Visibility of gingiva - An important determinant for an esthetic smile

Abstract

Background:Need for having better esthetics is the new emerging trend seen in patients’ demands and expectations. Various periodontal procedures including the mucogingival procedures have been designed to enhance the esthetics. The amount of gingival display of the patient is also an important parameter while considering the esthetics of the patient. Till date, very few studies have been done in which the amount of gingival visibility have been determined. So, the aim of this study was to evaluate the amount of visibility of gingiva during natural smile and forced smile in the patients visiting Himachal Dental College and Hospital.Materials and Methods:A total of 400 patients (242 females and 158 males), aged between 18 to 49 years, attending the outpatient department of Himachal Dental College, were included in this study. Patients were divided into two groups according to age and gender. Clinical photographs of the patients were taken and analyzed according to the following classification: (1) Very high smile line that is more than 2 mm of marginal gingiva visible or more than 2 mm apical to the cementoenamel junction visible for the reduced but healthy periodontium, (2) high smile line that is between 0 and 2 mm of marginal gingiva visible or between 0 and 2 mm apical to the cementoenamel junction visible for the reduced but healthy periodontium, (3) average smile line in which only gingival embrasures are visible, (4) low smile line in which gingival embrasures and cementoenamel junction not visible. Examination of the gingiva was done for both natural smile and forced smile.Results:During smile analysis, the following results were revealed for Natural smile and forced smile. Natural smile analysis revealed following: C1: 1%, C2: 6%, C3: 43.50% and C4 was 49.50%. Forced smile analysis revealed the following: C1: 1%, C2: 15.50%, C3: 59% and C4: 24.50%.Conclusions:Excessive gingival display is an esthetic concern both to the patient and clinician. Therefore, understanding the etiology and treatment options is crucial for the treatment of such patients. So, it becomes utmost duty of the dentist to see that visual attractiveness of the smile is associated strongly with the health of the periodontium.

Association of the nasolabial angle and lip length with the gingival and interdental smile line—A gender based evaluation

“…The enrichment of esthetics during restoration of the dentition especially in the anterior sextant has been desired by clinicians over the past several decades. Several attempts have been made by dental professionals in recognizing minute characteristics such as gingival zenith position, 16 gingival display, 17 tooth and gingival display, 18 and facial and dental proportions, 19 , which can be considered and incorporated to augment esthetics through different treatment approaches. Harmonious relationship of the perioral structures including the NLA and LL with the tooth and gingival exhibit at rest and during smiling along with their relationship in GSL and ISL seem to be of utmost importance in an esthetic smile, which is one of the main objectives of the present clinical study.…”

Contrasting perceptions of male and female dental students regarding smile aesthetics based on their gingival display

“…Subjects subsequently made an assessment on a scale of 1 to 4 based on the smile classification ( Figure 1), namely; 1) very high smile indicated by the width of the smile margin of the gingival upper jaw or apical to cement-enamel junction being more than two millimetres, 2) high smile line with the gingival upper jaw margin (apical to the cementoenamel junction) measuring more than two millimetres, 3) average smile line in which only a gingival embrasure is visible, 4) low smile line in which the gingival embrasure and cementoenamel junction is not visible. 12 The research subjects underwent re-assessment after two weeks to establish whether any difference existed between the first and the second assessment. In cases where a difference existed, a re-assessment process was undertaken two weeks after the second assessment with the average being calculated from the data collected.…”

Smile line - assessment and variations in relation to age and sex

“…Важен компонент на цялостната естетика на усмивката са формата, позицията и контурът на меките гингивални тъкани (5). Съвкупността от всички тези фактори определя наличието на една задоволително естетична усмивка (9).…”

“…Някои автори считат, че най-разпространена е средната линия на усмивката (варирайки от 56% до 68.94%), следвана от ниска линия на усмивката (от 15% до 20.48%) и висока линия на усмивката (от 10.48% до 29%). Поради това в повечето случаи при усмивка са видими само интерденталните папили (9). В едно свое изследване, позовавайки се на класификацията на Liebert, Hundgund и кол.…”