Abstract
Ethical Statement
Sayın Editör, Sunulan çalışma bir anket araştırmasıdır ve 2019 yılında yürütülmüştür. Çalışmanın planlanma sürecinde bir proje hazırlanmış, bu proje ilgili araştırma kurulu tarafından değerlendirilerek onaylanmıştır. Ancak, çalışmanın gerçekleştirildiği dönemde anket temelli araştırmalar için etik kurul onayı zorunlu olmadığından, ilgili kurul bu doğrultuda bir işlem veya yaptırım uygulamamıştır.
Supporting Institution
Not applicable
Project Number
D-KA19/15
References
- 1. Geduk S, Sahin O, Velioglu N. Comparison of subjective esthetic perceptions of dentists with different gender and clinical experiences with objective dentolabial esthetic measurements. Cumhuriyet Dent J 2020; 23(3):209-220.
- 2. Chang CA, Fields HW, Beck FM, Springer NC, Firestone AR, Rosenstiel S, Christensen JC. Smile esthetics from patients’ perspectives for faces of varying attractiveness. American Journal of Orthodontics and Dentofacial Orthopedics 2011;140(4):171-180.
- 3. Nordholm LA. Beautiful patients are good patients: evidence for the physical attractiveness stereotype in first impressions of patients. Soc Sci Med 1980;14A(1):81-83.
- 4. Langlois JH, Kalakanis L, Rubenstein AJ, Larson A, Hallam M, Smoot M. Maxims or myths of beauty? A meta-analytic and theoretical review. Psychol Bull 2000;126(3):390-423.
- 5. Shaw WC, Rees G, Dawe M, Charles CR. The influence of dentofacial appearance on the social attractiveness of young adults. Am J Orthod 1985;87(1):21-26.
- 6. Fradeani M. Evaluation of dentolabial parameters as part of a comprehensive esthetic analysis. Eur J Esthet Dent 2006;1(1):62-69.
- 7. Matthews TG. The anatomy of a smile. J Prosthet Dent 1978;39(2):128-134.
- 8. Newton JT, Prabhu N, Robinson PG. The impact of dental appearance on the appraisal of personal characteristics. Int J Prosthodont 2003;16(4):429-434.
- 9. Carlsson GE, Johansson A, Johansson AK, Ordell S, Ekbäck G, Unell L. Attitudes toward Dental Appearance in 50‐ and 60‐Year‐Old Subjects Living in Sweden. Journal of Esthetic and Restorative Dentistry 2008 25;20(1):46-55.
- 10. Scoble HO, White SN. Compound complex curves: the authentic geometry of esthetic dentistry. J Prosthet Dent 2014;111(6):448-454.
- 11. Dawson PE. Determining the determinants of occlusion. Int J Periodontics Restorative Dent 1983;3(6):8-21.
- 12. Hulsey CM. An esthetic evaluation of lip-teeth relationships present in the smile. Am J Orthod 1970;57(2):132-144
- 13. Sarver DM. The importance of incisor positioning in the esthetic smile: the smile arc. Am J Orthod Dentofacial Orthop 2001;120(2):98–111.
- 14. Sarver DM, Ackerman MB. Dynamic smile visualization and quantification: Part 2. Smile analysis and treatment strategies. Am J Orthod Dentofacial Orthop 2003;124(2):116-127.
- 15. Mackley RJ. An evaluation of smiles before and after orthodontic treatment. Angle Orthod 1993;63(3):183-189.
- 16. Kokich VO, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Dent 1999;11(6):311-324.
- 17. Tjan AH, Miller GD, The JG. Some esthetic factors in a smile. J Prosthet Dent 1984;51(1):24-28.
- 18. Pisulkar S, Agrawal R, Belkhode V, Nimonkar S, Borle A, Godbole S. Perception of buccal corridor space on smile aesthetics among specialty dentist and layperson. Journal of International Society of Preventive and Community Dentistry 2019;9(5):499-504.
- 19. Moore T, Southard KA, Casko JS, Qian F, Southard TE. Buccal corridors and smile esthetics. Am J Orthod Dentofacial Orthop 2005;127(2):208-213.
- 20. Ioi H, Nakata S, Counts AL. Effects of buccal corridors on smile esthetics in Japanese. Angle Orthod 2009;79(4):628-633.
- 21. Ritter DE, Gandini LG, Pinto ADS, Locks A. Esthetic influence of negative space in the buccal corridor during smiling. Angle Orthod 2006;76(2):198-203.
- 22. Morley J. A multidisciplinary approach to complex aesthetic restoration with diagnostic planning. Pract Periodontics Aesthet Dent 2000;12(6):575-577.
- 23. Morley J, Eubank J. Macroesthetic elements of smile design. J Am Dent Assoc 2001;132(1):39-45.
- 24. Foulger TE, Tredwin CJ, Gill DS, Moles DR. The influence of varying maxillary incisal edge embrasure space and interproximal contact area dimensions on perceived smile aesthetics. Br Dent J 2010; 14;209(3):E4.
- 25. Albino JE, Tedesco LA, Conny DJ. Patient perceptions of dental-facial esthetics: shared concerns in orthodontics and prosthodontics. J Prosthet Dent 1984;52(1):9-13.
- 26. Pogrel MA. What are normal esthetic values? J Oral Maxillofac Surg 1991;49(9):963-969.
- 27. Schmidt CJ, Tatum SA. Cosmetic dentistry. Curr Opin Otolaryngol Head Neck Surg 2006;14(4):254-259.
- 28. Bhuvaneswaran M. Principles of smile design. J Conserv Dent 2010;13(4):225-232.
- 29. Peck S, Peck L, Kataja M. The gingival smile line. Angle Orthod 1992;62(2):91-100.
- 30. Vig RG, Brundo GC. The kinetics of anterior tooth display. J Prosthet Dent 1978;39(5):502-504.
- 31. Roden-Johnson D, Gallerano R, English J. The effects of buccal corridor spaces and arch form on smile esthetics. American Journal of Orthodontics and Dentofacial Orthopedics 2005;127(3):343-350.
- 32. Gracco A, Cozzani M, D’Elia L, Manfrini M, Peverada C, Siciliani G. The smile buccal corridors: aesthetic value for dentists and laypersons. Prog Orthod 2006;7(1):56-65.
- 33. Parekh SM, Fields HW, Beck M, Rosenstiel S. Attractiveness of variations in the smile arc and buccal corridor space as judged by orthodontists and laymen. Angle Orthod 2006;76(4):557-563.
- 34. Owens EG, Goodacre CJ, Loh PL, Hanke G, Okamura M, Jo KH, Muñoz CA, Naylor WP. A multicenter interracial study of facial appearance. Part 2: A comparison of intraoral parameters. Int J Prosthodont 2002;15(3):283-288.
- 35. Mackley RJ. An evaluation of smiles before and after orthodontic treatment. Angle Orthod 1993;63(3):183-189
- 36. Allen EP. Use of mucogingival surgical procedures to enhance esthetics. Dent Clin North Am 1988;32(2):307-330.
- 37. Rosa M, Olimpo A, Fastuca R, Caprioglio A. Perceptions of dental professionals and laypeople to altered dental esthetics in cases with congenitally missing maxillary lateral incisors. Prog Orthod 2013;14:34.
- 38. Van der Geld P, Oosterveld P, Van Heck G, Kuijpers-Jagtman AM. Smile attractiveness. Self-perception and influence on personality. Angle Orthod 2007;77(5):759-765.
Smile Perception Through Different Eyes: Esthetic Preferences of Prosthodontics, Senior Dental Students and Laypersons
Abstract
Objectives: This study aimed to evaluate whether changes in the visibility of the lower incisors, the angulation of the incisors and lower lip harmony, amount of buccal corridor, upper gingival visibility, and the depth of the embrasure create differences in aesthetic perception among prosthodontists, senior dental students, and laypersons.
Material and Methods: Standardized frontal and intraoral photographs of a male and female model were digitally modified to reflect different aesthetic variations. A 13-question online survey was conducted with 148 prosthodontists, 245 senior dentistry students, and 147 laypersons, who selected the most aesthetically pleasing images. The responses were analyzed using statistical methods including Likelihood Ratio Test, Pearson's Chi-Square, Fisher's Exact Test, Continuity Corrected Chi-Square Test, and McNemar Test. A significance level of p < 0.05 was applied.
Results: Prosthodontists demonstrated the highest accuracy in evaluating aesthetic parameters. Female model images were perceived as more aesthetically correct than male model images. High lower incisor visibility was considered unaesthetic by all groups, while buccal corridor width changes had minimal impact. Reverse incisor inclination and lower lip misalignment were deemed unattractive. Normal upper gingival display was preferred for females, while no consensus was found for males. Altered lower incisor visibility by cosmetic treatment applied to upper incisors improved aesthetic perception in both genders.
Conclusion: This study underscores the importance of integrating scientific criteria with subjective perception in smile design. Personalized treatment approaches considering gender differences and patient expectations can optimize aesthetic outcomes. The findings provide valuable insights for clinicians in aesthetic and prosthetic dentistry.
Ethical Statement
Dear Editor, The submitted study is a survey-based research conducted in 2019. During the planning phase, a project proposal was prepared and approved by the relevant research committee. However, at the time the study was conducted, ethical approval was not mandatory for survey-based studies. Therefore, the committee did not impose any requirement or take action regarding ethics approval.
Supporting Institution
Not applicable
Project Number
D-KA19/15
Thanks
Not applicable
References
- 1. Geduk S, Sahin O, Velioglu N. Comparison of subjective esthetic perceptions of dentists with different gender and clinical experiences with objective dentolabial esthetic measurements. Cumhuriyet Dent J 2020; 23(3):209-220.
- 2. Chang CA, Fields HW, Beck FM, Springer NC, Firestone AR, Rosenstiel S, Christensen JC. Smile esthetics from patients’ perspectives for faces of varying attractiveness. American Journal of Orthodontics and Dentofacial Orthopedics 2011;140(4):171-180.
- 3. Nordholm LA. Beautiful patients are good patients: evidence for the physical attractiveness stereotype in first impressions of patients. Soc Sci Med 1980;14A(1):81-83.
- 4. Langlois JH, Kalakanis L, Rubenstein AJ, Larson A, Hallam M, Smoot M. Maxims or myths of beauty? A meta-analytic and theoretical review. Psychol Bull 2000;126(3):390-423.
- 5. Shaw WC, Rees G, Dawe M, Charles CR. The influence of dentofacial appearance on the social attractiveness of young adults. Am J Orthod 1985;87(1):21-26.
- 6. Fradeani M. Evaluation of dentolabial parameters as part of a comprehensive esthetic analysis. Eur J Esthet Dent 2006;1(1):62-69.
- 7. Matthews TG. The anatomy of a smile. J Prosthet Dent 1978;39(2):128-134.
- 8. Newton JT, Prabhu N, Robinson PG. The impact of dental appearance on the appraisal of personal characteristics. Int J Prosthodont 2003;16(4):429-434.
- 9. Carlsson GE, Johansson A, Johansson AK, Ordell S, Ekbäck G, Unell L. Attitudes toward Dental Appearance in 50‐ and 60‐Year‐Old Subjects Living in Sweden. Journal of Esthetic and Restorative Dentistry 2008 25;20(1):46-55.
- 10. Scoble HO, White SN. Compound complex curves: the authentic geometry of esthetic dentistry. J Prosthet Dent 2014;111(6):448-454.
- 11. Dawson PE. Determining the determinants of occlusion. Int J Periodontics Restorative Dent 1983;3(6):8-21.
- 12. Hulsey CM. An esthetic evaluation of lip-teeth relationships present in the smile. Am J Orthod 1970;57(2):132-144
- 13. Sarver DM. The importance of incisor positioning in the esthetic smile: the smile arc. Am J Orthod Dentofacial Orthop 2001;120(2):98–111.
- 14. Sarver DM, Ackerman MB. Dynamic smile visualization and quantification: Part 2. Smile analysis and treatment strategies. Am J Orthod Dentofacial Orthop 2003;124(2):116-127.
- 15. Mackley RJ. An evaluation of smiles before and after orthodontic treatment. Angle Orthod 1993;63(3):183-189.
- 16. Kokich VO, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Dent 1999;11(6):311-324.
- 17. Tjan AH, Miller GD, The JG. Some esthetic factors in a smile. J Prosthet Dent 1984;51(1):24-28.
- 18. Pisulkar S, Agrawal R, Belkhode V, Nimonkar S, Borle A, Godbole S. Perception of buccal corridor space on smile aesthetics among specialty dentist and layperson. Journal of International Society of Preventive and Community Dentistry 2019;9(5):499-504.
- 19. Moore T, Southard KA, Casko JS, Qian F, Southard TE. Buccal corridors and smile esthetics. Am J Orthod Dentofacial Orthop 2005;127(2):208-213.
- 20. Ioi H, Nakata S, Counts AL. Effects of buccal corridors on smile esthetics in Japanese. Angle Orthod 2009;79(4):628-633.
- 21. Ritter DE, Gandini LG, Pinto ADS, Locks A. Esthetic influence of negative space in the buccal corridor during smiling. Angle Orthod 2006;76(2):198-203.
- 22. Morley J. A multidisciplinary approach to complex aesthetic restoration with diagnostic planning. Pract Periodontics Aesthet Dent 2000;12(6):575-577.
- 23. Morley J, Eubank J. Macroesthetic elements of smile design. J Am Dent Assoc 2001;132(1):39-45.
- 24. Foulger TE, Tredwin CJ, Gill DS, Moles DR. The influence of varying maxillary incisal edge embrasure space and interproximal contact area dimensions on perceived smile aesthetics. Br Dent J 2010; 14;209(3):E4.
- 25. Albino JE, Tedesco LA, Conny DJ. Patient perceptions of dental-facial esthetics: shared concerns in orthodontics and prosthodontics. J Prosthet Dent 1984;52(1):9-13.
- 26. Pogrel MA. What are normal esthetic values? J Oral Maxillofac Surg 1991;49(9):963-969.
- 27. Schmidt CJ, Tatum SA. Cosmetic dentistry. Curr Opin Otolaryngol Head Neck Surg 2006;14(4):254-259.
- 28. Bhuvaneswaran M. Principles of smile design. J Conserv Dent 2010;13(4):225-232.
- 29. Peck S, Peck L, Kataja M. The gingival smile line. Angle Orthod 1992;62(2):91-100.
- 30. Vig RG, Brundo GC. The kinetics of anterior tooth display. J Prosthet Dent 1978;39(5):502-504.
- 31. Roden-Johnson D, Gallerano R, English J. The effects of buccal corridor spaces and arch form on smile esthetics. American Journal of Orthodontics and Dentofacial Orthopedics 2005;127(3):343-350.
- 32. Gracco A, Cozzani M, D’Elia L, Manfrini M, Peverada C, Siciliani G. The smile buccal corridors: aesthetic value for dentists and laypersons. Prog Orthod 2006;7(1):56-65.
- 33. Parekh SM, Fields HW, Beck M, Rosenstiel S. Attractiveness of variations in the smile arc and buccal corridor space as judged by orthodontists and laymen. Angle Orthod 2006;76(4):557-563.
- 34. Owens EG, Goodacre CJ, Loh PL, Hanke G, Okamura M, Jo KH, Muñoz CA, Naylor WP. A multicenter interracial study of facial appearance. Part 2: A comparison of intraoral parameters. Int J Prosthodont 2002;15(3):283-288.
- 35. Mackley RJ. An evaluation of smiles before and after orthodontic treatment. Angle Orthod 1993;63(3):183-189
- 36. Allen EP. Use of mucogingival surgical procedures to enhance esthetics. Dent Clin North Am 1988;32(2):307-330.
- 37. Rosa M, Olimpo A, Fastuca R, Caprioglio A. Perceptions of dental professionals and laypeople to altered dental esthetics in cases with congenitally missing maxillary lateral incisors. Prog Orthod 2013;14:34.
- 38. Van der Geld P, Oosterveld P, Van Heck G, Kuijpers-Jagtman AM. Smile attractiveness. Self-perception and influence on personality. Angle Orthod 2007;77(5):759-765.
Details
| Primary Language | English |
|---|---|
| Subjects | Prosthodontics |
| Journal Section | Research Article |
| Authors | |
| Project Number | D-KA19/15 |
| Submission Date | April 26, 2025 |
| Acceptance Date | July 5, 2025 |
| Publication Date | December 29, 2025 |
| Published in Issue | Year 2025 Volume: 28 Issue: 4 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
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