including gingival display, smile arc, midline deviation, buccal corridor, smile width, tooth rotation or malposition, diastema, upper and lower vermilion show, and tooth form were measured. Independent-sample t test and Pearson chi-square analysis were used to determine the differences between the pleasant and unpleasant groups for quantitative and qualitative variables, respectively. The linear regression model revealed variables with the most significant impact on the mean score. All quantitative and qualitative variables except tooth form significantly differed between pleasant and unpleasant smile groups (P<0.05). The consonant smile arc was associated with an increase of 12.59% in mean scores compared with the inconsonant smile arc. Each tooth reported with malposition was correlated with a decrease of 9.37% in the scores. In the same way, each 1-mm increase in midline diastema and occlusal cant coincided with a drop of 8.73% and 3.59% in scores, respectively. The results of this study suggested that smile arc, tooth malposition, midline diastema, and occlusal plane canting had the most impact on smile esthetics and should be given priority by orthodontists in the treatment plan of choice.

Influence of social media and corrected smile photographs in patients with malocclusion

The increased use of social networking sites, such as Instagram (Meta Platforms, Menlo Park, Calif), has been silently affecting facial satisfaction among patients. However, the potential of Instagram to motivate participants for orthodontic treatment when used with an adjunct, a photograph editing software, is yet to be assessed. From the initial 300 participants, 256 were included and randomly divided into an experimental group (participants were asked to provide their frontal smiling photograph) and a control group. The photographs received were corrected using photograph editing software and were shown along with other ideal smile photographs in an Instagram account to the experimental group, whereas the control group participants had access to only the ideal smile photographs. After browsing, the participants were given a modified version of the Malocclusion-Related Quality of Life Questionnaire. Questions assessing the general perception about one's smile, comparison with peers, desire to undergo orthodontic treatment, and the role of socioeconomic status showed a statistically significant difference (P<0.05) as most of the control group participants were unsatisfied with their teeth, had less desire to undergo orthodontic treatment and did not feel family's financial income to be a hurdle, contrary to the experimental group participants. A statistically significant difference (P<0.05) was also seen in assessing external acceptance, speech difficulties, and the influence of Instagram on orthodontic treatment, whereas the influence of photograph editing software did not show the same. The study concluded that the experimental group participants were motivated to undergo orthodontic treatment after viewing their corrected photograph.

Effect of smile on facial attractiveness before and after orthodontic treatment in females with more attractive and less attractive facial background

One of the goals of orthodontic treatment is to improve facial esthetics. This study aimed to determine the effect of smile on facial attractiveness before and after orthodontic treatment in females with "more attractive" and "less attractive" facial backgrounds. In addition, changes in facial attractiveness after orthodontic treatment were examined. Frontal rest and smile photographs of 60 female patients (mean age, 26.32 years) before and after orthodontic treatment were included in 4 separate online questionnaires. The link for each questionnaire was sent to 40 layperson raters (20 females, 20 males). They were asked to give a score from 0 to 100 on the basis of the visual analog scale for the attractiveness of each image. Then the data were collected and analyzed. The mean score of the pretreatment smile was significantly smaller than the frontal rest view, and the difference was significantly greater in the "more attractive" group (P= 0.012). After treatment, the smiling view was significantly more attractive than the frontal rest view, and the difference was significantly greater in the "less attractive" group (P= 0.014). In addition, the attractiveness of both smiling and rest views increased significantly after orthodontic treatment, and these changes were significantly greater in the "more attractive" group (P<0.001 and P= 0.011). An unesthetic pretreatment smile negatively impacted facial attractiveness, and orthodontic treatment significantly improved facial attractiveness. These negative and positive effects were greater in more attractive facial backgrounds.

Evidentiary value of smile photographs from the internet for human identification: A pilot study

Evidentiary value of smile photographs from the internet for human identification: A pilot study

Validation of Andrews Analysis in the Virtual Environment

Andrews analysis is a tool to establish the aesthetic anteroposterior position of the maxilla. Andrews analysis has not been evaluated through computer-aided surgical simulation (CASS). The purpose of this study was to evaluate the accuracy of Andrews profile analysis when performed in the virtual environment. A retrospective cohort study was implemented with consecutive patients undergoing orthognathic surgery between February 2020 and February 2022 at the University of Alabama, Birmingham. Traditional Andrews analysis with lateral smiling photographs were taken during the presurgical appointment in adjusted natural head position (aNHP). The standard cone-beam CT obtained for CASS and archived on the KLS Martin (Jacksonville, Florida) database was accessed for retrospective measurement. Lateral facial photographs in aNHP were imported into the virtual environment and the three dimensional (3D) composite model was then oriented into aNHP. The software engineer, blinded to the traditional measurements, then performed the Andrews analysis in the virtual environment by placing a vertical glabella line on the 3D composite model in aNHP. The linear horizontal distance of the maxillary central incisor perpendicular to the vertical glabella line was recorded. Method of Andrews analysis measurement (traditional photographic evaluation vs CASS) MAIN OUTCOME VARIABLE: Linear Andrews analysis measurement. Additional covariates evaluated were sex, age at surgery, and dentofacial deformity diagnosis. Descriptive statistics were computed to compare photographic analysis versus CASS analysis. A P value of <.05 was considered statistically significant. The average age was 25.7years old and 54% of patients were female. For the photographic analysis, the mean incisor-goal anterior limit line distance was -0.44±7.12mm (95% CI, -1.13 to 0.37mm; P=.46). For the virtual analysis, the mean incisor-goal anterior limit line distance was 0.13±7.21 (95% CI,-0.004 to 0.30; P=.89). The Pearson correlation coefficients between the photograph and 3D analysis were very strong (0.93). The root mean square deviation between the photographic and 3D analysis cohorts was 2.7mm. Given the high correlation coefficients between all demographics, CASS can be utilized for Andrews analysis to determine ideal anteroposterior maxillary position to streamline data collection and the planning process.

Skeletal, Dental and Smile Esthetic Changes in Skeletal Class II patients Treated with Maxillary Premolar Extraction and Non-extraction Mechanotherapy – A Cross-sectional Study

ABSTRACT Introduction This study aimed to compare smile aesthetics in skeletal class II subjects who underwent fixed appliance therapy with maxillary premolar extraction (PME) and non-extraction fixed mechanotherpy (NEF), and to evaluate the perception of esthetic smiles among three panels of raters. Materials and Methods A cross-sectional study was conducted on a sample of 36 skeletal class II subjects ideally planned for PME. The study subjects were divided into two groups: 18 cases treated with PME and 18 cases treated with NEF at the patient’s request. Seven smile variables were measured on pre- and post-treatment frontal close-up smile photographs of two groups. Ten laypersons, general dentists and orthodontists evaluated those photographs on visual analogue scale. An Independent t-test was applied to compare the post-treatment smile variables and scores between the groups. Results In a comparison of post-treatment photographs between the groups, a statistically significant difference was found in the values of arch form index (AFI) (p = 0.01) and overjet (p = 0.006). A statistically significant difference was observed in the perception of smile aesthetics among the raters (p < 0.001). Conclusions Patients ideally planned for maxillary premolar extraction when treated with non-extraction fixed mechanotherapy using class II elastics did result in dental and soft tissue improvement but were not able to achieve ideal values at the end of treatment. Laypersons and dentists preferred smile aesthetics in maxillary first premolar extraction treatment, whereas all three panels of raters gave higher scores to non-extraction fixed mechanotherapy in terms of improvement in the smile.

A novel pictorial smile chart: Reliability and validity

Smile analysis provides data on the positive and negative elements of a patient's smile. We aimed to develop a simple pictorial chart to record relevant parameters of the smile analysis in a single diagram and to investigate the reliability and validity of this chart. A panel of 5 orthodontists developed a graphical chart, which was reviewed by 12 orthodontists and 10 orthodontic residents. The chart comprises facial, perioral, and dentogingival zones analyzing 8 continuous and 4 discrete variables. The chart was tested on frontal smiling photographs of 40 young (aged 15-18 years) and 40 old (aged 50-55 years) patients. All measurements were performed twice with an interval of 2 weeks by 2 observers. Pearson's correlation coefficients for observers and age groups varied from 0.860 to 1.000 and between observers from 0.753 to 0.999. Minor significant mean differences were found between the first and second observations, which were not clinically relevant. The kappa scores for the dichotomous variables were in perfect agreement. To test the sensitivity of the smile chart, differences between the two age groups were assessed as differences because aging is expected. In the older age group, philtrum height and visibility of mandibular incisors were significantly larger, whereas the upper lip fullness and buccal corridor visibility were significantly lesser (P<0.001). The newly developed smile chart can record essential smile parameters to aid diagnosis, treatment planning, and research. The chart is simple and easy to use, has face and content validity and good reliability.

Finishing Analysis of Dental Outcome (FADO) as a New Guide in Orthodontic Treatment.

Orthodontic treatment has both functional and esthetic goals. The finishing phase is one of the most important and seeks to solve occlusal, dental, functional, and esthetic problems, offering the possibility of obtaining the best possible outcome. This paper aims to describe the Finishing Analysis of Dental Outcome (FADO) guide as a tool to improve orthodontic treatment results. A literature review of finishing procedures and orthodontic treatment outcomes was made. Moreover, current parameters of the esthetics of the smile were considered. The information was systematized to produce a protocol applicable to practice. This guide includes the assessment of mini-esthetic, micro-esthetic, and occlusal results using the Cast Radiographic Evaluation of the American Board of Orthodontics. Treatment options for each item were also suggested. Clinical cases were used to illustrate the application of the guide. The FADO Guide is presented and explained to give the clinician a systematic and orderly guide to achieve the best possible results in orthodontic treatment. To fulfill the FADO Guide, cast models, a panoramic radiograph, smile photographs (frontal and lateral), and an intraoral frontal photo are needed. The FADO Guide includes four sections: mini-esthetic evaluation (the evaluation of the smile), micro-esthetic evaluation, occlusal analysis, and radiographic analysis. The FADO guide presents a systematic approach to the application of a finishing protocol in orthodontics. Furthermore, this guideline can improve clinical practice andbe used as a checklist to optimize clinical outcomes.

Análise de fotos do sorriso postadas em redes sociais como alternativa para a identificação humana

ABSTRACT Photos of smiles posted on social media contain information on individuals’ anatomical and oral morphological characteristics, which can be important for ante and post-mortem human identification, during confrontation for forensic purposes. Objective: The study aimed to evaluate the feasibility of using smile photographs on social networks as a source of information for human forensic identification. Methods: The study sample consisted of forty individuals, randomly divided into four equal groups, two groups in Instagram (IG®) and two groups in Facebook (FB®). Standardized oral photographs of the anterior teeth of the participants, from three different angles (post-mortem photos) were taken using a Nikon® EOS 550D camera. Photos of smiles posted in FB and IG by the participants were also collected (ante-mortem photos). The analysis were carried out by 4 forensic experts, 18 dental professors, and 21 dental students. They compared simulated ante and post-mortem photos, to identify the alleged victims. Results: The correct identification score ranged from 28.6% (students) to 100% (forensic experts). The most frequently reported dental characteristics used for the identification were morphology of the anterior teeth, zenith, and gingival recessions. There was no statistically significant association between the rate of correct identification and the degree of difficulty reported during the analysis (p= 0,068), whereas there was also no association between this index and or the duration of the analysis (p=0,884). Conclusions: Therefore, the photographs of the smile posted on social media proved to be a database of dental information, and with potential to assist in identification with dental forensic purposes.