Aesthetic perception after root coverage procedure

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.

A survey of the characteristics of an open smile was conducted with 454 full-face photographs of randomly selected dental and dental hygiene students. Findings show that an average smile exhibits approximately the full length of the maxillary anterior teeth, has the incisal curve of the teeth parallel to the inner curvature of the lower lip, has the incisal curve of the maxillary anterior teeth touching slightly or missing slightly the lower lip, and displays the six upper anterior teeth and premolars. Consideration of the characteristics may be useful in improving the esthetics of restorations.