Perception of laypersons and dental professionals and students as regards the aesthetic impact of gingival plastic surgery.

OBJECTIVE: To evaluate the degree of perception of laypersons, professionals, and dental students, regarding the aesthetic appearance of the smile in cases of gingival plastic surgery of the maxilla for correction of a gingival smile, by examining alterations in photographs. MATERIALS/METHODS: Alterations were made to an extraoral front-view-photograph of a gingival smile in normal occlusion, by gingival recontouring of the maxilla, simulating a gingival plastic surgery procedure to diminish gingival exposure. For this purpose, specific image-manipulation program (Adobe-Photoshop-Software-CS3) was used. Images were printed on photographic-paper, attached to questionnaire, distributed among laypersons, professionals, and dental students to evaluate degree of aesthetics (n = 150). To evaluate degree of aesthetics, an attractiveness scale was used, with 0 representing hardly attractive, 5 for attractive, and 10 for very attractive. Differences between examiners were examined by Mann-Whitney test. All the statistics were performed with a confidence level of 95 per cent. RESULTS: Both dental professionals and students and laypersons were capable of identifying alterations resulting from gingival plastic surgery. In all evaluated groups, they demonstrated that large gingival extension does not always affect aesthetic appearance of the smile, and maxillary incisors not being much visualized is characterized as hardly attractive, with statistically lower scores being attributed (P < 0.05). CONCLUSIONS: According to aesthetic parameters, the presence of the gingiva is important in the composition of the smile, however, only when exposed to small extent.

Photos vs silhouettes for evaluation of profile esthetics between white and black evaluators.

OBJECTIVE: To determine whether photos or silhouettes are adequate methods for evaluating the esthetic profiles of black subjects and whether black and white evaluators have different preferences for esthetic profiles. MATERIALS AND METHODS: One photographic record of the profile of a black female patient with accentuated dental bimaxillary dentoalveolar protrusion was randomly selected. The image of the patient's profile was altered to produce a series of seven photos and seven silhouettes (a total of 14 images) with different lip positions but uniform distances in relation to the esthetic plane created by Ricketts (line E). Fifty black and 50 white lay evaluators were invited to enumerate the photos and silhouettes, produced according to the lip position, in the order in which they considered most esthetically pleasing. RESULTS: The number of preferences found to be within the esthetic norm was slightly higher among the photographs than among the silhouettes; the esthetic profile with a deviation of -2 mm from line E was elected as the most attractive, and the esthetic pattern with a deviation of +6 mm from the normal line E was considered the least attractive. There were no statistically significant differences between the preferences related to the variables race, sex, and educational background. CONCLUSIONS: The esthetic attractiveness of the facial profiles of black subjects in photos and silhouettes was evaluated in a similar manner among black and white evaluators. Among both black and white evaluators, the greatest preference was for the slightly concave profile, which was within the limit considered standard.