Facial attractiveness and the aged

Patient's Perception on the Esthetic Outcome of Anterior Fixed Prosthetic Treatment

OVERVIEW

Patient's perception to the esthetic result of the treatment received can be different from a dentist opinion. Understanding patient's opinion, demand and expectation is part of successful treatment procedure.

OBJECTIVE

The purpose of this study was to investigate patient's opinion about the esthetic result of the fixed prosthetic treatment received in upper anterior teeth.

MATERIALS AND METHODS

About 90 volunteer subjects, 58 males and 32 females were given a self-evaluation questionnaire with 11 questions to respond as Yes or No. The questions regarded the esthetic result of a fixed prosthodontic treatment received for their upper anterior teeth. The same questioner was completed for each subject by three clinicians through clinical photographs for different views of subject's smile. Agreement between patients and clinicians was calculated for all subjects to evaluate patient's perception to their esthetic results.

RESULTS

An agreement of 47.8 to 72.2% was observed between patients and clinicians, and the average agreement was 53.64 to 60%. The highest agreement was related to satisfaction with the color of the crown and/or bridge margin while the least agreement was related to the satisfaction with the natural looking of the restoration.

CONCLUSION

There was variability in the agreement between the patients and the dentists with the satisfaction of the esthetic result of anterior restoration. Factor, such as gender, age and educational level may affect the results of the agreement.

Patients' acceptance of corticotomy-assisted orthodontics

OBJECTIVE

To study patients' acceptance of corticotomy-assisted orthodontics as a treatment option.

METHODS

Adult patients seeking orthodontic treatment were asked to complete two sets of questionnaires; the first set included questions about age, sex, and level of education and general questions about orthodontic treatment; and the second set was related to the corticotomy-assisted orthodontics. Before answering the corticotomy questions, a brief description of the clinical procedure was explained and photographs of an actual procedure were shown.

RESULTS

A total of 150 subjects were approached and 129 (86%) agreed to answer the questionnaires (72 male and 57 female patients). Of these, only 3.1% did hear about corticotomy and 7.8% selected corticotomy instead of extraction. Fear from the surgery (53.2%) was the most frequent reason for not selecting corticotomy followed by fear from pain (36.9%). The acceptance of corticotomy between males and females was similar. No relationship was found between the level of education and prior knowledge of the procedure, P=0.857. Prior knowledge about corticotomy was not a factor in selecting it as a treatment option (P=0.556) to reduce the treatment time (P=0.427).

CONCLUSION

The acceptance of corticotomy-assisted orthodontics as a treatment option was low. Fear from the surgery was the main reason for not selecting it. The acceptance of corticotomy-assisted orthodontics was not related to patient's level of education or sex.

Perception of facial attractiveness following modification of the nose and teeth

OBJECTIVE

We investigated how laypeople perceive persons with straight teeth and nose, mild to moderate modification of the nose, and mild to moderate modification of the teeth. The objectives were to determine: (1) how modification of the nose or teeth affects others' perceptions of target persons' facial attractiveness, (2) whether these evaluations are affected by the target persons' or raters' gender, (3) whether the frontal view or three-quarter view has any effect on the ratings.

MATERIALS AND METHODS

Survey data were collected from 226 college students at Seton Hill University (49% male, 51% female; age range, 18-25 years) who rated, on a 100mm VAS, photos of subjects with straight teeth and nose (control), mild to moderate modification of the nose, and mild to moderate modification of the teeth from the frontal and three-quarter views.

RESULTS

Male and female target photos with teeth modification were considered the least attractive. Both male and female target photos showed that female raters evaluated both control and nose modification conditions more positively than did male raters. For male and female target photos, the frontal view was less esthetically pleasing under teeth modification.

CONCLUSIONS

Both male and female evaluators judged teeth modification as the least attractive compared to nose modification. It is recommended for rhinoplasty patients with malaligned teeth that it may be beneficial for cosmetic surgeons to establish an interdisciplinary approach working with orthodontists.

Self-Evaluated Dental Appearance Satisfaction among Young Adults

BACKGROUND

Dental appearance satisfaction is important among young adults because judgment concerning the personal characteristics of individuals is influenced by their dental appearance in the absence of other information.

AIM

The aim of the study was to determine the self-evaluated dental appearance satisfaction among young adults.

SUBJECTS AND METHODS

This cross-sectional survey of financial industry prone undergraduates of University of Benin was conducted between July and September, 2010. The self-administered questionnaire which assessed information on demographic characteristics, smoking habit, alcohol use, previous dental visit, dental appearance satisfaction, tooth shape, size, arrangement and strength was the tool of data collection. The data was subjected to descriptive, Chi-square and regression statistics using statistical package for the social sciences version 17.0 (Chicago, IL, USA). (P < 0.05) was considered to be significant.

RESULTS

A total of 399 undergraduates which are made up of 179 (44.9%) males and 220 (55.1%) females with mean age of 24.66 (4.20) years participated in this study. Self-evaluated dental appearance satisfaction was expressed by 79.4% (317/399) of the participants. The significant predictors of self-evaluated dental appearance satisfaction were skin color (P = 0.03, odds ratio [OR] =2.57, 95% confidence interval [CI] =1.09-6.09) and perceived tooth strength (P = 0.02, OR = 5.83, 95% CI = 1.40-24.28) among males and alcohol consumption (P = 0.04, OR = 0.45, 95% CI = 0.21-0.95] and perceived size of tooth (P = 0.02, OR = 2.37, 95% CI = 1.15-4.89) among females. The significant predictors of self-evaluated dental appearance satisfaction among the participants were ethnicity (P = 0.04, OR = 0.55, 95% CI = 0.32-0.96), skin color (P = 0.04, OR = 1.74, 95% CI = 1.03-2.93), perceived tooth size (P = 0.03, OR = 1.82, 95% CI = 1.07-3.09) and strength (P = 0.01, OR = 3.42, 95% CI = 1.58-7.41).

CONCLUSION

Ethnicity, tooth arrangement, size and strength need to be given detailed consideration in tooth replacement as they emerged as the significant predictors of self-evaluated dental appearance satisfaction among young adults.

Software-based evaluation of human attractiveness: a pilot study

STATEMENT OF PROBLEM

The difficulty of evaluating esthetics in an unbiased way may be overcome by using automated software applications.

PURPOSE

The purpose of this study was to assess the use of a smartphone application as an objective tool for evaluating attractiveness and to evaluate its potential in dentistry.

MATERIAL AND METHODS

Ten white participants (mean age ±SD, 42.1 ±22.6 years) were randomly chosen, and frontal facial pictures of each participant were made. The smartphone application PhotoGenic was used to evaluate the attractiveness of the participants. For comparison, 100 randomly (age>16 years, social environment of the research team) selected raters were asked to evaluate the same participants. The influence of participants' facial expression, age, and sex as well as the raters' age, sex, and occupation was investigated. Statistical analyses (linear mixed models with random intercepts; least square means, 95% confidence interval; P<.05) were implemented.

RESULTS

PhotoGenic produced a mean ±SD attractiveness score of 6.4 ±1.2 and the rater group of 4.9 ±1.8 (P<.001; score range, 0-10). Female raters tended to slightly higher attractiveness scores. The participants' sex, facial expression, and age seemed to not be of high relevance; however, the raters' sex and occupation had an impact on the evaluation.

CONCLUSION

PhotoGenic rated the participants' attractiveness with higher scores (more attractive) than did the human raters. Currently, PhotoGenic is not used as an objective evaluation tool for treatment outcomes for dental treatments because the visibility of the teeth (smiling facial expression) has no influence on the evaluation.

Case series of laser-assisted treatment of excessive gingival display: an alternative treatment

OBJECTIVE

The objective of this study was to investigate the stable and significant outcomes of laser-assisted lip repositioning technique for the treatment of excessive gingival display.

BACKGROUND DATA

"Gummy smile" is a major concern for a large number of patients visiting the dentist. The hyperactivity of the upper lip is one of the main causes of a gummy smile, and several techniques have been proposed for its treatment.

METHODS

Ten patients with excessive gingival display were treated with laser-assisted lip repositioning technique. The technique is composed of removing a strip of mucosa by laser incisions from the maxillary buccal vestibule, and coronal repositioning of the new mucosal margin. The clinical dimensions of gingival display were measured from the left, right posterior, and anterior sides at baseline, 6 and 12 months postoperatively. Subjects completed surveys to evaluate satisfaction with outcomes. Clinical and patient-centered parameters [visual analog scale for pain and aesthetics (VAS)] were measured at 7 days and again at 12 months after the surgery.

RESULTS

The baseline anterior gingival display of 4.3±1.8 mm significantly decreased to 1.1±1.0 mm at 6 months (p<0.0001) and was maintained at 12 months (1.2±1.5 mm). The baseline left, right gingival display (4.9±2.2 mm; 5.0±1.4 mm) significantly decreased (1.2±1.4 mm; 1.3±1.1 mm) at 12 months (p<0.0001). Patients were satisfied with their smile after surgery and would likely choose to undergo the procedure again.

CONCLUSIONS

The treatment of gummy smile with laser-assisted lip repositioning successfully reduced the preoperative gingival display without postoperative complications, in all cases.

Effect of lip position and gingival display on smile and esthetics as perceived by college students with different educational backgrounds

Aim

The aim of this study was to evaluate the influence of education on the perception of female college students on the effect of lip position and gingival display upon smiling and esthetics.

Methods

A photograph of a smiling subject was altered to show varying degrees of gingival display. Female students, who were studying in different colleges, assessed a total of five images, using a numerical rating scale.

Results

A total of 440 college students from eight educational faculties (dentistry, dental assistants, medicine, medical technology, nursing, science, arts, and pharmacology) participated in this study. There was no difference found between students’ ratings of the altered images (P<0.05). The perception of a gummy smile was found to be similar among the participants. There was agreement between all participants that 2 mm of gingival display was the most attractive smile, while a 4 mm covering of the teeth by the upper lip was the least attractive.

Conclusion

Educational influence did not have an effect of the perception of a gummy smile.

The signs and symptoms of tooth wear in a referred group of patients

AIM

To determine the prevalence of signs and symptoms in a group of tooth wear patients referred to a hospital-based consultant clinic.

METHOD

The clinical records of 290 patients referred to the Liverpool University Dental Hospital for tooth wear were reviewed retrospectively. A systematic sampling technique was used to select every alternate patient held on the consultant database.

RESULTS

There were significantly more males than females in a ratio of 2.3:1. Significantly more males (56%) presented with severe tooth wear compared with females (31%) (p <0.001). Aesthetic concerns were the most prevalent presenting complaint (59%) and sensitivity was the second most common presenting complaint (40%). Functional problems and pain were less prevalent at 17% and 14% respectively. Subjects who had lost posterior support had more severe wear and more worn anterior teeth, which was statistically significant (p = 0.001). The proportion of subjects with undiagnosed apical pathology on worn teeth was 13%.

CONCLUSIONS

Tooth wear predominated in males in this study. Patient dissatisfaction with appearance is the most common complaint and endodontic signs and symptoms are low in prevalence. Contrary to previous studies, lack of posterior support resulted in greater severity of wear, therefore restoring support is recommended.

Impact of brackets on smile esthetics: laypersons and orthodontists perception

OBJECTIVE: This study evaluated the influence of orthodontic appliances on smile esthetics assessed by lay adolescents, lay adults and orthodontists. METHODS: A facial photograph of a smiling young woman was used under the following conditions: With metal orthodontic brackets ligated by different elastic ligature colors (green, red and gray), with ceramic bracket brackets (transparent elastic ligature) and without brackets, totaling five 15 x 20 cm pictures. For the photograph assessment, 16 lay adolescents, 16 lay adults and 16 orthodontists were randomly selected. The photographs were randomly arranged in an album, followed by a visual analog scale (VAS) for the scores registration. Scores in both evaluations of each group of evaluators (adolescents, adults and orthodontists) were submitted to error analysis by WILCOXON test and multiple comparison among groups performed by Kruskal - Wallis at 5% significance. RESULTS: Orthodontists, adults and adolescents agreed in their opinions, although the orthodontists gave lower scores in their assessments. It could be observed that ceramic brackets were more acceptable concerning the smile esthetics, whereas the metal brackets received the lowest scores. CONCLUSION: Orthodontists, adults and even adolescents seem to prefer esthetic solutions during orthodontic treatment.

Satisfaction With Dental Appearance Among Diverse Groups of Dentate Adults

Objectives: To quantify (a) the prevalence of dissatisfaction with dental appearance in a diverse sample of dentate adults and (b) the associations between dissatisfaction with dental appearance, sociodemographic factors, and other measures of oral health. Methods: Data were taken from the Florida Dental Care Study , a population-based longitudinal cohort study of oral health and related behaviors. The sample included 873 participants at baseline. Descriptive analysis and logistic regression were conducted to analyze the baseline data in the current report. Results: Females, problem-oriented dental attenders, and participants who had not completed high school were significantly more dissatisfied with their dental appearance than their respective counterparts. Dissatisfaction with dental appearance was also independently associated with six specific clinical and self-reported measures of oral health. Discussion: Dissatisfaction with dental appearance was common in this population-based sample of middle-aged and older adults, and was significantly associated with key sociodemographic and oral health factors.

Anterior dental extractions among Dinka and Nuer refugees in the United States: a case series

Few U.S. adults today experience life without permanent anterior teeth and know little about how an incomplete anterior dentition affects adult well-being. Sudanese refugees, who had resettled in the U.S. and who had six mandibular anterior teeth ritually extracted during youth, provided an opportunity to examine the significance of the effect of this partial edentulism. The authors interviewed five adult refugees whose anterior dentition was restored using dental implants. Factors considered before and after restoration included incisal ability, food item recognition, food consumption patterns and related social factors. Before restoration of the anterior dentition, participants could not incise typical foods eaten in the U.S. and expressed embarrassment about their dental status, which limited smiling, speaking and social interaction. This case series offers insight into the bio-cultural importance of the anterior dentition for all populations living with a visible gap in the lower jaw.

Priorities for oral health goals in a sample of older adults

This study was conducted to identify oral health factors that are important to people who are elderly. By identifying factors valued by patients who are older, dental professionals can gain better insights into the preferences and priorities that patients use in making dental treatment decisions. To determine which factors are important to this population, we compiled a list of oral health goals identified through a literature review. To supplement this initial list, we undertook line-by-line (open) coding of transcripts of two sets of semi-structured interviews. The first set of interviews explored the decision of older adults to seek treatment in response tooth pain. The second set of interviews elicited anticipated responses to three scenarios involving extensive restoration and one scenario involving extraction and prosthetic replacement among older patients at a dental school.