Attractiveness of Variations
in the Smile Arc and Buccal
Corridor Space as Judged
by Orthodontists and
Laymen
www.indiande...
INTRODUCTION
 Orthodontics has taken a century not necessarily to learn but to
accept that the soft tissues largely deter...
FACTORS INFLUENCING SMILE
 Arch form
 Smile arc
 Overjet (incisor inclination)
 Transverse cant of maxillary occlusion...
REVIEW OF LITERATURE
 Frush and Fisher(1958)
 Hulsey (1970)
 Ackerman et al in (1998)
 D. M. Sarver in (2001)
 Roden-...
PURPOSE OF STUDY
 To evaluate, using digital manipulated images and an internet
study, the effects of changes in smile ar...
MATERIALS AND METHODS
www.indiandentalacademy.com
IMAGE MANIPULATION
 Digital archive
 Frontal intraoral photograph of ideally aligned teeth and one
extraoral photograph ...
PILOT SURVEY
 Experienced orthodontists
 Set the standards
 Forty orthodontists
 Follow-up reliability
 Given written...
www.indiandentalacademy.com
MAIN SURVEY
 115 available laypersons and 131 orthodontists responded
voluntarily
 Majority of orthodontists were male, ...
www.indiandentalacademy.com
 The raters rated each image on a VAS anchored with highly
unattractive on the left and highly attractive on the right
 ...
STATISTICAL ANALYSIS
 Intraclass correlation coefficient (ICC): reliability of raters
 Differences in attractiveness rat...
RESULTS
www.indiandentalacademy.com
RELIABILITY
 overall ICC for rating the same picture twice in the main study
was 0.87(0.83–0.91) with laypersons and orth...
ATTRACTIVENESS
 Attractiveness scores for all smile arcs with absent and ideal
buccal corridors were nearly identical for...
www.indiandentalacademy.com
www.indiandentalacademy.com
 Orthodontists, especially female orthodontists, used a greater
range of the rating instrument than laypersons
 Buccal c...
DISCUSSION
www.indiandentalacademy.com
DATA COLLECTION METHODS
 VAS, may mean different things to different raters
 To address these limitations, this study us...
ATTRACTIVENESS
 The sex of the model only demonstrated importance when the
smile arc was ideal and the buccal corridor ex...
COMPARISON TO PREVIOUS
RESEARCH
 The findings of this study agree with those of Hulsey's study
regarding smile arc and pa...
 Moore et al found that laypersons were able to distinguish
differing levels of buccal corridor and preferred broader smi...
CONCLUSIONS
 Excessive buccal corridors and flat smile arcs in both male
and female smiles are rated as less attractive b...
THANK YOU…
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.com
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Smile arc and buccal corridor space /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Smile arc and buccal corridor space /certified fixed orthodontic courses by Indian dental academy

  1. 1. Attractiveness of Variations in the Smile Arc and Buccal Corridor Space as Judged by Orthodontists and Laymen www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  2. 2. INTRODUCTION  Orthodontics has taken a century not necessarily to learn but to accept that the soft tissues largely determine the outcome of orthodontic treatment.  This increased attention to soft tissues and de-emphasis on perfection combine to form a biologically driven paradigm that will serve orthodontics in the twenty first century.  More orthodontic patient evaluates the treatment outcome by their smiles and overall enhancement of facial appearance. www.indiandentalacademy.com
  3. 3. FACTORS INFLUENCING SMILE  Arch form  Smile arc  Overjet (incisor inclination)  Transverse cant of maxillary occlusion plane  Gingival display  Shade of the teeth  Coincidence of dental midline to facial midline  Buccal corridor www.indiandentalacademy.com
  4. 4. REVIEW OF LITERATURE  Frush and Fisher(1958)  Hulsey (1970)  Ackerman et al in (1998)  D. M. Sarver in (2001)  Roden-Johnson et al (2005)  Moore et al (2005) www.indiandentalacademy.com
  5. 5. PURPOSE OF STUDY  To evaluate, using digital manipulated images and an internet study, the effects of changes in smile arcs and buccal corridors and their interactions on the perceptions of smile attractiveness as judged by orthodontists and lay raters. www.indiandentalacademy.com
  6. 6. MATERIALS AND METHODS www.indiandentalacademy.com
  7. 7. IMAGE MANIPULATION  Digital archive  Frontal intraoral photograph of ideally aligned teeth and one extraoral photograph that displayed esthetic lips from different patients.  Adobe photoshop® 7.0  Three-dimensional spherical render function  1-12 images from flat to accentuated smile arc  Lip curvature coincides with 7th image(ideal curvature)  By airbrushing, seven different sizes of buccal corridor quantified in relation to the teeth numbered 1–7 were created  A “male” set of lips  Composite smile www.indiandentalacademy.com
  8. 8. PILOT SURVEY  Experienced orthodontists  Set the standards  Forty orthodontists  Follow-up reliability  Given written definitions of smile arcs and buccal corridors  Quask™ form artist: emoticons www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10. MAIN SURVEY  115 available laypersons and 131 orthodontists responded voluntarily  Majority of orthodontists were male, caucasian, from the central united states, and 22 years postresidency  Laypeople were college educated, caucasian, and from the central united states with a median income of $50,000 to $75,000  Combinations of the three smile arc variations (flat, ideal, excessive) and the buccal corridor variations (none, ideal, excessive) were used to create nine female and nine male composite images www.indiandentalacademy.com
  11. 11. www.indiandentalacademy.com
  12. 12.  The raters rated each image on a VAS anchored with highly unattractive on the left and highly attractive on the right  Visual cues  Standardization  Raters were asked to evaluate the nine female and nine male smiles twice to determine reliability for a total of 36 smiles, which were randomized each time the survey was taken www.indiandentalacademy.com
  13. 13. STATISTICAL ANALYSIS  Intraclass correlation coefficient (ICC): reliability of raters  Differences in attractiveness ratings were analyzed using a factorial analysis of variance (ANOVA) with repeated measures  Post hoc testing was done using the Tukey-Kramer method  Although it is not known whether this difference translates to attractiveness, this study set a conservative and arbitrary benchmark of a 15% VAS difference as clinically significant www.indiandentalacademy.com
  14. 14. RESULTS www.indiandentalacademy.com
  15. 15. RELIABILITY  overall ICC for rating the same picture twice in the main study was 0.87(0.83–0.91) with laypersons and orthodontists showing reliability of 0.91(0.89– 0.93) and of 0.81(0.77–0.85), respectively www.indiandentalacademy.com
  16. 16. ATTRACTIVENESS  Attractiveness scores for all smile arcs with absent and ideal buccal corridors were nearly identical for males and females  Whereas excessive buccal corridors brought all ratings down  For both sexes, flat smile arcs overwhelmed the attractiveness of all buccal corridors and were rated in the lower 40% of the scale  Regardless of sex, for all buccal corridors, the raters significantly preferred the ideal and excessive smile arcs compared with the flat smile arcs  Buccal corridor size made a significant difference only when the smile arc was ideal for males www.indiandentalacademy.com
  17. 17. www.indiandentalacademy.com
  18. 18. www.indiandentalacademy.com
  19. 19.  Orthodontists, especially female orthodontists, used a greater range of the rating instrument than laypersons  Buccal corridors and smile arcs generally made less difference to laypersons than to orthodontists  All raters, regardless of buccal corridors, generally preferred ideal smile arcs compared with excessive smile arcs and excessive smile arcs compared with flat smile arcs  All orthodontists, regardless of buccal corridors, rated the excessive smile arc as significantly more attractive than the flat smile arc  There were no significant differences between male and female laypersons or orthodontists for any ratings www.indiandentalacademy.com
  20. 20. DISCUSSION www.indiandentalacademy.com
  21. 21. DATA COLLECTION METHODS  VAS, may mean different things to different raters  To address these limitations, this study used an adjusted mean to compare ratings across groups  potential bias: Web-based survey higher socioeconomic status www.indiandentalacademy.com
  22. 22. ATTRACTIVENESS  The sex of the model only demonstrated importance when the smile arc was ideal and the buccal corridor excessive  Under these conditions, the male was viewed as more unattractive, perhaps because the excessive buccal corridor set by the pilot study was much larger than that for the females  Although female orthodontists used more of the rating scale than others, and they detected significant differences between some categories male orthodontists did not www.indiandentalacademy.com
  23. 23. COMPARISON TO PREVIOUS RESEARCH  The findings of this study agree with those of Hulsey's study regarding smile arc and partially agree regarding buccal corridors  The raters in this study found no differences in buccal corridor except when they became excessively large and the smile arc was ideal  Yoon et al(1992)  Roden-Johnson et al did not quantify buccal corridors—they were classified as present or absent. It is possible that their buccal corridors did not meet the threshold for excessive buccal corridors determined by this study. www.indiandentalacademy.com
  24. 24.  Moore et al found that laypersons were able to distinguish differing levels of buccal corridor and preferred broader smiles with minimal buccal corridors www.indiandentalacademy.com
  25. 25. CONCLUSIONS  Excessive buccal corridors and flat smile arcs in both male and female smiles are rated as less attractive by both orthodontists and laypersons.  Flat smile arcs overwhelmingly decrease attractiveness ratings regardless of the buccal corridor. www.indiandentalacademy.com
  26. 26. THANK YOU… For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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