Differences in tooth shade value according to age, gender and skin color: A pilot study

Perception of laypersons, orthodontists, and oral and maxillofacial surgeons about the transverse occlusal plane

INTRODUCTION

Transverse occlusal plane (TOP) should be parallel to the true horizontal lines of the face (ie, the interpupillary line [IP] and commissural line [CL]). This study aimed to investigate the opinions of laypersons, orthodontists, and oral and maxillofacial surgeons about the impact of imbalanced IP and CL on facial attractiveness.

METHODS

We used a symmetrical face image as the reference. Then, using Photoshop software, we constructed the following 6 photographs: TOP roll relative to CL and IP (3° and 6°) with parallelism of CL and IP, CL roll relative to TOP and IP (3° and 6°) with parallelism of TOP and IP, TOP and CL roll relative to IP (3° and 6°). Consequently, the participants rated the photographs on the basis of their attractiveness. Kruskal-Wallis and Mann-Whitney U tests were used to compare the ratings.

RESULTS

One hundred thirty-one laypersons, 22 orthodontists, and 20 surgeons participated in this study. It was found that 51.1% of laypersons, 86.4% of orthodontists, and 70% of surgeons selected the reference photograph as the most beautiful, followed by the photograph with a 3° roll of CL relative to TOP, with parallelism of TOP and IP (29% of laypersons, 31.8% of orthodontists, and 35% of surgeons).

CONCLUSIONS

Most participants selected the reference photograph as the most beautiful and realized a roll in the horizontal planes up to 3°. The parallelism of the esthetic line of dentition relative to interpupillary is preferred over its parallelism relative to CL.

Tooth Shade and Blood Type: A Descriptive Cross-sectional Study in Tunisia

AIM

The aim of the study was to assess the prevalence of tooth shade and its correlation with blood type.

MATERIALS AND METHODS

This study analyzed 312 blood donors at the university Hospital in Monastir between November 2021 and June 2022. Both male and female subjects were included, with ages ranging from 18 to 60 years old. Patients with certain dental conditions or habits were excluded from the study. The study recorded various information about blood donors, including gender, age, governorate of origin, tooth shade, and blood type. The tooth shade values were recorded using A-D shade guide. Data input and tabulation were carried out using Microsoft Excel 2016 and SPSS (version 25.0).

RESULTS

The study included 312 participants, with 85.58% males and 14.42% females. Tooth shade value B was the most prevalent (43%), and D was the least prevalent (7%). The statistical analysis showed that there was no significant link between tooth shade and blood type. However, there were three statistically significant categories: Blood type B/Tooth shade B, Blood type O/Tooth shade C, and Blood Type O/Tooth shade D.

CONCLUSION

The study examined the link between tooth color and blood type but did not find a significant link. However, significant values were found in different subgroups. A wider selection of subjects and a more rigorous measurement equipment might lead to more favorable results.

CLINICAL SIGNIFICANCE

By considering the patient's blood type alongside other relevant factors, clinicians can enhance the accuracy and precision of tooth shade selection, resulting in harmonious and natural-looking dental restorations. This approach improves patient satisfaction and acceptance.

Does age determine the lightness and darkness of tooth shades? A retrospective study

The study aimed to analyze whether age determines the lightness and darkness of tooth shades. The demand for esthetics has soared to a next level progressively in many developing countries including India; the importance provided to match the tooth shade creates a great difference in the satisfactory outcome of the patient in the field of dentistry. Therefore, this particular study analyzed the differences in tooth shade values based on age factor among the Indian population. 238 individual's case sheets with the age between 18 and 65 years. 18-30 years of age were considered as group 1 (young adults), 31-45 years in group 2 (middle age), and above 45 years in group 3 (older age). The clinical intraoral pictures of the patients which were taken prior to the treatment were obtained and the shade of any one of the upper permanent central incisors was assessed using the Vitapan 3D-Master shade guide, especially the middle portion of the facial surface of the incisors. The collected data were imported to Statistical Package for the Social Sciences, version 17 (IBM Corporation). Chi-square test was used to assess the significance. From the data, 17.2% showed A1 shade, 35.2% A2 shade, 7.5% A3 shade, 5% A4 shade, 7.1% B1 shade, 15.9% B2 shade, 7.1% B3 shade, 3.3% B4 shade, and 1.1% C1 shade. The individuals under the category of above 45 years showed darker tooth shade compared to young adults and middle age population (Chi-square test, P < 0.001). Significant association was established with darker tooth shades by increasing age and vice versa. The older age population showed a higher correlation for dark shade between teeth. The aging process significantly affects the teeth color. Hence, as a dentist, it is important to know about the distribution of tooth shade and its association with age to get an outcome with adequate patient satisfaction.

Tooth Shade Relationship with Age, Gender, and Skin Color in a Saudi Population: A Cross-Sectional Study

Objectives: The aim of this study was to assess the relationship between tooth shade among different groups of patients according to their age, gender, and skin color in a Saudi population. Materials and methods: Participants were divided based on age into Group 1 (10–20 years), Group 2 (21–30 years), Group 3 (31–40 years), and Group 4 (41+ years), and according to gender. Tooth shade was measured by Vita easyshade, Shade scanner, 3D Master shade system. The skin color was determined according to the Firzpatrick Scale. It consists of six shades, namely: I, II, III, IV, V, and VI. The skin complexion of the participants was divided into six categories: white/very fair, fair, light brown, moderate brown, dark brown, and black. Results: One hundred and ninety-eight individuals were recruited. Around 70% were males. Females had 25.4% A2 followed by 22% A1, and 22% A3 shade types, while males had B3 shade (18%) followed by A2 and A3 (15.8%). A statistically significant difference was observed between shade and gender (p < 0.05). A statistically significant difference was observed between shade and age group (p < 0.05), where increased age was correlated with darker teeth shades. Shade A1 was correlated with type I skin color in 57.1% of individuals. Skin color type II had A2 as a dominant shade by 34.1%. A2 and A3 shades were equally observed in skin color III by 20.3%. Overall, statistically significant differences were observed between shade and skin color groups (p < 0.05). Conclusions: In conclusion, the most frequent classical shade noted among male and female participants was shade type A, which represents reddish brownish. Group 2 (21–30 years) had the B3 shade as the most prominent shade type among age groups. Gender, age, and skin types all showed a significant relation with the tooth shade.

Comparison of Digital and Paper Assessment of Smile Aesthetics Perception

Objectives:

Despite the widespread of assessment of smile aesthetic perception in many areas, there has yet to be a direct comparison of digital and paper-based photographs for the assessment of smile aesthetics. Here we compared digital and paper-based photographs representing different smile aesthetic features using visual analog scale (VAS) scoring.

Materials and Methods:

One hundred students were randomly recruited from a university campus. Participants were asked to record their perception of smile aesthetics via paper and digital-based platforms. The minimum clinically important difference between platforms was set at 15 mm. The percentage of participants who rated smile attractiveness worse on digital images was recorded. The paired one-tailed Student’s t test was used to determine differences between digital and paper platforms, and Bland–Altman analysis and intraclass correlations (ICCs) were used to test for agreement between paper and digital photographs.

Results:

Ninety-nine subjects participated, 55 men (mean age = 22.05, standard deviation [SD] = 1.91) and 44 women (mean age 22.05, SD = 1.84). There were statistically significant differences between paper-based and digital photographs for all images except one (paired t test; P < 0.05). Digital ratings were lower than paper-based ratings for all images, and differences were clinically significant in four out of eight images. A high percentage of participants (50.5%–85.9%) rated smile attractiveness worse on digital images than on paper for all images. There was poor agreement between the two methods as assessed by ICCs and Bland–Altman analysis.

Conclusion:

Equivalence between paper and digital images for smile aesthetics cannot be assumed, and paper-based photographs may lead to clinically relevant overestimations of perceived attractiveness. As academic dentistry increasingly relies on digital imaging and sharing in the post-COVID-19 world, further validation of digital platforms for smile aesthetics assessment is warranted, and care should be taken when interpreting the results of studies assessing smile perception based on different platforms.

Comparison of photographic and conventional methods for tooth shade selection: A clinical evaluation

Aim:

This study aimed to compare three different methods used for shade selection, i.e., visual method, spectrophotometer, and digital photography method.

Materials and Methods:

Fifty participants were selected from the Out Patient Department of Prosthodontics. Presence of the maxillary right central incisor with no history of any restorative or endodontic procedures was the primary inclusion criterion. The shade of the right maxillary central incisor was determined using all the three shade selection procedures, namely, visual, spectrophotometric, and digital photography method for all the selected participants. The shades obtained in the visual method using a shade guide were noted down for further comparisons. The spectrophotometer reported the L*, a*, and b* values along with the actual shade whereas the digital photography method reported only the L*, a*, and b* values. The agreement between the readings obtained by the three different methods was compared and subjected to appropriate statistical analysis.

Results:

The results showed that when the three methods studied were compared, there was a statistically significant proportion of agreement between spectrophotometric and visual method (P < 0.01) with higher proportion of “yes” (agreement) and between the spectrophotometric and digital photography method (P < 0.01) with higher proportion of “yes” (agreement). Coefficient of agreement (using Kappa coefficient) between spectrophotometric and visual shades revealed a fair agreement. The mean ΔE was 1.69. There was a statistically significant difference between the proportion of ΔE more than and <2, between spectrophotometric and digital photography methods (P < 0.01) with higher proportion of <2 ΔE. Furthermore, percentage of agreement between shades obtained by the visual and spectrophotometric method showed maximum agreement with A1 shade.

Conclusion:

It was concluded that the digital photography method emerged as a reliable method for shade selection in a clinical setup.