A lifelong smile: a journey that begins during pregnancy!

It has become clear that pregnant women have a high risk of developing oral diseases, both in the supporting tissues and in the teeth. This is precisely why the first meeting between the dentist and the mother-to-be should take place as early as possible, either while she is still planning her pregnancy or as soon as she becomes pregnant. During this appointment it is appropriate to examine the presence of any risk factors for the future mother's oral health such as medication intake, presence of chronic pathologies or bad habits (smoking). The woman must be informed of all the changes that may occur during this period and that may negatively affect the pregnancy itself and the health (not only oral) of the foetus. At the same time, all the most important indications regarding correct oral hygiene, dietary and fluoroprophylaxis practices that all pregnant women should follow to ensure optimal oral health for themselves and their newborn child should be provided. In addition to this counselling phase, it is strictly the dentist's responsibility to proceed with the diagnostic phase, thanks to which he or she will be able to assess the woman's oral condition and, in the presence of pathological pictures, plan all the therapeutic interventions necessary to achieve a healthy condition before the beginning of such a delicate period. And why not, to lay the foundations for a life-long oral health!

Study on the Association between anterior tooth Colour Preference based on the FAHP and individual factors.

BACKGROUND: The relationship between tooth colour and individual satisfaction in oral aesthetics has long been a topic of interest. In this study, we utilized the fuzzy analytic hierarchy process (FAHP) to investigate the impacts of sex and age on tooth colour preference. The findings of this study should provide a scientific basis for oral aesthetic practice. METHODS: In the current study, a random selection method was employed, and a survey was completed by 120 patients. To obtain tooth colour data, standard tooth colour charts were used. Smile photos were taken as template images using a single-lens reflex camera. The FAHP was utilized to conduct a weight analysis of tooth colour preferences among patients of different sexes and age groups. RESULTS: There were significant differences in tooth colour preference based on sex and age. Men tend to prefer the B1 colour, while women may prioritize the aesthetic effects of other colours. Additionally, as patients age, their preferences for tooth colour become more diverse. These findings offer valuable insights for oral aesthetics practitioners, enabling them to better address the aesthetic needs of patients across different sexes and ages. This knowledge can aid in the development of more personalized treatment plans that align with patients' expectations. CONCLUSION: In this study, we utilized scientific analysis methods to quantify the popularity of different tooth colours among various groups of people. By doing so, we established a scientific foundation for clinical practice. The findings of this study offer valuable insights for oral aesthetic research, enhancing our understanding of tooth colour. Additionally, these findings have practical applications in the field of oral medicine, potentially improving patients' quality of life and overall oral health.

The subjective value of genuine smiles guides real-world social behaviour.

The mechanisms that underpin human social behaviour are poorly understood, in part because natural social behaviour is challenging to study. The task of linking the mechanisms thought to drive social behaviour to specific social behaviours in a manner that maintains ecological validity poses an even greater challenge. Here we report evidence that the subjective value people assign to genuine smiles, as measured in the laboratory, determines their responsiveness to genuine smiles encountered in a naturalistic social interaction. Specifically, participants (university undergraduates; age 17 to 36) who valued genuine smiles to a greater degree also showed stronger attention capture effects to neutral faces that were previously associated with genuine smiles and faster reciprocity of a social partner's smiles in a real social interaction. Additionally, the faster participants responded to the partner's genuine smiles the higher the partner's ratings of interaction quality were after the interaction. These data suggest that individual differences in subjective value of genuine smiles, measured in the lab, is one element that underpins responsiveness to natural genuine smiles and subsequent social outcomes.

Eyelid retraction during smiling in a patient with monocular congenital ptosis: a case report.

BACKGROUND: Blepharoptosis is a common symptom in ophthalmology clinic, but eyelid retraction when smiling in a ptosis eye is a rare manifestation. Here we report a novel manifestation that eyelid retraction during smiling in a patient with monocular congenital ptosis. CASE DESCRIPTION: A 10-year-old girl with isolated and mild unilateral congenital ptosis showed eyelid retraction in ptotsis eye when smiling together with a lid lag on downgaze. She didn't have any systematic and ocular diseases other than myopia and astigmatism.Eyelid retraction during smiling is 5 mm, resulting in a significant difference in the height of bilateral palpebral fissures.As for ptosis, is mild.The margin to reflex distance 1 is 1.0 mm on the right eye(ptosis eye) and 3.0 mm on the left eye. A lid lag of 1.0 mm on downward gaze was noted on the right, she could close her eyes fully while sleeping.The ice pack test, laboratory test for thyroid function, whole-exome sequencing (WES) and magnetic resonance imaging(MRI) of the orbital and ocular motor nerves showed normal results.Her symptoms alleviated after 6 months, with the retraction of the right upper eyelid when smiling was approximately 3 mm, thus the difference in the palpebral fissure height when smiling was smaller than that at the initial presentation. CONCLUSION: Blepharoptosis may accompanied with abnormal innervation like eyelid retraction, this phenomenon can be alleviated with age.The results of the levator muscle function test should be carefully examined to determine whether it is ptosis in an impaired innervation eyelid.

The psychology of Mona Lisa's smile.

Mona Lisa's ambiguous expression, oscillating between melancholy and contentment, has captivated viewers for centuries, prompting diverse explanations. This article proposes a novel interpretation grounded in the psychological theory of perceptual organisation. Central to the investigation is the "Ambiguity-Nuance", a subtly shaded, blended region framing the upper part of the lips, hypothesised to influence perceived expression due to perceptual organization. Through carefully crafted artwork and systematic manipulations of Mona Lisa reproductions, experiments reveal how alterations in the perceptual relationships of the Ambiguity-Nuance yield significant shifts in perceived expression, explaining why Mona Lisa's appearance changes and under which conditions she looks content versus melancholic based on perceptual organization. These findings underscore the pivotal role of psychological principles in shaping ambiguous expressions in the Mona Lisa, and extend to other Leonardo's portraits, namely La Bella Principessa and Scapigliata. This study sheds light on the intersection of psychology and art, offering new perspectives on timeless masterpieces.

Reading of ingroup politicians' smiles triggers smiling in the corner of one's eyes.

Spontaneous smiles in response to politicians can serve as an implicit barometer for gauging electorate preferences. However, it is unclear whether a subtle Duchenne smile-an authentic expression involving the coactivation of the zygomaticus major (ZM) and orbicularis oculi (OO) muscles-would be elicited while reading about a favored politician smiling, indicating a more positive disposition and political endorsement. From an embodied simulation perspective, we investigated whether written descriptions of a politician's smile would trigger morphologically different smiles in readers depending on shared or opposing political orientation. In a controlled reading task in the laboratory, participants were presented with subject-verb phrases describing left and right-wing politicians smiling or frowning. Concurrently, their facial muscular reactions were measured via electromyography (EMG) recording at three facial muscles: the ZM and OO, coactive during Duchenne smiles, and the corrugator supercilii (CS) involved in frowning. We found that participants responded with a Duchenne smile detected at the ZM and OO facial muscles when exposed to portrayals of smiling politicians of same political orientation and reported more positive emotions towards these latter. In contrast, when reading about outgroup politicians smiling, there was a weaker activation of the ZM muscle and no activation of the OO muscle, suggesting a weak non-Duchenne smile, while emotions reported towards outgroup politicians were significantly more negative. Also, a more enhanced frown response in the CS was found for ingroup compared to outgroup politicians' frown expressions. Present findings suggest that a politician's smile may go a long way to influence electorates through both non-verbal and verbal pathways. They add another layer to our understanding of how language and social information shape embodied effects in a highly nuanced manner. Implications for verbal communication in the political context are discussed.

Determining the widths of the maxillary anterior teeth for esthetics: comparison of the Mondelli and Albers formulas, esthetic proportion, and golden ratio.

The purpose of this study was to compare various formulas for idealized proportions of the maxillary incisors to the actual dimensions of natural teeth. The Mondelli formula 1 (MF1), Mondelli formula 2 (MF2), Albers formula (AF), esthetic proportion (EP) for width and height of anterior teeth, and golden ratio (GR) were calculated for a total of 50 dental students (30 women and 20 men) who participated in the study. The following measurements were obtained directly in the participant's mouth with a digital caliper: the mesiodistal and incisogingival dimensions of the maxillary central incisors, lateral incisors, and canines; the intercanine distance; and the smile width. The participants were photographed, and the smile width was also measured on the photographs. The MF1 and MF2 were each calculated twice, using both direct measurements and photographic measurements. The projected central incisor widths calculated using the MF1, MF2, and AF were compared among themselves and against the actual measurements using analysis of variance and Fisher test for multiple comparisons (α = 0.05). The EP and GR were analyzed using descriptive statistics. There was a statistically significant difference between all of the widths projected by the formulas and the actual widths of the central incisors (P < 0.05). Whether calculated from a direct or a photographic measurement, the incisor widths projected by the MF1 and MF2 were statistically similar to each other (P > 0.05). The EP values were similar to those reported in the literature. Only 2% of the participants had an incisor width ratio (central incisor/lateral incisor) that matched the GR of 1.618, while 86% fell within the range of 1.2 to 1.4. Overall, the proportions calculated with the MF1, MF2, AF, EP, and GR did not exactly match the actual dimensions of natural teeth. The formulas and the proportions available in the literature can assist in esthetic planning, but the individual characteristics of each patient and expertise of the dentist should guide treatment for each case.

Winners and losers: Emotional shifts across elections are conveyed by a politician's smile.

The human smile can convey both rewarding and affiliative social intent and thus has significant utility in politics, where the ability to bond with and reassure voters is vital to electoral success. We examine experimental evidence from the 2019 UK general election to investigate the influence of a politician's reward or affiliative smile on voter emotions. It was hypothesised that the winner's affiliative smile would engender positive affect across all partisan groups compared to the winner's reward smile display. Participants from a nationally representative sample were shown campaign footage containing both types of smiles from the leaders of the main competing political parties both before and after the election. Increases in happiness and affinity were revealed across all partisan groups when shown footage of the eventual winner's affiliative smile; at the same time, supporters of losing parties indicated a decrease in negative affect. Affinity has been shown to increase civic engagement. Thus, we conclude that affiliative smiles displayed by leading candidates during the campaign likely acted as a mechanism to align voter behaviour with the dominant political message.

A comparative study of the use of digital technology in the anterior smile experience.

OBJECTIVES: this study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations. METHODS: Sixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index. RESULTS: Based on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction. CONCLUSION: Digitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.

Digitalization: New era of dentistry.

The visual appeal of teeth and smiles significantly influences both how others perceive individuals and their self-image and confidence. The subjective nature of dental esthetics, varying greatly among patients and dental professionals, has made digital smile design tools essential for creating natural and personalized esthetics. Contemporary digital methods and workflows encompass all clinical phases, from diagnosis to the creation of a smile aligned with the patient's facial features, and the completion of the restoratives. Digital technologies not only streamline treatment planning, smile designing, and the creation of restorations but also enable effective and time-efficient collaboration among different dental specialists and dental laboratory technicians, enhancing overall patient care. The use of contemporary digital tools in interdisciplinary esthetic treatments is presented, underscoring the role of high magnification for precision, implant placement, minimal invasiveness, and clinical effectiveness.

Reanatomização estética dos dentes anteriores com resina composta: relato de caso / Reanatomización estética de dientes anteriores com resina compuesta: reporte de caso / Aesthetic reanatomization of front teeths with composite resin: case report

Introdução: A alta busca por tratamentos estéticos levou a indústria odontológica a aprimorar suas técnicas e desenvolver materiais com novas características que possibilitam a mimetização da estrutura dental, associando alta qualidade estética à saúde. Para isso, é necessário uma anamnese detalhada e exame físico intra e extrabucal, análise morfológica dos dentes e da face, para que a reabilitação proposta seja adequada. Objetivo: O objetivo deste estudo é descrever um caso clínico de reanatomização dos elementos dentais anteriores superiores, por meio de restaurações diretas em resina composta, restabelecendo a estética e função da paciente. Relato de caso: Paciente do sexo feminino, 19 anos, procurou a Clínica Escola da Faculdade de Odontologia do Recife -FOR relatando insatisfação com seu sorriso e declarou não estar disposta a se submeter a um tratamento ortodôntico. Ao realizar o exame clínico, observou-se que havia desalinhamento dos elementos dentários ântero-superiores. Após a realização do enceramento diagnóstico e validação da mesma através do mockupcom resina bisacrílica, optou-se por realizar a reanatomização estética com resina composta nanohíbrida, de forma conservadora, ou seja, sem desgastar os dentes em questão. Conclusão: As etapas do planejamento foram fundamentais para maior previsibilidade e obtenção do excelente resultado. Os materiais e técnicas selecionados para realização dos procedimentos aliaram características de resistência e estética, visando maior longevidade (AU).

Introduction: The high demand for aesthetic treatments has led the dental industry to improve its techniques and develop materials with new characteristics that allow mimicking the tooth structure, associating high aesthetic quality with health. This requires a detailed anamnesis,intra-and extraoral physical examination, and morphological analysis of the teeth and faceto allow an adequate proposed rehabilitation. Objective:The objective of this study is to describe a clinical case of reshaping of upper anterior teeth, by direct composite resin restorations, reestablishing the patient's aesthetics and function. Case report:Female patient, 19 years old, sought the Clínica Escola da Faculdade de Odontologia do Recife -FOR, reporting dissatisfaction with her smile and declared that she was unwilling to undergo orthodontic treatment. Clinical examinationrevealed misalignment of the upper anteriorteeth. After diagnostic waxing and validation by mockup with bis-acryl resin, it was decided to perform the aesthetic reshaping with nanohybrid composite resin in a conservative manner, i.e., without tooth wearing . Conclusion:The planning stages were fundamental for greater predictability and obtaining excellent results. The materials and techniques selected for the procedurescombined resistance and aesthetic characteristics, aiming at greater longevity (AU).

Introducción:La gran demanda para tratamientos estéticos ha llevado a la industria dental a mejorarsus técnicas y desarrollar materiales con nuevas características que permitan mimetizar la estructura dental, combinando una alta calidad estética con la salud. Para que esto ocurra, es necesario realizer una anamnesis detallada y un examen físicointra y extraoral, así como un análisis morfológico de los dientes y de la cara, para que la rehabilitación propuesta sea da adecuada. Objetivo:El objetivo de este studio es describir un caso clínico de reanatomización de los elementos dentales de resinacompuesta, restabeleciendo la estética y función de la paciente. Informe de caso:Paciente del sexo feminine, 19 años de edad, que acudió a la Clínica Escuela de La Facultad de Odontología de Recife ­FOR menifestando insatisfaccíon con su sonrisa y declarando no estar dispuesta a someterse a tratamiento de ortodoncia. En el examen clínico se observódesalineación de los elementos dentarios anterosuperiores. Tras realizar un encerado diagnóstico y validarlo con un mock-up de resina bisacrílica, se optó porrealizer una reanatomización estética con resina compuesta nanohíbrida de forma conservadora, es decir, sin desgastarlos dientes implicados. Conclusión:Las etapas de planificacíon han sido fundamentales para una mayor previsibilidad y la obtención de excelentes resultados. Los materiales y técnicas seleccionados para la realización de los procedimentos combinaron características de resistencia y estética, buscando una mayor longevidad (AU).

Asociación entre el biotipo facial y la posición del labio superior en la sonrisa / Association between facial biotype and the position of upper lip of the smile

Introducción: Para obtener una sonrisa ideal, es necesario que todas sus partes estén en armonía, mediante un equilibrio neurológico, muscular y esquelético. Así pues, la elaboración de un análisis facial y de sonrisa en el diagnóstico de ortodoncia, resulta de vital importancia, ya que la estética dental está muy relacionada conel tipo de sonrisa y el biotipo facial. Objetivo: determinar si existe asociación entre el biotipo facial y la posición del labio superior en la sonrisa. Material y métodos: el estudio es de tipo descriptivo, transversal y observacional. El universo de estudio fueron 1200 casos de la base de datos de la clínica de Posgrado de la Universidad Autónoma de Nayarit, México del año 2013 al 2023. La muestra fue de 120 pacientes pretratamiento de ortodoncia, analizando en ellos el biotipo facial y la altura de la línea de sonrisa. Se realizó la estadística descriptiva, pruebas de chi-cuadrado y V de Cramer. Resultados: el 34% presentó un biotipo braquifacial, el 31% dolicofacial y un 35% mesofacial. Se encontró en mayor porcentaje una línea de la sonrisa alta. En los pacientes dolicofaciales y mesofaciales la línea de sonrisa fue alta y en los pacientes braquifaciales fue media. La asociación entre el biotipo facial y la línea de sonrisa fue grande. Conclusiones: existe asociación entre el biotipo facial y la línea de sonrisa por lo que al realizar el diagnóstico en ortodoncia debe ser un factor a considerar. (AU)

Introduction: To obtain an ideal smile, it is necessary that all its parts are in harmony, through neurological, muscular and skeletal balance. Therefore, carrying out a facial and smile analysis in orthodontic diagnosis is of vital importance, since dental aesthetics is closely related to the type of smile, and the facial biotype. Objective: Determine if there is an association between facial biotype and the position of the upper lip in the smile. Material and Methods: The study is descriptive, cross-sectional and observational. The study was made of 1,200 cases from the database of the Postgraduate clinic of the Universidad Autónoma de Nayarit, Mexico from 2013 to 2023. The sample was 120 orthodontic pretreatment patients, analyzing their facial biotype and the height of the smile line. Descriptive statistics, chi square and Cramer’s V tests were performed. Results: 34% presented a brachyfacial biotype, 31% dolichofacial and 35% mesofacial. A high smile line was found in a higher percentage. In the dolichofacial and mesofacial patients the smile line was high and in the brachyfacial patients it was medium. The association between facial biotype and smile line was big. Conclusions: There is an association between the facial biotype and the smile line, so when making the orthodontic diagnosis it should be a factor to consider. (AU)

Masked or not, I smile to you: Exploring full-term and preterm infants' social smiles to adults wearing a protective facemask.

The early emergence of social smiles is an important milestone of infants' socio-emotional development. Our aim was to assess how the use of protective facemasks by adults affects the display of social smiles in preterm (PT) and full-term (FT) infants at 3 months (corrected age for prematurity). We enrolled 30 FT and 30 PT infants (gestational age ≤ 32 weeks). Infants' social smiles displays were assessed at 2-3-month-age (corrected) across a three-episode (masked mother; unmasked mother; masked adult female stranger) videotaped interactive task. During each episode, the adult was instructed to maintain specific facial expressions (happy-smiling, sad-frowning, neutral-unresponsive) for 15 second windows and then instructed to interact spontaneously for 45 s (of which the first 15 s were coded). FT and PT infants did not differ in the display of social smiles. In both groups, social smiles were mostly exhibited in response to happy/smiling and spontaneously interacting partners. Overall, no effect of wearing a protective facemask emerged. The use of protective facemasks did not result in a lower display of social smiles. The findings suggest that FT and PT might be equally sensitive to their adult interactive partners in terms of social smiles displays at 2-3-month-age.

The association between self-esteem and aesthetic component of smile among adolescents.

OBJECTIVES: Self-esteem plays a crucial role during adolescence in a shaping of an individual's overall well-being and confidence. The aim of this study was to explore the relationship between the self-esteem in adolescents and their smile aesthetics, as well as to assess the alignment of opinions on this matter between adolescents and dentists. METHODS: Sample included 413 students in Split-Dalmatia County, aged 13 to 18 (60% females). Data on demographic issues, orthodontic history, and desire for orthodontic treatment were collected by the self-administrated questionnaire. Coopersmith's Self-Esteem Inventory was also used. Smile aesthetics was assessed by each participant and dentist independently using an Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN AC). RESULTS: Self-esteem was higher in adolescents who rated their smile aesthetics equally to the dentist than in those who considered their aesthetics to be worse than the dentist (18.5 vs. 16; P = 0.011). The multiple linear regression revealed that the self-esteem of adolescents was positively related to undergone previous orthodontic treatment (ß = 1.286, P = 0.020) while negatively related to the female gender (ß = -2.531, P ≤ 0.001) and IOTN AC assessed by dentist (ß = -0.356, P = 0.015). It was not related to educational level or desire for orthodontic treatment. CONCLUSION: The self-esteem in adolescence is influenced the most by gender, but the orthodontic treatment and better smile aesthetics might also contribute.

Relationships between perception of black triangles appearance, personality factors and level of education.

This analytical cross-sectional study evaluated the perception of black triangles (BT) and examined the relationships between the perception of BT, personality factors, different educational backgrounds and demographic factors. 435 participants were included and divided into four groups: dentists, clinical (4th and 5th year) dental students, pre-clinical (3rd year) dental students, and laypeople. Participants' perception of the attractiveness of smile profiles of maxillary and mandibular anterior dentition with BT was rated using a ten-point VAS scale with 0 being the least, and 10 being the most attractive smile profile. The personality was assessed using the NEO-FFI personality questionnaire. The smile profile with multiple large BT was rated the least attractive for the maxillary (mean = 3.6) and mandibular (mean = 3.9) tested profiles. The smile profile without BT was rated the most attractive for the maxillary (mean = 9.1) and mandibular (mean = 8.8) tested profiles. The dental professionals perceived the maxillary smile profile with multiple large BT as less attractive than the non-dental participants (t = - 2.715, P = 0.007). Being a male, having dental education, having lower Neuroticism scores, as well as having higher Openness, Agreeableness, Conscientiousness, and Extraversion scores predicted and contributed more towards perceiving various tested smile profiles as more attractive. These findings show that black triangles negatively impacts the perception of smile attractiveness, and that personality traits and having dental education impact the perception of smile attractiveness for smiles with black triangles.

Creating an Extraordinary Outcome With Ordinary Digital Planning.

A patient was dissatisfied with her previous extensive dental treatment and wanted a comfortable bite with less gingival display for a more attractive smile. This article describes a systematic approach that was used in diagnosis, planning, and treatment sequencing to effectively manage the esthetic, functional, and biomechanical concerns involved in the case while minimizing risks. Digital planning enhanced interdisciplinary communication making the outcome more efficient and predictable.

Smile attractiveness in patients treated with or without 4 premolar extractions: A 36-year follow-up.

INTRODUCTION: This study aimed to assess the smile attractiveness in patients treated with or without 4 premolar extractions at a 36-year follow-up. METHODS: The sample comprised 52 patients with Class I and II malocclusion divided into 2 groups. Group 1 consisted of 15 patients treated without extractions (10 females and 5 males), with a mean pretreatment, posttreatment, and long-term posttreatment (T3) age of 13.2, 15.1, and 49.8 years, respectively. The mean treatment time was 1.9 years, and the mean long-term follow-up period was 34.7 years. Group 2 consisted of 37 patients (25 females and 12 males) treated with 4 premolar extractions, with a mean pretreatment, posttreatment, and long-term posttreatment age of 13.3, 15.7, and 53.6 years, respectively. The mean treatment time was 2.3 years, and the mean long-term follow-up period was 37.9 years. The mean retention time was 2 years for both groups. Frontal smiling photographs were obtained at long-term follow-up. Smile attractiveness was evaluated in an online questionnaire in which the evaluator could rate the smiling photographs with a 10-point scale. The randomly selected evaluator sample consisted of 62 laypeople, 33 dentists, and 89 orthodontists. Independent t tests, 1-way analysis of variance, and Tukey tests were used for intergroup comparisons at P <0.05. RESULTS: The smile attractiveness on the long term was similar in the groups treated with 4 premolar extractions (4.70 ± 1.35) or without extractions (4.51 ± 1.46). Women and orthodontists were more critical in assessing smile attractiveness than men, dentists, and laypeople. CONCLUSIONS: After long-term posttreatment, the smile attractiveness was similar in patients treated with 4 premolar extractions or without extractions.

Aesthetic treatment planning simplified using digital smile design: A case report.

Digital smile design (DSD) plays an essential role in the planning of aesthetic treatments. However, most digital smile designing software programmes are expensive and require specialised training and skill for effective implementation. This paper illustrates the use of Adobe Photoshop and Microsoft PowerPoint, which are economical and user friendly for planning aesthetics in a clinical case.