A Comparison of the Smile Esthetic Understanding of Periodontists, Orthodontists, General Dentists, and Dental Students

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Esthetics, Smiling, Tooth


Objective: The aim of this study was to evaluate smile esthetics among periodontists, orthodontists, general dentists, and dental students.

Methods: The study consisted of five groups: periodontists, orthodontists, general dentists, fifth-year dental students, and fourth-year dental students. The evulaters used the Smile Esthetics Index (SEI) consisting of 10 items to analyze the natural smile photographs of 15 different individuals. One-way ANOVA was performed for the comparison of group means. The Duncan multiple comparison test was also used to identify different groups. Non-linear principal component analysis was performed to determine the configuration of the relationship between categories of variables in two-dimensional space.

Results: The group with the highest reliability coefficient among the groups was the fourth-year dental students (Cronbach's Alpha = 0.89). This was followed by general dentists, periodontists, fifth-year dental students, and orthodontists. According to the evaluation of the total score averages of the fifteen pictures, a statistically significant difference was observed between the groups (p = 0.041). Accordingly, the fourth-year dental students (5.78 ±1 .13) had a lower total score than the fifth-year dental students (6.56 ± 0.88), and this difference was statistically significant. However, no significant difference was observed between the fourth-year dental students and the general and specialized dentists and between the fifth-year dental students and graduated and specialized dentists in terms of the total score given to the pictures.

Conclusion: It was observed that the reliability coefficient was high in all groups evaluated with SEI. It can be concluded that esthetic perception is formed by actively performing the profession of dentistry, and this situation does not change according to specialization.


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Höfel L, Lange M, Jacobsen T (2007) Beauty and the teeth: perception of tooth color and its influence on the overall judgment of facial attractiveness. Int J Periodontics Restorative Dent 27:349–357

Otta E, Abrosio FFE, Hoshino RL (1996) Reading a Smiling Face: Messages Conveyed by Various Forms of Smiling. Percept Mot Skills 82:1111–1121. https://doi.org/10.2466/pms.1996.82.3c.1111

Cortellini P, Bissada NF (2018) Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Periodontol 89:S204–S213. https://doi.org/10.1002/JPER.16-0671

Badran SA (2010) The effect of malocclusion and self-perceived aesthetics on the self-esteem of a sample of Jordanian adolescents. Eur J Orthod 32:638–644. https://doi.org/10.1093/ejo/cjq014

Rotundo R, Nieri M, Bonaccini D, et al (2015) The Smile Esthetic Index (SEI): A method to measure the esthetics of the smile. An intra-rater and inter-rater agreement study. Eur J Oral Implantol 8:397–403

Rotundo R, Genzano L, Nieri M, et al (2021) Smile esthetic evaluation of mucogingival reconstructive surgery. Odontology 109:295–302. https://doi.org/10.1007/s10266-020-00544-6

Arroyo-Cruz G, Orozco-Varo A, Vilches-Ahumada M, Jiménez-Castellanos E (2022) Comparative analysis of smile esthetics between top celebrity smile and a Southern European population. J Prosthet Dent 128:1336–1341. https://doi.org/10.1016/j.prosdent.2021.03.019

Krishnan V, Daniel ST, Lazar D, Asok A (2008) Characterization of posed smile by using visual analog scale, smile arc, buccal corridor measures, and modified smile index. Am J Orthod Dentofacial Orthop 133:515–523. https://doi.org/10.1016/j.ajodo.2006.04.046

Gaikwad S, Kaur H, Vaz AC, et al (2016) Influence of Smile Arc and Buccal Corridors on Facial Attractiveness: A Cross-sectional Study. J Clin Diagn Res 10:ZC20–ZC23. https://doi.org/10.7860/JCDR/2016/19013.8436

Rotundo R, Nieri M, Lamberti E, et al (2021) Factors influencing the aesthetics of smile: An observational study on clinical assessment and patient’s perception. J Clinic Periodontology 48:1449–1457. https://doi.org/10.1111/jcpe.13531

Cronbach L (1951) Coefficient alpha and the internal structure of tests. Psychometrika 297–334

Alpaslan Yayli NZ, Sari ET Investigation of The Relationship Between Periodontal Health and Self- Confidence. Van Medical Journal 27:255–262. https://doi.org/10.5505/vtd.2020.70104

Birkeland K, Bøe OE, Wisth PJ (2000) Relationship between occlusion and satisfaction with dental appearance in orthodontically treated and untreated groups. A longitudinal study. Eur J Orthod 22:509–518. https://doi.org/10.1093/ejo/22.5.509

Shaw WC, Rees G, Dawe M, Charles CR (1985) The influence of dentofacial appearance on the social attractiveness of young adults. Am J Orthod 87:21–26. https://doi.org/10.1016/0002-9416(85)90170-8

Stefanini M, Jepsen K, de Sanctis M, et al (2016) Patient-reported outcomes and aesthetic evaluation of root coverage procedures: a 12-month follow-up of a randomized controlled clinical trial. J Clin Periodontol 43:1132–1141. https://doi.org/10.1111/jcpe.12626

Faure-Brac M, Antezack A, Melloul S, et al (2022) Smile Aesthetic Evaluation on Videographs: An Intra-Rater and Inter-Rater Agreement Study. Dent J (Basel) 10:87. https://doi.org/10.3390/dj10050087

Pham TAV, Nguyen PA (2022) Morphological features of smile attractiveness and related factors influence perception and gingival aesthetic parameters. Int Dent J 72:67–75. https://doi.org/10.1016/j.identj.2021.02.001

Wang C, Hu W-J, Liang L-Z, et al (2018) Esthetics and smile-related characteristics assessed by laypersons. J Esthet Restor Dent 30:136–145. https://doi.org/10.1111/jerd.12356

Sabri NABM, Ridzwan SBB, Soo SY, et al (2023) Smile Attractiveness and Treatment Needs of Maxillary Midline Diastema with Various Widths: Perception among Laypersons, Dental Students, and Dentists in Malaysia. Int J Dent 2023:9977868. https://doi.org/10.1155/2023/9977868

Pausch NC, Katsoulis D (2017) Gender-specific evaluation of variation of maxillary exposure when smiling. J Craniomaxillofac Surg 45:913–920. https://doi.org/10.1016/j.jcms.2017.03.002

Zange SE, Ramos AL, Cuoghi OA, et al (2011) Perceptions of laypersons and orthodontists regarding the buccal corridor in long- and short-face individuals. Angle Orthod 81:86–90. https://doi.org/10.2319/031210-145.1

Dag OD, Dagli I, Kurt A (2024) The influence of different tooth proportions obtained using digital smile design on the perception of smile esthetics. J Esthet Restor Dent 36:494–502. https://doi.org/10.1111/jerd.13164




How to Cite

Altindal, D., & Tunca, Y. (2024). A Comparison of the Smile Esthetic Understanding of Periodontists, Orthodontists, General Dentists, and Dental Students. European Journal of Therapeutics, 30(3), 267–276. https://doi.org/10.58600/eurjther2074



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