Influence of maxillary lateral incisor width ratio on perception of smile esthetics among orthodontists and laypersons

Abstract

Objective This study aimed to analyze the impact of different maxillary lateral incisor width ratios on the perception of smile esthetics among orthodontists and laypersons. Methods A smile photograph of a male subject showing the lips and gingival margins was selected. The smile was standardized for maxillary central incisor width proportions and ideally perceived smile esthetics. The maxillary lateral incisor width was symmetrically modified in increments of ratios of the central incisor from a ratio of 4:10 to a ratio of 8:10. The images were analyzed by 283 laypersons and 83 orthodontists who ranked the level of attractiveness using a visual analog scale. Results There were significant differences between the esthetic perception of the five different width ratios, and between the orthodontists and laypersons in their evaluations of esthetics (P < 0.0004). There were no significant differences in esthetic evaluations between genders. Conclusions For orthodontists, the most attractive width ratio was 5.7:10, while the highest ranked ratio among laypersons was 8:10, although laypersons ranked all ratios very similarly. Both groups ranked the width ratio of 4:10 the lowest. Orthodontists were more critical in their assessment of esthetics. Clinical significance To what proportions or protocol should a peg‐shaped maxillary lateral incisor or missing lateral, that is, to be replaced with an implant/crown be restored? This is an important clinical question that is often encountered by the orthodontist and the restoring dentist. The literature suggests that orthodontists and laypeople have different perceptions of smile esthetics, and it is important to have patient centered goals when treatment planning. Further research is necessary to identify the width ratio of which the lateral incisor is perceived to be esthetic as well as the ideal ratio to consider when restoring lateral incisors. This research assessed and compared the perception that orthodontists and laypeople have on smile esthetics regarding different width ratios of lateral incisors.

Esthetic Perception of Different Clinical Situations of Maxillary Lateral Incisor Agenesis According to Populations with Dental and Non-Dental Backgrounds: A Systematic Review and Meta-Analysis

“…Regarding the participating population, only two studies grouped the population according to age (25–60 years [ 16 ] and a mean age of 25 years [ 49 ]), which is a relevant factor [ 54 ], as older groups of laypeople tolerate more discrepancies in smile esthetics than younger groups, except for gingival exposure >6 mm during the smile (considered nonesthetic by all age groups). By contrast, the influence of gender on the esthetic perception of smiles is considered insignificant in the literature [ 30 , 48 , 49 , 54 , 55 ]. In this study, most studies only briefly described the participant’s gender, while the others omitted the subject.…”

Effect of smile esthetics on the quality of life in a Han Chinese population

“…Numerous studies have evaluated the perception of smile esthetics by laypersons and dental professionals 12,24,37 . Most studies found that laypersons and dental professionals have different perceptions of smile esthetics 12,24 .…”

“…23,35,36 Numerous studies have evaluated the perception of smile esthetics by laypersons and dental professionals. 12,24,37 Most studies found that laypersons and dental professionals have different perceptions of smile esthetics. 12,24 Hence, clinicians may consider the OHR-QoL of their patients in determining the treatment goal to improve the therapeutic effect and to maximize patient satisfaction, instead of focusing too much on specific components of smile esthetics.…”

“…12,24,37 Most studies found that laypersons and dental professionals have different perceptions of smile esthetics. 12,24 Hence, clinicians may consider the OHR-QoL of their patients in determining the treatment goal to improve the therapeutic effect and to maximize patient satisfaction, instead of focusing too much on specific components of smile esthetics. Notably, more esthetic concerns might be raised by females in clinical practice.…”

“…7 Furthermore, studies have reported that excessive gingival exposure has a substantial impact on how people perceive smile esthetics. 8,9 In addition, the buccal corridor, 10 the number of visible teeth in a smile, 11 and the maxillary lateral incisor dimension 6,12 are considered potential factors that affect smile esthetics in the literature.…”