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      Smile Attractiveness and Treatment Needs of Maxillary Midline Diastema with Various Widths: Perception among Laypersons, Dental Students, and Dentists in Malaysia


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          Smile attractiveness and the need for treatment of maxillary midline diastema with various widths are perceived differently between dentally trained and nondentally trained individuals of different sociodemographic backgrounds. This study aims to evaluate how laypersons, dental students, and dentists in Malaysia differ in their perceptions on smile attractiveness and treatment needs of maxillary midline diastema. A smiling photograph with well-aligned maxillary central incisors with proportionate width-to-height ratio and healthy gingival tissues was selected and digitally manipulated to create maxillary midline diastema with 0.5, 2.0, and 4.0 mm widths. The smile attractiveness and the perceived need for treatment of varying widths of maxillary midline diastemas were rated by laypersons, dental students, and dentists using the Likert scale via a single set of self-administered questionnaires. The impact of sociodemographic variables on aesthetic perception of different gap widths was tested using univariate analysis followed by a multiple linear regression model. A total of 158 laypersons, 118 dental students, and 138 dentists participated in this study. Both laypersons and dentists showed significantly higher mean aesthetic scores for 0.5 mm maxillary midline diastema, lower mean aesthetic scores, and hence higher mean treatment needs scores for 4.0 mm maxillary midline diastema as compared with dental students ( p < 0.05). In general, female respondents perceived a gap width of up to 2.0 mm as aesthetically pleasing. Higher educational group and the Malay ethnicity had tolerance threshold of 0.5 mm gap width. The older group considered 4.0 mm gap width as aesthetically unpleasing. In conclusion, both laypersons and dentists accepted a 0.5 mm maxillary midline diastema as an attractive smile but considered 4.0 mm maxillary midline diastema as unpleasing smile which required treatment. Perceptions of laypersons and dentists were significantly different from dental students. Educational level, gender, ethnicity, and age were significantly associated with smile attractiveness of maxillary midline diastema at different investigated widths.

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          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.
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            Perceptions of Jordanian laypersons and dental professionals to altered smile aesthetics.

            The purposes of this study were to rate the attractiveness of different smile variables, to compare the perception of Jordanian laypeople, general practitioners, and orthodontists to altered smile aesthetics, and to identify the threshold where different variables begin to impair smile aesthetics. A smiling photograph of a female dental student was selected and digitally manipulated to create changes in buccal corridor space (BCS), the amount of gingival display, and the midline diastema. These altered images were rated by three groups of Jordanians: 200 laypeople (100 females and 100 males), 200 general practitioners (100 females and 100 males), and 160 orthodontists (40 females and 120 males). Smile aesthetics scores were calculated and comparisons between groups were performed using the univariate general linear model. The results showed that profession and gender affected BCS and midline diastema attractiveness ratings (P<0.001). Wide BCSs, a gingival display of more than 2 mm, and the presence of a midline diastema of any size were rated as unattractive by all groups.
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              Perception of Saudi dentists and lay people to altered smile esthetics.

              To evaluate and compare the perceptions of Saudi dentists and lay people to altered smile features.

                Author and article information

                Int J Dent
                Int J Dent
                International Journal of Dentistry
                15 April 2023
                : 2023
                : 9977868
                Department of Restorative Dentistry, Faculty of Dentistry, The National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
                Author notes

                Academic Editor: Gianrico Spagnuolo

                Author information
                Copyright © 2023 Nur Amirah Binti Mohamad Sabri et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 4 November 2022
                : 25 March 2023
                : 27 March 2023
                Research Article



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