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Introduction: Our objective was to determine the perception of smile esthetics among orthodontists and
laypeople with respect to asymmetries on the maxillary incisor edges in a frontal smile analysis. Methods:
Two frontal close-up smile photos of 2 women, 1 white and 1 Afro-Brazilian, were selected for this study.
Both smiles displayed healthy maxillary anterior dentitions. The images were digitally altered to create tooth
wear on the maxillary left central and lateral incisors in 0.5-mm increments. The nal images were randomly
assembled into a photo album that was given to 120 judges, 60 orthodontists and 60 laypersons. Each rater
was asked to evaluate the attractiveness of the images with visual analog scales. The data collected were
statistically analyzed with 1-way analysis of variance with the Tukey post-hoc test and the unpaired Student t
test. Results: The most attractive smiles in both types of smiles were those without asymmetries and the 0.5mm wear in the lateral incisor. In general, tooth wear was considered unattractive by both groups of raters
following a pattern: the more tooth wear, the more unattractive the smile; tooth wear in the central incisor was
considered more unattractive than in the lateral incisor. For both group of raters, 0.5 mm of wear in the
central incisor was considered unattractive, whereas the thresholds for lateral incisor discrepancies were 0.5
mm for orthodontists and 1.0 mm for laypersons. Conclusions: The result of this study corroborates the clinical
assumption that symmetry between the maxillary central incisors is a paramount goal for esthetic treatments.
(Am J Orthod Dentofacial Orthop 2013;143:658-64)
658
659
Fig 1. Tooth wear in a white woman in 0.5-mm increments: A, control; B, 0.5 mm, lateral incisor; C, 1.0
mm, lateral incisor; D, 1.5 mm, lateral incisor; E, 0.5 mm, central incisor; F, 1.0 mm, central incisor; G,
1.5 mm, central incisor.
660
Fig 2. Tooth wear in an Afro-Brazilian woman in 0.5-mm increments: A, control; B, 0.5 mm, lateral
incisor; C, 1.0 mm, lateral incisor; D, 1.5 mm, lateral incisor; E, 0.5 mm, central incisor; F, 1.0 mm,
central incisor; G, 1.5 mm, central incisor.
661
Mean
86.00
78.20
51.64
37.04
51.49
22.35
9.21
SD
9.99
8.45
16.2
16.05
13.33
10.82
3.7
Laypersons
Results*
A
A
B
C
B
D
E
Mean
87.26
87.15
80.43
61.91
72.44
29.34
22.36
SD
9.71
8.31
13.89
10.92
9.25
14.29
12.21
Results*
A
A
A, B
C
B
D
D
Difference
y
y
y
y
y
y
*Smiles with the same letter did not differ from each other (P \0.05); ystatistical difference between the 2 group of raters (P \0.05).
Mean
83.41
80.40
55.72
30.11
57.66
24.04
16.05
SD
11.20
9.92
10.64
13.70
16.17
14.45
12.89
Laypersons
Results*
A
A
B
C
B
C, D
D
Mean
87.61
86.16
80.32
50.38
72.52
29.18
23.98
SD
8.74
7.26
8.79
12.61
11.35
14.32
15.00
Results*
A
A
A, B
C
B
D
D
Difference
y
y
y
y
y
*Smiles with the same letter did not differ from each other (P \0.05); ystatistical difference between the 2 group of raters (P \0.05).
RESULTS
662
2.
663
3.
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