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      Does the presence of unilateral gingival recession on maxillary canines influence smile esthetics?

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          ABSTRACT

          Objective:

          The objective of this study was to determine orthodontists’, periodontists’, and laypersons’ perception of smile esthetics, regarding the presence of different levels of gingival recession on the maxillary left canine.

          Material and Methods:

          Two close-up smile images (frontal and oblique) of a white female were selected for this study. The images were digitally altered to create different levels of gingival recession on maxillary left canine, in 0.5-mm increments. They were randomly arranged into a photo album that was shown to 135 evaluators: 45 orthodontists, 45 periodontists, and 45 laypersons. Each evaluator was asked to rate the smile attractiveness, using to a visual analog scale. Data were analyzed statistically using ANOVA, Tukey’s post-hoc test, and Student t-test.

          Results:

          According to the orthodontists and periodontists, all levels of recession were considered as unesthetic in both types of images. According to the laypersons, gingival recession > 1.5 mm in the frontal image and > 1.0 mm in the oblique image were considered unesthetic.

          Conclusion:

          The results showed that the presence of unilateral gingival recession on maxillary canines may negatively influence smile attractiveness, depending on the evaluator type and the level of the recession.

          RESUMO

          Objetivo:

          o objetivo do presente estudo foi determinar a percepção estética do sorriso, por ortodontistas, periodontistas e leigos, em relação à presença de recessão gengival no canino superior esquerdo.

          Métodos:

          foram selecionadas duas imagens aproximadas do sorriso (frontal e oblíqua) de uma mulher leucoderma. As imagens foram manipuladas para criar diferentes níveis de recessão gengival no canino superior esquerdo, em incrementos de 0,5 mm. Foram, então, distribuídas aleatoriamente em um álbum, que foi entregue a 135 avaliadores: 45 ortodontistas, 45 periodontistas e 45 leigos. Cada avaliador foi convidado a avaliar a atratividade das imagens em uma escala visual analógica. Os dados foram analisados estatisticamente pela ANOVA e pós-teste de Tukey e teste t de Student.

          Resultados:

          para ortodontistas e periodontistas, todos os níveis de recessão foram detectados como antiestético, em ambas as formas de visualização. Para os leigos, na vista frontal, a recessão gengival foi considerada antiestética a partir de 1,5 mm; enquanto na vista oblíqua, a partir de 1,0 mm.

          Conclusão:

          os resultados demonstraram que a presença de recessão gengival em caninos superiores pode impactar negativamente a atratividade do sorriso, dependendo do tipo de avaliador e da magnitude da recessão.

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          Most cited references32

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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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            Smile attractiveness. Self-perception and influence on personality.

            To investigate self-perception of smile attractiveness and to determine the role of smile line and other aspects correlated with smile attractiveness and their influence on personality traits. Participants judged their smile attractiveness with a patient-specific questionnaire. The questionnaire contained a spontaneous smiling photograph of the participant. Objective smile-line height was measured using a digital videographic method for smile analysis. Personality was assessed with the Dutch Personality Index. Cronbach's alpha for the smile judgment questionnaire was .77. The results showed that size of teeth, visibility of teeth, and upper lip position were critical factors in self-perception of smile attractiveness (social dimension). Color of teeth and gingival display were critical factors in satisfaction with smile appearance (individual dimension). Participants, smiling with teeth entirely displayed and some gingival display (two to four millimeters), perceived their smile line as most esthetic. Smiles with disproportional gingival display were judged negatively and correlated with the personality characteristics of neuroticism and self-esteem. Visibility and position of teeth correlated with dominance. The results of this research underpin the psychosocial importance and the dental significance of an attractive smile.
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              Comparing the Perception of Dentists and Lay People to Altered Dental Esthetics

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                Author and article information

                Journal
                Dental Press J Orthod
                Dental Press J Orthod
                dpjo
                Dental Press Journal of Orthodontics
                Dental Press International
                2176-9451
                2177-6709
                Jan-Feb 2020
                Jan-Feb 2020
                : 25
                : 1
                : 56-63
                Affiliations
                [1 ]Universidade Federal da Bahia, Faculdade de Odontologia (Salvador/BA, Brazil).
                [2 ]Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Ortodontia (Salvador/BA, Brazil).
                Author notes
                Contact address: Andre Wilson Machado Universidade Federal da Bahia (Salvador, Bahia, Brasil) Av. Araújo Pinho, 62 - Canela, Salvador/BA, Brasil - CEP: 40.110-040 E-mail: awmachado@ 123456gmail.com
                [»]

                The authors report no commercial, proprietary or financial interest in the products or companies described in this article.

                Conception/design of the study: BAF, JBPR, AWM. Data acquisition, analysis or interpretation: BAF, JBPR, AWM. Writing the article: BAF. Critical revision of the article: BAF, JBPR, AWM. Final approval of the article: BAF, JBPR, AWM. Overall responsibility: BAF, JBPR, AWM.

                Author information
                http://orcid.org/0000-0002-3254-2985
                http://orcid.org/0000-0001-6368-1542
                http://orcid.org/0000-0002-1313-7191
                Article
                10.1590/2177-6709.25.1.056-063.oar
                7077941
                443f8078-d665-4f98-a437-d66734a42ec8

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 19 August 2018
                : 22 October 2018
                Page count
                Figures: 2, Tables: 5, Equations: 0, References: 28, Pages: 8
                Categories
                Original Article

                orthodontics,dental esthetics,smile
                orthodontics, dental esthetics, smile

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