Altered gingival display in 2.0-mm increments. 1 −4 mm; 2 −2.0 mm; 3 0 mm; 4 +2.0 mm; 5 +4.0 mm; and 6 +6 mm 

Altered gingival display in 2.0-mm increments. 1 −4 mm; 2 −2.0 mm; 3 0 mm; 4 +2.0 mm; 5 +4.0 mm; and 6 +6 mm 

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Background Age is a factor affecting smile esthetics. Three variables of smile esthetics associated with the maxillary anterior teeth and age-related changes have recently received considerable attention: (i) the incisal edge position of the maxillary central incisors, (ii) the maxillary gingival display, and (iii) the presence of a black triangle...

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... distance between the upper lip and gingival margin of the maxillary incisors was 0 mm in the reference image. The gingival display was altered using 2-mm increments by decreasing (−) the distance of the gingival margin between the maxillary incisors and upper lip by 2.0 and 4.0 mm and by increasing (+) the margin by 2.0, 4.0, and 6.0 mm (Fig. ...

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... The appearance of a smile plays a fundamental role in judging the attractiveness of a face [1][2][3]. Such a linkage has been extensively investigated by many scientific studies aimed at evaluating the perception of smile aesthetics based on the characteristics of the occlusion as well as on the make-up of the examining population [4][5][6][7][8][9][10][11][12]. A regular and healthy-looking smile is considered an expression of well-being and self-confidence, closely linked to a younger and more attractive appearance [13][14][15][16]. ...
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Smart eye-tracking technology (SEET) that determines visual attention using smartphones can be used to determine the aesthetic perception of different types of clear aligners. Its value as a communication and comprehension tool, in addition to the ethical and legal concerns which it entails, can be assessed. One hundred subjects (50 F, 50 M; age range 15–70) were equally distributed in non-orthodontic (A) and orthodontic (B) groups. A smartphone-based SEET app assessed their knowledge of and opinions on aligners. Subjects evaluated images of smiles not wearing aligners, with/without attachments and with straight/scalloped gingival margins, as a guided calibration step which formed the image control group. Subsequently, the subjects rated the same smiles, this time wearing aligners (experimental images group). Questionnaire data and average values for each group of patients, and images relating to fixation times and overall star scores, were analyzed using these tests: chi-square, t-test, Mann–Whitney U, Spearman’s rho, and Wilcoxon (p < 0.05). One-way ANOVA and related post-hoc tests were also applied. Orthodontic patients were found to be better informed than non-orthodontic patients. Aesthetic perception could be swayed by several factors. Attachments scored lower in aesthetic evaluation. Lips distracted attention from attachments and improved evaluations. Attachment-free aligners were better rated overall. A more thorough understanding as to the opinions, expectations and aesthetic perception of aligners can improve communication with patients. Mobile SEET is remarkably promising, although it does require a careful medicolegal risk–benefit assessments for responsible and professional use.
... Previous studies evaluating the perception of attractiveness have used either profile or frontal photographs. 21,27,28 In these studies, photographs are modified 2-dimensionally using Photoshop (Adobe Systems, San Jose, Calif) or equivalent software. Researchers have also used silhouette images in similar studies. ...
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... However, face and mouth photography does not infuence smile attractiveness perceptions [2]. In the literature, smile photographs included in questionnaires have included teeth, lips, and a minimal amount of surrounding skin to avoid the efects of facial structures on smile attractiveness [5,14,17,23]. Te set of 27 smile photographs used in this study was ordered randomly, and each photograph was rated within 10 s. Tus, the raters did not know what aspect was modifed in each photo and did not rate in an incremental trend, which eliminated the bias of rating. ...
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This study determined the effect of lip thickness, lipstick color, and tooth shade on the smile attractiveness perceptions of dentists, laypersons, dental students, and other faculty students. A set of 27 smile photographs was prepared with different lip thicknesses (Tk, thick; M, medium; and Tn, thin), lipstick shade (R, red; P , pink; and O, orange), and tooth shades (0M1, 0M3, and A1). A total of 212 Thai participants in four rater groups (dentists, laypersons, dental students, and other faculty students) rated smile attractiveness using a visual analog scale (VAS). Statistical analyses were performed using the Kruskal-Wallis test and pairwise analysis at a 0.05% level of significance. Tk or M lip thickness was associated with more smile attractiveness than Th lip thickness. The R lipstick is more attractive than the P and O lipsticks. The 0M1 tooth shade appeared to be the most attractive for laypersons and other faculty students, whereas tooth shades (0M1, 0M3, or A1) did not influence the smile attractiveness perception of dentists and dental students. The smile attractiveness perception was influenced by the lip appearance and tooth shade for each rater group, which are essential for an attractive smile design.
... These results do not align with the results of the present study, in which only small differences were noted between middle-aged adults and elders. Sriphadungporn and Chamnannidiadha reported that age had an impact on the perception of smile esthetics [35], which also disagrees with our findings, as no significant differences were found between different age ranges. Differences were only found between different levels of malocclusion. ...
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... Van der Geld et al., 2007 also found that gingival display was a critical factor in people's satisfaction with their smile: a total dental display with a gingival display of 2 to 4mm was considered the most aesthetic according to their study. Other studies in which participants evaluated the smiles presented in images with different gingival display levels showed that the latter significantly influences the perception of the smile attractiveness (Kaya B & Uyar R 2013;Sriphadungporn C & Chamnannidiadha N 2017;Sybaite J et al., 2020;Hunt O 2002;(Tosun H & Kaya B 2020). Excessive gingival display (6 mm) is generally considered the least attractive (Sriphadungporn C & Chamnannidiadha N 2017;Sybaite J et al., 2020). ...
... Other studies in which participants evaluated the smiles presented in images with different gingival display levels showed that the latter significantly influences the perception of the smile attractiveness (Kaya B & Uyar R 2013;Sriphadungporn C & Chamnannidiadha N 2017;Sybaite J et al., 2020;Hunt O 2002;(Tosun H & Kaya B 2020). Excessive gingival display (6 mm) is generally considered the least attractive (Sriphadungporn C & Chamnannidiadha N 2017;Sybaite J et al., 2020). ...
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Abstract Background: This study aimed to assess the smile dimensions according to gender, age, and the perception of the overall quality and attractiveness of the smile. Methods: A cross-sectional study including 204 Moroccan men and women distributed over five age categories was conducted between January and September 2021. Gender, age, satisfaction and auto-evaluation of the smile were collected using questionnaire. Then, two images of each participant, one at rest and one upon the largest smile were taken. The following distances were measured on the images: length of the lips and width of the mouth at rest and upon smile, gingival and maxillary central incisor displayed upon smile. Results: Dimensions were significantly more important in men. Women displayed significantly more gingiva. With age, the length of the upper lip at rest increased significantly until the age of 50 and the width of the mouth upon smile continued increasing significantly. 74% of the participants were satisfied with their smile. Participants' satisfaction with their smile was not associated with the degree of gingival display. Conclusion: Males have more important dimensions of the lips and the mouth. Females display more gum than males. Age influences the upper lip length at rest which increases up to the age of 50, and the mouth width upon smile which continues to increase with age. Practical Implications: The definition of specific facial norms for each ethnic group considering gender and age groups is essential to establish diagnoses and orthodontic treatment plans.
... Esthetic tolerance may be affected by age, education level, social status, and cultural differences. [3][4][5] In addition, some studies have reported higher esthetic tolerance of a deep bite and anterior open bite (AOB) than protrusion and crowding, 5,6 but others found that esthetic tolerance of a deep bite and AOB were low. 3,7 Studies about the effect of recognition on the tolerance of a problem have been conducted mostly in the field of socioeconomics and with varied results. ...
... First, previous studies found that age, sex, education level, and socioeconomic factors were related to selfrecognition of malocclusion. 4,22,33,34 The lack of influence of these factors found in the current study may have been attributed to type II error. Increasing the number of samples in each stratification could help to yield more accurate results. ...
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Objectives To determine recognition ability and the levels of esthetic tolerance of deep bite and anterior open bite (AOB) among laypeople and investigate the factors affecting levels of tolerance. Materials and Methods Using a questionnaire, laypeople (N = 100) were examined, and overbite was measured. They were tested for whether they recognized deep bite and AOB. Esthetic tolerance thresholds for deep bite and AOB were selected by incremental depiction in grayscale images. Stepwise logistic regression analyses were used to quantify the effect of recognition and other factors (age, sex, education level, occupation, history of orthodontic treatment, interest in orthodontic treatment or retreatment, and overbite presence) affecting the tolerance of overbite problems (α = 0.05). Results Of the participants, 55% and 94% recognized deep bite and AOB, respectively. Participants with a deep bite were significantly more likely to esthetically tolerate deep bite compared with those without a deep bite (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.29–9.89). Participants who recognized a deep bite problem had significantly lower esthetic tolerance to deep bite compared with participants who did not recognize a deep bite (OR, 0.17; 95% CI, 0.06–0.45). None of the other eight chosen factors significantly affected the tolerance level of AOB (P > .05). Conclusions Participants with a deep bite or those who did not recognize a deep bite had significantly higher esthetic tolerance of deep bite than those without or those who recognized the problem (P < .05).
... This result is partially in agreement with the findings of previous studies. [26][27][28] Pithon et al. 26 reported that younger laypeople are more critical of dental esthetics than older people. A similar finding was observed in a study 27 which focused on the definition of smile attractiveness and its esthetic criteria differences, in which younger evaluators were more critical when evaluating smiles with diastema. ...
... [1] Likewise, the smile is an important aspect of facial aesthetics. [2] A beautiful smile and harmonic facial esthetics are attributes that contribute to the well-being of any person. [1] However, the definition of dental esthetics varies widely among continents, countries, different regions, and populations. ...
... [3] Nowadays, the focus on facial esthetics as an indicator of social value has increased. [2] Esthetic dentistry also plays a special role in patients' lives, especially currently where media promotes the attractiveness in perfect faces and ideal smiles [4] and social media continually attracts patients' attention for cosmetic dentistry. This results in increasing patients' requests to get an ideal smile. ...
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Purpose: This study aims to assess the factors that determine the aspiration for "Hollywood smile" among the residents in five Gulf countries. Materials and methods: A survey was conducted among subjects aged 18-60 years. A self-designed 19 items questionnaire was prepared which consisted of multiple choices and open-ended questions. The first part of the survey included demographic questions. The second part included questions related to Hollywood smile. Descriptive statistics were calculated, and the association between different variables was assessed by Chi-square test where P ≤ 0.05 was considered statistically significant. Results: A total of 2061 subjects participated in the survey. The majority of participants were females (76.81%), 97.28% of them were aware of the term "Hollywood smile," and social media was the source of information. Statistically significant difference was noted among participants who underwent treatment according to residency place, age, educational level, and socioeconomic status (SES) and participants who were willing to undergo treatment in future according to gender, age, and SES. Conclusion: Subjects of younger age, higher education level, and higher SES underwent treatment. However, 23.83% of people were willing to undergo treatment. This reflects the increasing demand for esthetic treatment in future.
... Earlier studies have shown that the perfect smile arc enhances smile attractiveness while the reverse smile arc greatly decreases smile attractiveness (Hulsey, 1970;Zachrisson, 1998;Gracco et al., 2006;Zawawi et al., 2013;Mokhtar et al., 2015;Sriphadungporn & Chamnannidiadha, 2017), and only a few studies have shown that the smile arc has little impact on the aesthetic benefit of a smile (McNamara et al., 2008;Rai et al., Arabian cities. Future studies should also include participants from diverse cultures and ethnicities to evaluate intercultural differences in smile attractiveness perception. ...
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Smile aesthetic, known as the static and dynamic relationship of the dentition and supporting structures to the facial soft tissues, is one of the most important elements of facial attractiveness. The objective of the study was to assess the perception of smile aesthetics and attractiveness through digital image manipulation of aesthetic variables and to compare those perceptions according to diverse sociodemographic data among female Saudi laypeople attending the dental clinic. A crosssectional study of 193 female Saudi participants were randomly selected and consented to answer the study questionnaire. Nine smile photograph images were created to compare different smile aesthetic perceptions. Two groups were recruited: 120 participants in the first group (under 30 years old) and 73 participants in the second group (30 years old or above). All participants in both groups were asked to choose the attractiveness of each smile image using multiple-choice options. A statistically significant finding showed that normal buccal corridors were chosen as the most attractive smile by 42.5% of the participants in the younger group and by a significantly higher ratio of the participants with a bachelor’s degree or higher level of education at 49% (p < 0.05). Laypeople’s preferences regarding smile attractiveness vary, but a normal appearance was the ideal choice for the majority. Orthodontic treatment should consider the general sociocultural understanding of smile perception.
... Many studies indicate that the age of the evaluators affects the perception of smile components. In the study by Sriphadungporn C et al. [53], younger subjects preferred gingival exposure of 0-2 mm when smiling, while older subjects were much less critical and positively evaluated gingival exposure ranging from −4 to +2 mm. The older age group also showed greater tolerance for the presence of a black triangle between the upper central incisors. ...
Article
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Dental aesthetics is an essential factor affecting people’s psychosocial wellbeing. One of the most critical components of an aesthetic smile is symmetry within the dentition. Dentists and orthodontists, unlike laypersons, are critical in assessing dental aesthetics. This study aimed to evaluate the accuracy of patients’ assessment of the symmetry of their maxillary incisors and some factors that influence it. The study was conducted on 83 participants aged from 11 to 39 years. First, the participants filled out a questionnaire to obtain patients’ opinions of the symmetry of their upper incisors. This stage was followed by an intraoral examination, during which we used a digital caliper to measure the width of four maxillary incisors. The data were entered into STATISTICA v. 13.3. The following conclusions were drawn from the study. First, the respondents were generally able to determine the asymmetry of the incisors. Second, among the maxillary incisors, the participants defined the symmetry of maxillary central incisors more accurately than the maxillary lateral incisors. The cut-off value for incisor asymmetry noticeable to a layperson is 0.2 mm for maxillary medial incisors and 0.55 for maxillary lateral incisors. Third, we found no dependence of the accuracy of the assessment of incisor asymmetry on the age of the subjects; however, in our study group, the age range (spread) was not significant, so further studies are recommended. Finally, results concerning the relationship with gender showed that males assess the level of symmetry of their maxillary incisors more accurately than females.