Perception of attractiveness of missing maxillary lateral incisors replaced by canines.

OBJECTIVE: The aim of this study was to evaluate the degree of perception of attractiveness of the smile among dentists, dental students, and lay persons in cases of agenesis of the maxillary lateral incisors replaced by canines for space closure. METHODS: A smiling front view extraoral photograph of a 20-year-old woman was digitally altered simulating agenesis and its treatment, by means of: repositioning, reshaping or bleaching the canine, and gingival contour. A questionnaire was distributed to individuals of the three groups (n= 150), with a view to evaluating their degree of esthetic perception. An attractiveness scale was also used, with '0' representing unattractive and '10', very attractive. RESULTS: In the comparative evaluation among all the photographs, the original image obtained the highest level of acceptance. Photograph 'i' (agenesis of both lateral incisors treated with reposition and reshaping of the canines) was ranked as the least attractive by the dentists, whereas the student and lay persons ranked photograph 'f' (agenesis of both lateral incisors treated with reposition of the canines, gingival contour, bleaching and reshaping) as the worst. CONCLUSION: The methods of treatment most accepted among the dentists and students were those that involved changes in the gingival contour, whereas among lay persons, they were those that involved only reshaping.

Perception of attractiveness of missing maxillary lateral incisors replaced by canines

ABSTRACT Objective: The aim of this study was to evaluate the degree of perception of attractiveness of the smile among dentists, dental students, and lay persons in cases of agenesis of the maxillary lateral incisors replaced by canines for space closure. Methods: A smiling front view extraoral photograph of a 20-year-old woman was digitally altered simulating agenesis and its treatment, by means of: repositioning, reshaping or bleaching the canine, and gingival contour. A questionnaire was distributed to individuals of the three groups (n= 150), with a view to evaluating their degree of esthetic perception. An attractiveness scale was also used, with '0' representing unattractive and '10', very attractive. Results: In the comparative evaluation among all the photographs, the original image obtained the highest level of acceptance. Photograph 'i' (agenesis of both lateral incisors treated with reposition and reshaping of the canines) was ranked as the least attractive by the dentists, whereas the student and lay persons ranked photograph 'f' (agenesis of both lateral incisors treated with reposition of the canines, gingival contour, bleaching and reshaping) as the worst. Conclusion: The methods of treatment most accepted among the dentists and students were those that involved changes in the gingival contour, whereas among lay persons, they were those that involved only reshaping.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar o grau de percepção da atratividade do sorriso por dentistas, estudantes de Odontologia e leigos, em casos de agenesia dos incisivos laterais superiores substituídos por caninos, para fechamento do espaço. Métodos: uma fotografia extrabucal frontal do sorriso de uma mulher com 20 anos de idade foi alterada simulando agenesia e seu tratamento por meio de: reposicionamento do canino, remodelação, clareamento ou contorno gengival. Um questionário foi distribuído aos indivíduos dos três grupos (n= 150), com o objetivo de avaliar o grau de percepção estética. Uma escala de atratividade também foi usada, com '0' representando pouco atraente e '10', muito atraente. Resultados: na avaliação comparativa entre as fotografias, a imagem original obteve o maior nível de aceitação. A fotografia "i" (agenesia de ambos os incisivos laterais tratada com reposição e remodelação dos caninos) foi classificada como a menos atraente pelos dentistas, enquanto os estudantes e os leigos classificaram a "f" (agenesia de ambos os incisivos laterais tratada com reposição dos caninos, contorno gengival, clareamento e remodelação) como a pior. Conclusão: os métodos de tratamento mais aceitos entre dentistas e estudantes foram aqueles que envolviam mudanças no contorno gengival, enquanto entre os leigos foram aqueles que envolviam apenas remodelação.

Assessing changes in quality of life using the Oral Health Impact Profile (OHIP) in patients with different classifications of malocclusion during comprehensive orthodontic treatment.

BACKGROUND: The objectives of this study were to investigated changes in OHRQoL among patients with different classifications of malocclusion during comprehensive orthodontic treatment. METHODS: Clinical data were collected from 81 patients (aged 15 to 24) who had undergone comprehensive orthodontic treatment. Participants were classified 3 groups: Class I (n = 35), II (n = 32) and III (n = 14) by Angle classification. OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14). All subjects were examined and interviewed at baseline (T0), after alignment and leveling (T1), after correction of molar relationship and space closure (T2), after finishing (T3). Friedman 2-way analysis of variance (ANOVA) and Wilcoxon signed rank tests were used to compare the relative changes of OHRQoL among the different time points. A Bonferroni correction with P < 0.005 was used to declare significance. RESULTS: Significant reductions were observed in all seven OHIP-14 domains of three groups except for social disability (P > 0.005) in class I and class II, Handicap in class II and class III (P > 0.005). Class I patients showed significant changes for psychological disability and psychological discomfort domain at T1, functional limitation, physical pain at T2. Class III patients showed a significant benefit in all domains except physical pain and functional limitation. Class II patients showed significant changes in the physical pain, functional disability, and physical disability domains at T1. CONCLUSIONS: The impact of comprehensive orthodontic treatment on patients' OHRQoL do not follow the same pattern among patients with different malocclusion. Class II patients benefits the most from the stage of space closure, while class I patients benefits the first stage (alignment and leveling) of treatment in psychological disability and psychological discomfort domains.

Smile attractiveness of patients treated for congenitally missing maxillary lateral incisors as rated by dentists, laypersons, and the patients themselves.

STATEMENT OF PROBLEM: Esthetic judgments can help dental professionals better understand how attentive people are to their own smiles and those of others. PURPOSE: The purpose of this study was to evaluate the smile attractiveness of patients treated for maxillary lateral incisor agenesis compared with that of individuals with a complete dentition. MATERIAL AND METHODS: Photographs were made of the smiles of patients with maxillary lateral incisor agenesis who were treated with space closure and teeth recontouring (n=26) or space opening and implants (n=20) and of a control group with a complete dentition (n=22). Both laypersons and dentists assessed smile attractiveness by using a visual analog scale. Patients and controls also assessed the level of satisfaction with their own smile. Assessments were performed twice, and the reliability of the method was determined with Cronbach α and intraclass correlation. Multifactorial and 1-way ANOVA were used to analyze smile attractiveness and participant satisfaction, followed by the Bonferroni post hoc test (α=.05). RESULTS: Attractiveness ratings by dentists and laypersons did not differ significantly among the study groups (P=.64). The ratings of male dentists and female laypersons differed significantly from those of other evaluators (P=.01). Patients with space closure and teeth recontouring were significantly more satisfied than controls (P=.002). No significant differences were found between the patients with implants and controls or between the patients with implants and those with space closure and teeth recontouring. CONCLUSIONS: The smiles of patients with maxillary lateral incisor agenesis were judged to be as attractive as those of the controls. Male dentists were the most critical raters, closely followed by female laypersons. All participants had high levels of satisfaction with their own smile; patients treated with space closure and teeth recontouring were the most satisfied.

Perceptions of dental professionals and laypeople to altered dental esthetics in cases with congenitally missing maxillary lateral incisors.

BACKGROUND: The smile perception of patients is not strictly related to standardized protocols and technical implications which certainly affect clinicians' decisions. The absence of maxillary lateral incisors could affect smile esthetics either with treatment or not. The aim of the present study was to investigate if different perceptions on altered smiles due to missing maxillary lateral incisors, with or without treatment, exist among different groups of people (laypersons, adult orthodontic patients, general dentists, and orthodontists). METHODS: An ideal smile model was selected and altered simulating different malocclusions and treatment options. Twelve simulations were submitted to four categories of respondents: laypeople, adult orthodontic patients, general dentists and orthodontists. They were asked to express smile perception for each simulation by ranking and rating simulations using a 0 to 100 visual analog scale. Analysis of variance was used to determine if there were statistically significant differences in values assigned among the four categories of respondents for each simulation. RESULTS: Significant differences in smile perceptions were found between professionals (dentists and orthodontists) and laypeople. Presence of dental tipping and marked diastema in the arch were disharmonious aspects less tolerated in a smile by all categories of evaluators. Simulations associated with space closure orthodontic treatment were ranked as the most attractive smile and significantly ranked higher by dental professionals than patients and laypeople. CONCLUSIONS: Treatment, absence of diastema, and symmetry were the most accepted characteristics by all categories of respondents. Ideal orthodontic treatment options might be overestimated by clinicians when compared to laypeople's smile perception.

Psychosocial reward of orthodontic treatment in adult patients.

SUMMARY: The purpose of this study was to assess the short-term psychosocial impact of dental aesthetic improvement in adult subjects. Sixty-nine adult patients (61 females and 8 males, aged 21-59 years) requesting aesthetic dental improvement were prospectively and randomly recruited for the study in a private orthodontic office. A general interview included patient motivation and expectations from treatment. After clinical examination, discussion of the mode of treatment and the expected outcome, the patients were requested to complete the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) with several additions. The duration of their treatment was 6-14 months, and the main goals were tooth alignment, crowding alleviation, or space closure. After removal of the appliances, they completed an identical PIDAQ. Each patient served as his/her own control. Assessment of the impact of aesthetic improvement was based on the responses to the same questions relating to the patients' perceived dental aesthetics before and after treatment, their self-esteem, and changes in their social behaviour resulting from the treatment. The data were analysed using Cohen's and Pearson's correlation analyses and chi-square and Student's t-tests. A statistically significant improvement (P < 0.001) was found for all four factors: dental self-confidence (DSC), social impact (SI), psychological impact (PI), and aesthetic concern (AC). The reliability of the questionnaire, using Cronbach's alpha, was between 0.709 and 0.947. The degree of significance was not related to age, marital status, education, or gender. Dental aesthetics generated a significant improvement in adult patients' quality of life for the period examined (up to 6 months post-treatment).

Evaluation of patient satisfaction after therapy of unilateral clefts of lip, alveolus and palate.

INTRODUCTION: Cleft lip, alveolus and palate (CLAP) is a craniofacial abnormality and is one of the most frequent human developmental anomalies. Therapy of clefts does not only comprise surgical closure of the cleft, but rather aims at an aesthetically and functionally optimal result at adult age. MATERIAL AND METHODS: Thirty-three cleft patients with total clefts of lip, alveolus and palate were enrolled in this study. Osseous bridging of the alveolar cleft (osteoplasty) was performed in all patients followed by different types of subsequent treatment. All patients answered a questionnaire to assess their satisfaction with the treatment result and their facial appearance. Patient satisfaction was correlated to the type of alveolar cleft repair. RESULTS: The returned questionnaires revealed varying patient satisfaction with their appearance, occlusal conditions, and dental aesthetics depending on the type of dental treatment in the alveolar cleft area. Questionnaire analysis by gender revealed clear gender-dependent differences in self-rated satisfaction. CONCLUSION: Aesthetics gain increasing importance for self-perception. Therefore, patient satisfaction with her facial appearance should move even more into focus of therapy of clefts.

The effect of esthetic consultation methods on acceptance of diastema-closure treatment plan: a pilot study.

BACKGROUND: The authors conducted a study to determine which of four consultation methods helped patients best understand a proposed treatment plan for maxillary anterior diastema closure. METHODS: The authors presented 24 subjects with four types of consultation in random order: before-and-after photographs of other patients, diagnostic models with wax setups, resin-based composite/esthetic preview/mock-ups and computer-imaging simulations. After viewing each method, the authors asked the subjects about treatment acceptability. At the end of the demonstrations of all four methods, the authors asked the subjects which consultation method helped them best understand the proposed treatment plan. RESULTS: A total of 87.5 percent of the subjects indicated that they would accept the proposed treatment plan after they were shown the computer-imaging simulation, 50 percent said they would after they were shown the resin-based composite/esthetic preview/mock-up, 41.7 percent said they would after they were shown photographs of other patients, and 25 percent said they would after they were shown diagnostic models with wax setups. When asked which method helped them best understand the proposed treatment, 54.2 percent of the subjects selected computer-imaging simulation, 33.3 percent selected resin-based composite/esthetic preview/mock-ups, and 12.5 percent selected before-and-after photographs of other patients. None of the subjects selected diagnostic models with wax setups. A chi2 test for goodness of fit indicated that these differences were statistically significant. CONCLUSION: Subjects preferred computer-imaging simulation to the other three consultation methods, and they indicated that computer-imaging simulation provided a better understanding of the proposed treatment plan for diastema closure. CLINICAL IMPLICATIONS: The use of computer-imaging simulation enhances the patient's understanding of a proposed treatment plan concerning maxillary anterior diastema closure.