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Perception of discrepancy in the upper midline position in conjunction with the gingival display according to various occupations in Iran

  • Hooman Zarif Najafi (Orthodontic Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences) ;
  • Taraneh Estedlal (Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences) ;
  • Maryam Saki (Orthodontic Research Center, Health System Research Center, Shiraz University of Medical Sciences) ;
  • Maryam Azadi (Private Practice)
  • Received : 2022.07.22
  • Accepted : 2023.01.12
  • Published : 2023.05.25

Abstract

Objective: This study evaluated the influence of various gingival displays on the esthetic perception in the presence of upper dental midline discrepancy. Methods: A smiling image of a male subject was altered digitally to produce five image series: normal smile (series A), decreased tooth show (series B), increased gingival show (series C), maxillary cant (series D), and asymmetric upper lip elevation (series E). In each image series, the midline was deviated to the right and left incrementally. A total of 210 raters (four professional groups and laypersons, n = 42 in each group) determined the midline deviation threshold and the attractiveness of midline position in each series. Results: The right and left thresholds were statistically similar for the symmetrical series (A, B, and C), while for series D, the right threshold was significantly lower. In most rater groups, the mean threshold order was: B > A > E > C > D. In all the series, the raters selected the coincident midline as the most attractive series except for series D, for which 1-2-mm deviations to the left were selected as the most attractive by almost all the groups. Conclusions: It is crucial to establish the coincident midline position in a symmetrical smile, especially when a gummy smile exists. In the asymmetrical gingival show, a coincident midline might not be the most esthetic midline position.

Keywords

Acknowledgement

The authors would like to thank the Vice-Chancellor for Research Affairs of Shiraz University of Medical Sciences (Shiraz, Iran) for supporting the research (grant number: 96-01-21-14557).

References

  1. Godinho J, Goncalves RP, Jardim L. Contribution of facial components to the attractiveness of the smiling face in male and female patients: a cross-sectional correlation study. Am J Orthod Dentofacial Orthop 2020;157:98-104. https://doi.org/10.1016/j.ajodo.2019.01.022
  2. Flores-Mir C, Silva E, Barriga MI, Lagravere MO, Major PW. Lay person's perception of smile aesthetics in dental and facial views. J Orthod 2004;31:204-9; discussion 201. https://doi.org/10.1179/146531204225022416
  3. Silva BP, Jimenez-Castellanos E, Martinez-de-Fuentes R, Fernandez AA, Chu S. Perception of maxillary dental midline shift in asymmetric faces. Int J Esthet Dent 2015;10:588-96. https://pubmed.ncbi.nlm.nih.gov/26794054/
  4. Silva BP, Jimenez-Castellanos E, Martinez-de-Fuentes R, Greenberg JR, Chu S. Laypersons' perception of facial and dental asymmetries. Int J Periodontics Restorative Dent 2013;33:e162-71. https://doi.org/10.11607/prd.1618
  5. Ker AJ, Chan R, Fields HW, Beck M, Rosenstiel S. Esthetics and smile characteristics from the layperson's perspective: a computer-based survey study. J Am Dent Assoc 2008;139:1318-27. https://doi.org/10.14219/jada.archive.2008.0043
  6. Kokich VO, Kokich VG, Kiyak HA. Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations. Am J Orthod Dentofacial Orthop 2006;130:141-51. https://doi.org/10.1016/j.ajodo.2006.04.017
  7. Dym H, Pierre R 2nd. Diagnosis and treatment approaches to a "gummy smile". Dent Clin North Am 2020;64:341-9. https://doi.org/10.1016/j.cden.2019.12.003
  8. Hwang WS, Hur MS, Hu KS, Song WC, Koh KS, Baik HS, et al. Surface anatomy of the lip elevator muscles for the treatment of gummy smile using botulinum toxin. Angle Orthod 2009;79:70-7. https://doi.org/10.2319/091407-437.1
  9. Waldrop TC. Gummy smiles: the challenge of gingival excess: prevalence and guidelines for clinical management. Semin Orthod 2008;14:260-71. https://doi.org/10.1053/j.sodo.2008.07.004
  10. Ishida Y, Ono T. Nonsurgical treatment of an adult with a skeletal Class II gummy smile using zygomatic temporary anchorage devices and improved superelastic nickel-titanium alloy wires. Am J Orthod Dentofacial Orthop 2017;152:693-705. https://doi.org/10.1016/j.ajodo.2016.09.030
  11. Parrini S, Rossini G, Castroflorio T, Fortini A, Deregibus A, Debernardi C. Laypeople's perceptions of frontal smile esthetics: a systematic review. Am J Orthod Dentofacial Orthop 2016;150:740-50. https://doi.org/10.1016/j.ajodo.2016.06.022
  12. An SM, Choi SY, Chung YW, Jang TH, Kang KH. Comparing esthetic smile perceptions among laypersons with and without orthodontic treatment experience and dentists. Korean J Orthod 2014;44:294-303. https://doi.org/10.4041/kjod.2014.44.6.294
  13. Beyer JW, Lindauer SJ. Evaluation of dental midline position. Semin Orthod 1998;4:146-52. https://doi.org/10.1016/s1073-8746(98)80016-9
  14. Chang CA, Fields HW Jr, Beck FM, Springer NC, Firestone AR, Rosenstiel S, et al. Smile esthetics from patients' perspectives for faces of varying attractiveness. Am J Orthod Dentofacial Orthop 2011;140:e171-80. https://doi.org/10.1016/j.ajodo.2011.03.022
  15. Ferreira JB, Silva LE, Caetano MT, Motta AF, CurySaramago AA, Mucha JN. Perception of midline deviations in smile esthetics by laypersons. Dental Press J Orthod 2016;21:51-7. https://doi.org/10.1590/2177-6709.21.6.051-057.oar
  16. Johnston CD, Burden DJ, Stevenson MR. The influence of dental to facial midline discrepancies on dental attractiveness ratings. Eur J Orthod 1999;21:517-22. https://doi.org/10.1093/ejo/21.5.517
  17. Pinho S, Ciriaco C, Faber J, Lenza MA. Impact of dental asymmetries on the perception of smile esthetics. Am J Orthod Dentofacial Orthop 2007;132: 748-53. https://doi.org/10.1016/j.ajodo.2006.01.039
  18. Cracel-Nogueira F, Pinho T. Assessment of the perception of smile esthetics by laypersons, dental students and dental practitioners. Int Orthod 2013;11:432-44. https://doi.org/10.1016/j.ortho.2013.09.007
  19. Rothas DA. Evaluation of the maxillary dental midline relative to the face [Master Thesis]. Chapel Hill: University of North Carolina; 2008. https://doi.org/10.17615/qmmk-xv57
  20. Sharma N, Rosenstiel SF, Fields HW, Beck FM. Smile characterization by U.S. white, U.S. Asian Indian, and Indian populations. J Prosthet Dent 2012;107:327-35. https://doi.org/10.1016/S0022-3913(12)60085-7
  21. Shyagali TR, Chandralekha B, Bhayya DP, Kumar S, Balasubramanyam G. Are ratings of dentofacial attractiveness influenced by dentofacial midline discrepancies? Aust Orthod J 2008;24:91-5. https://pubmed.ncbi.nlm.nih.gov/19113072/ https://doi.org/10.2478/aoj-2008-0013
  22. Springer NC, Chang C, Fields HW, Beck FM, Firestone AR, Rosenstiel S, et al. Smile esthetics from the layperson's perspective. Am J Orthod Dentofacial Orthop 2011;139:e91-101. https://doi.org/10.1016/j.ajodo.2010.06.019
  23. Williams RP, Rinchuse DJ, Zullo TG. Perceptions of midline deviations among different facial types. Am J Orthod Dentofacial Orthop 2014;145:249-55. https://doi.org/10.1016/j.ajodo.2013.02.034
  24. Zhang YF, Xiao L, Li J, Peng YR, Zhao Z. Young people's esthetic perception of dental midline deviation. Angle Orthod 2010;80:515-20. https://doi.org/10.2319/052209-286.1
  25. Ngoc VTN, Tran DK, Dung TM, Anh NV, Nga VT, Anh LQ, et al. Perceptions of dentists and nonprofessionals on some dental factors affecting smile aesthetics: a study from Vietnam. Int J Environ Res Public Health 2020;17:1638. https://doi.org/10.3390/ijerph17051638
  26. Kaya B, Uyar R. Influence on smile attractiveness of the smile arc in conjunction with gingival display. Am J Orthod Dentofacial Orthop 2013;144:541-7. https://doi.org/10.1016/j.ajodo.2013.05.006
  27. Alyami AH, Sanea JA, Togoo RA, Ain TS. Aesthetic perception about gingival display on maxillary incisor inclination among Saudi dentists, orthodontist and lay persons. J Clin Diagn Res 2018;12:56-60. https://doi.org/10.7860/JCDR/2018/33965.11835
  28. Graber LW, Vanarsdall RL, Vig KWL, Huang GJ. Orthodontics: current principles and techniques. 6th ed. Philadelphia: Elsevier Mosby; 2017. https://www.amazon.com/Orthodontics-Lee-Graber-DDS-PhD/dp/0323378323
  29. Proffit WR, Fields HW, Larson B, Sarver DM. Contemporary orthodontics. 6th ed. Philadelphia: Elsevier Health Sciences; 2018. https://shop.elsevier.com/books/contemporary-orthodontics/proffit/978-0-323-54387-3
  30. Fernandes L, Pinho T. Esthetic evaluation of dental and gingival asymmetries. Int Orthod 2015;13:221-31. https://doi.org/10.1016/j.ortho.2015.03.005
  31. Ioi H, Nakata S, Counts AL. Influence of gingival display on smile aesthetics in Japanese. Eur J Orthod 2010;32:633-7. https://doi.org/10.1093/ejo/cjq013
  32. Naini FB, Donaldson AN, Cobourne MT, McDonald F. Assessing the influence of mandibular prominence on perceived attractiveness in the orthognathic patient, clinician, and layperson. Eur J Orthod 2012;34:738-46. https://doi.org/10.1093/ejo/cjr098
  33. Naini FB, Donaldson AN, McDonald F, Cobourne MT. Assessing the influence of asymmeftry affecting the mandible and chin point on perceived attractiveness in the orthognathic patient, clinician, and layperson. J Oral Maxillofac Surg 2012;70:192-206. https://doi.org/10.1016/j.joms.2010.12.055
  34. Al-Ansari A, Ellakany P, Fouda S, Al-Sheikh R, El Tantawi M. Intention to seek esthetic dental treatment and the theory of planned behavior in Saudi dental students and the general population. J Prosthet Dent 2020;124:774-9. https://doi.org/10.1016/j.prosdent.2019.07.005
  35. Meyer-Marcotty P, Stellzig-Eisenhauer A. Dentofacial self-perception and social perception of adults with unilateral cleft lip and palate. J Orofac Orthop 2009;70:224-36. https://doi.org/10.1007/s00056-009-8813-9
  36. Alhammadi MS, Halboub E, Al-Dumaini AA, Malhan SM, Alfaife F, Otudi J. Perception of dental, smile and gingival esthetic components by dental specialists, general dental practitioners, dental assistants and laypersons: a cross-sectional study. World J Dent 2022;13:250-60. https://doi.org/10.5005/jpjournals-10015-1918
  37. Sadrhaghighi H, Zarghami A, Sadrhaghighi S, Eskandarinezhad M. Esthetic perception of smile components by orthodontists, general dentists, dental students, artists, and laypersons. J Investig Clin Dent 2017;8:e12235. https://doi.org/10.1111/jicd.12235