Analysis of gingival display during static and dynamic smiles in a Turkish sample: a clinical study

Abstract

Purpose: The aim of this study is to determine the prevalence of smile types in spontaneous smiles among a Turkish population aged 18–23 and to compare it with the prevalence of static smiles. Materials and methods: This study was carried out with 150 undergraduate students at Başkent University Faculty of Dentistry (75 females, 75 males). For this purpose, photo recordings for static smiles and 20-second video recordings for dynamic smiles were taken 40 cm from the participant’s nose. Measurements were made with an electronic ruler. Results: High smile line was found to be the highest prevalence in both static and dynamic smiles (p < 0.001). The average soft tissue display is higher in dynamic smiles (p < 0.05). In both static and dynamic smiles, the average amount of gingival display was higher in females than in males (p < 0.05). Conclusion: When the smile line was evaluated on the photograph recordings while the patient was posing, it was found to be lower than the natural spontaneous smile line obtained from the video recordings. Since the gingival display increases when patients smile naturally instead of posing, clinical evaluations and restorative considerations should be planned according to the dynamic smile.

Keywords

• smile line
• dynamic smile
• static smile
• gingiva
• esthetic

References

1. Mickevičiūtė E, Bitinienė D, Žekonis G, Sakalauskienė J, Žilinskas J. The prevalence of facial and dentolabial parameters among students of the Faculty of Dentistry of Lithuanian University of Health Sciences. Stomatologija, 20:139-44, 2018.
2. Fradeani M. Evaluation of dentolabial parameters as part of a comprehensive esthetic analysis. Eur J Esthet Dent 2006;1:62–9.
3. Ioi H, Nakata S, Counts AL. Influence of gingival display on smile aesthetics on Japanese. Eur J Orthod 2010;32:633-7.
4. Del Monte S, Afrashtehfar KI, Emami E, Abi Nader S, & Tamimi F. Lay preferences for dentogingival esthetic parameters: A systematic review. J Prosthet Dent 2017;118: 717-24.
5. Ahrari F, Heravi F, Setayesh Y. Which Factors Affect Dental Esthetics and Smile Attractiveness in Orthodontically Treated Patients? J Dent 2015;12:491–503.
6. Tjan AH, Miller GD, The JG. Some esthetic factors in a smile. J Prosthet Dent 1984;51: 24-28.
7. Liébart MF, Fouque-Deruelle C, Santini A, Dillier FL, Monnet-Corti V, Glise JM, Borghetti A. Smile line and periodontium visibility. Perio 2004;1:17-25.
8. Mahn E, Sampaio CS, Silva BP, Silva BP,Stanley K, Valdes AM, Gutierrez J & Coachman C. Comparing the use of static versus dynamic images to evaluate a smile. J Protshet Dent 2019;123:739-46.

9. Suzuki, L., Machado, A. W., & Bittencourt, M. A. V. An evaluation of the influence of gingival display level in the smile esthetics. Dental Press J Orthod 2011;16:1-10.
10. Hu X, Lin Y, Heberer S, Nelson K. Analysis of soft tissue display in Chinese subjects during an enjoyment smile. Quintessence Int 2012;43:105-10.
11. Cavalcanti SM, Guerra SMG, Valentim FB, Rosetti EP. Esthetic perception of smiles with different gingival conditions. Gen Dent 2019;67: 66-70.
12. Bhuvaneswaran M. Principles of smile design. J Conserv Dent 2010;13:225-32.
13. Ackerman MB, Brensinger C, Landi JR. An evaluation of dynamic lip-tooth characteristics during speech and smile in adolescents. Angle Orthod 2004;74:43-50.
14. Desai S, Upadhyay M, Nanda R. Dynamic smile analysis: Changes with age. Am J Orthod Dentofacial Orthop 2009;136:310.
15. Pinzan-Vercelino CRM, Costa ACS, Ferreira MC, Bramante FS, Fialho MPN, Gurgel JA. Comparison of gingival display in smile attractiveness among restorative dentists, orthodontists, prosthodontists, periodontists, and laypeople. J Prosthet Dent 2020;123:314-21.
16. Coachman C, Calamita M, Sesma N. Dynamic Documentation of the Smile and the 2D/3D Digital Smile Design Process. Int J Periodontics Restorative Dent 2017;37:183–193.
17. Van Der Geld P, Oosterveld P, Bergé, SJ, Kuijpers-Jagtman AM. Tooth display and lip position during spontaneous and posed smiling in adults. Acta Odontol Scand 2008;66:207–13.
18. Dindaroglu F, Dogan S, Erdinç AM. Smile esthetics: age related changes, and objective differences between social and spontaneous smiles. J Clin Pediatr Dent 2011;36:99-106.
19. Machado AW. 10 commandments of smile esthetics. Dental Press J Orthod 2014;19:136-57.
20. Sarver DM, Ackerman JL. Orthodontics about face: the re-emergence 
of the esthetic paradigm. Am J Orthod Dentofacial Orthop 2000;117:575-6. 

21. Menezes EBC, Bittencourt MAV, Machado AW. Do different vertical positions of maxillary central incisors influence smile esthet- ics perception? Dental Press J Orthod 2017;22:95-105.
22. Sepolia S, Sepolia G, Kaur R, Gautam DK, Jindal V, Gupta SC. Visibility of gingiva-An important determinant for an esthetic smile. J Indian Soc Periodontol 2014;18:488-92.
23. Jensen J, Joss A, Lang NP. The smile line of different ethnic groups in relation to age and gender. Acta Med Dent Helv 1999;4:38-46.