The Impact Of Orthodontic Relapse on The Perception of Smile Aesthetics: An Evaluation by Patients Undergoing Orthodontic Treatment

Abstract

Objectives: To evaluate the impact of potential tooth movement following orthodontic relapse on the aesthetic perception of patients undergoing orthodontic treatment. Materials and Methods: Frontal and lateral smiling photographs of one female and one male volunteer who had previously received orthodontic treatment and hade a regular profile with class I occlusion and class I skeletal pattern were evaluated. Variables included in the evaluation made by 200 laypeople who had undergone orthodontic treatment using photographs of male and female smiles: median diastema, overbite change, central tooth extrusion, labiolingual inclination of incisors and labiolingual translation of lateral teeth. Evaluators rated the overall attractiveness and acceptability of each photo using a scale of 0 to 10 (0: least attractive; 10: most attractive). Results: There were statistical differences in aesthetic ratings between female and male evaluators. Median diastema and central tooth extrusion of 0.5 mm or larger affected female and male model attractiveness scores. The acceptable range for overbite, maxillary incisor inclination, and labiolingual translation of the maxillary lateral tooth varied between the female and the male models. Conclusions: Female evaluators were more critical in aesthetic evaluation. 0.5-mm median diastema and central tooth extrusion adversely affected smile aesthetics. Although there were differences between male and female models, raters tolerated limited overbite (0 mm) less than increased overbite. Moreover, the lingual inclination of the upper incisors was more acceptable than labial movement. Perception of labiolingual translation of the upper lateral tooth varied depending on the perspective and model being evaluated.

Keywords

• : aesthetics
• incisors
• perception
• relapse
• smiling

Ortodontik Nüks Sonrası Değişikliklerin Ortodonti Hastalarının Gülümseme Estetiği Algısına Etkisi

Abstract

Amaç: Ortodontik relaps sonrası diş hareketinin, ortodontik tedavi gören hastaların estetik algıları üzerindeki etkisini değerlendirmek. Gereç ve Yöntemler: Daha önce ortodontik tedavi görmüş, Sınıf I oklüzyon ve iskelet ilişkisine sahip sahip düzgün profilli bir kadın ve bir erkek gönüllünün frontal ve lateral gülümseme fotoğrafları değerlendirildi. Kadın ve erkek gülümseme fotoğrafları kullanılarak, ortodontik tedavi görmüş 200 kişi tarafından değerlendirilen değişkenler: median diastema, overbite değişimi, santral diş ekstruzyonu, kesici dişlerin labiolingual inklinasyonu ve lateral dişin labiolingual translasyonu. Değerlendiriciler, her fotoğrafın genel çekiciliğini ve kabul edilebilirliğini 0'dan 10'a kadar bir ölçek kullanarak derecelendirdi (0: en az çekici; 10: en çekici). Bulgular: Kadın ve erkek değerlendiriciler arasında estetik derecelendirmelerde istatistiksel farklılıklar mevcuttu. Kadın ve erkek model çekicilik skorları, 0.5 mm veya daha büyük median diastema ve santral diş ekstrüzyonundan etkilendi. Overbite, maksiller kesici diş inklinasyonu ve maksiller lateral dişin labiolingual translasyonu için kabul edilebilir aralık, kadın ve erkek model arasında farklılık gösterdi. Sonuç: Kadın değerlendiriciler estetik değerlendirmede daha eleştireldi. 0.5 mm median diastema ve santral diş ekstruzyonu gülümseme estetiğini olumsuz etkiledi. Erkek ve kadın modeller arasında farklılıklar olmasına rağmen, değerlendiriciler sınırlı overbite’ı (0 mm) artan overbite’a göre daha az tolere etti. Ayrıca üst kesici dişlerin lingual eğiminin labial eğime göre daha kabul edilebilir olduğu gözlendi. Üst lateral dişin labiolingual translasyon algısı, değerlendirilen perspektife ve modele bağlı olarak değişiklik gösterdi.

Keywords

• relaps
• algı
• estetik
• gülümseme
• kesici dişler

References

1. Kučera J, Littlewood SJ, Marek I. Fixed retention: pitfalls and complications. Br Dent J 2021;230(11):703- 708. doi:10.1038/s41415-021-2892-4
2. Johnston CD, Littlewood SJ. Retention in orthodontics. Br Dent J 2015;218(3):119-122. doi:10.1038/ sj.bdj.2015.47
3. Mollov ND, Lindauer SJ, Best AM, Shroff B, Tufekci E. Patient attitudes toward retention and perceptions of treatment success. Angle Orthod 2010;80(4):656-661. doi:10.2319/102109-594.1
4. Karslı N, Ocak I, Gülnar B, Tüzüner T, Littlewood SJ. Patient perceptions and attitudes regarding post–orthodontic treatment changes. Angle Orthod 2023;93(4):440-446. doi:10.2319/100222-677.1
5. Saccomanno S, Saran S, Laganà D, Mastrapasqua RF, Grippaudo C. Motivation, Perception, and Behavior of the Adult Orthodontic Patient: A Survey Analysis. Biomed Res Int 2022;2022:1-6. doi:10.1155/2022/2754051
6. Menezes EBC, Bittencourt MAV, Machado AW. Do different vertical positions of maxillary central incisors influence smile esthetics perception? Dental Press J Orthod 2017;22(2):95-105. doi:10.1590/2177-6709.22.2.095- 105.oar
7. Acar YB, Abuhan E, Boyacıyan R, Özdemir F. Influence of facial type on attractiveness of vertical canine position from the perspective of orthodontists and laypeople. Angle Orthod 2022;92(2):233-239. doi:10.2319/020121-95.1
8. Jiang X, Cao Z, Yao Y, Zhao Z, Liao W. Aesthetic evaluation of the labiolingual position of maxillary lateral incisors by orthodontists and laypersons. BMC Oral Health 2021;21(1):42. doi:10.1186/s12903-021-01402-9

9. Ma W, Preston B, Asai Y, Guan H, Guan G. Perceptions of dental professionals and laypeople to altered maxillary incisor crowding. Am J Orthod Dentofacial Orthop 2014;146(5):579-586. doi:10.1016/j.ajodo.2014.07.018
10. Chaves PRB, Karam AM, Machado AW. Does the presence of maxillary midline diastema influence the perception of dentofacial esthetics in video analysis? Angle Orthod 2021;91(1):54-60. doi:10.2319/032020- 200.1
11. Springer NC, Chang C, Fields HW, et al. Smile esthetics from the layperson’s perspective. Am J Orthod Dentofacial Orthop 2011;139(1):e91-e101. doi:10.1016/j. ajodo.2010.06.019
12. Cao L, Zhang K, Bai D, Jing Y, Tian Y, Guo Y. Effect of maxillary incisor labiolingual inclination and anteroposterior position on smiling profile esthetics. Angle Orthod 2011;81(1):121-129. doi:10.2319/033110-181.1
13. Steinnes J, Johnsen G, Kerosuo H. Stability of orthodontic treatment outcome in relation to retention status: An 8-year follow-up. Am J Orthod Dentofacial Orthop 2017;151(6):1027-1033. doi:10.1016/j. ajodo.2016.10.032
14. Ker AJ, Chan R, Fields HW, Beck M, Rosenstiel S. Esthetics and Smile Characteristics From the Layperson’s Perspective. J Am Dent Assoc 2008;139(10):1318-1327. doi:10.14219/jada.archive.2008.0043
15. Ghaleb N, Bouserhal J, Bassil-Nassif N. Aesthetic evaluation of profile incisor inclination. Eur J Orthod 2011;33(3):228-235. doi:10.1093/ejo/cjq059
16. Betrine Ribeiro J, Alecrim Figueiredo B, Wilson Machado A. Does the presence of unilateral maxillary incisor edge asymmetries influence the perception of smile esthetics? J Esthet Restor Dent 2017;29(4):291-297. doi:10.1111/jerd.12305
17. Geron S, Atalia W. Influence of sex on the perception of oral and smile esthetics with different gingival display and incisal plane inclination. Angle Orthod 2005;75(5):778- 784. doi:10.1043/0003-3219(2005)75[778:IOSOTP]2.0. CO;2
18. Zhang Y fan, Xiao L, Li J, Peng Y ran, Zhao Z. Young People’s Esthetic Perception of Dental Midline Deviation. Angle Orthod 2010;80(3):515-520. doi:10.2319/052209- 286.1
19. Flores-Mir C, Silva E, Barriga MI, Lagravère MO, Major PW. Lay person’s perception of smile aesthetics in dental and facial views. J Orthod 2004;31(3):204-209. doi:10.1179/146531204225022416
20. Abu Alhaija ESJ, Al-Shamsi NO, Al-Khateeb S. Perceptions of Jordanian laypersons and dental professionals to altered smile aesthetics. Eur J Orthod 2011;33(4):450-456. doi:10.1093/ejo/cjq100
21. Pasukdee P, Cheng JHC, Chen DS. Smile preferences of orthodontists, general dentists, patients, and the general public in three-quarter and lateral views. Am J Orthod Dentofacial Orthop 2021;159(4):e311-e320. doi:10.1016/j.ajodo.2020.09.012
22. Kokich VO, Kokich VG, Kiyak HA. Perceptions of dental professionals and laypersons to altered dental esthetics: Asymmetric and symmetric situations. AmJ Orthod Dentofacial Orthop 2006;130(2):141-151. doi:10.1016/j.ajodo.2006.04.017
23. Kumar S, Valiathan A, Gandhi S. Perception of smile esthetics among Indian dental professionals and laypersons. Indian J Dent Res 2012;23(2):295. doi:10.4103/0970-9290.100456
24. Machado AW, Moon W, Gandini LG. Influence of maxillary incisor edge asymmetries on the perception of smile esthetics among orthodontists and laypersons. Am J Orthod Dentofacial Orthop 2013;143(5):658-664. doi:10.1016/j.ajodo.2013.02.013
25. Mackley R J. An evaluation of smiles before and after orthodontic treatment. Angle Orthod 1993;63:183-189.
26. Sarver DM, Ackerman MB. Dynamic smile visualization and quantification: part 2. smile analysis and treatment strategies. Am J Orthod Dentofacial Orthop 2003;124(2):116-127. doi:10.1016/S0889- 5406(03)00307-X
27. Sarver DM. The importance of incisor positioning in the esthetic smile: The smile arc. Am J Orthod Dentofacial Orthop 2001;120(2):98-111. doi:10.1067/ mod.2001.114301
28. Işıksal E, Hazar S, Akyalçın S. Smile esthetics: Perception and comparison of treated and untreated smiles. Am J Orthod Dentofacial Orthop 2006;129(1):8- 16. doi:10.1016/j.ajodo.2005.07.004
29. Chang CA, Fields HW, Beck FM, et al. Smile esthetics from patients’ perspectives for faces of varying attractiveness. Am J Orthod Dentofacial Orthop 2011;140(4):e171-e180. doi:10.1016/j.ajodo.2011.03.022