The effectiveness of a masked counterconditioning approach using continuous flash suppression to alleviate body dissatisfaction in women with high body image concerns

BACKGROUND AND OBJECTIVES

Research that used counterconditioning (CC) to reduce women's negative body image has led to mixed results. One explanation could be that the negative responses elicited by own body pictures hinder the effectiveness of CC procedures in adjusting overly negative attitudes towards the own body. In this study we therefore tried to prevent the impact of negative responses by limiting women's perceptual awareness of the own body pictures during the CC procedure.

METHODS

Women with a negative body image were randomly assigned to an experimental (n = 75) or control (n = 71) condition. In the experimental condition, participants' masked body pictures were systematically followed by visible social approval cues (i.e., smiling faces), whereas neutral body-unrelated control pictures were followed by a blank screen. In the control condition, both own body and control pictures were followed by a blank screen.

RESULTS

Participants in the experimental condition did not report a more positive evaluation of the own body (pictures) after CC than participants in the control condition. Also, the strength of automatic affective body evaluations as indexed by a single-target Implicit Association Test did not differ between conditions.

LIMITATIONS

Many participants did not remain fully unaware of their body pictures during conditioning.

CONCLUSIONS

The findings provided no support for the idea that CC with masked own body pictures can be used in women with body dissatisfaction to improve their body image.

The impact of dental midline angulation towards the facial flow curve on the esthetics of an asymmetric face: Perspective of laypeople and orthodontists

PURPOSE

The objective of the present article was to evaluate the ımpact of dental midline angulation in asymmetrical faces.

MATERIALS AND METHODS

A full-portrait image was used to create a set of digitally modified images with a different degree of facial asymmetry, towards the right and the left side of the face respectively. Half of the images were designed with an equivalent angulation of the dental midline in respect to the curve of the lower third of the face and half of them without. Through a web survey, 250 laypeople and 250 orthodontists were asked to assess the attractiveness of each image separately.

RESULTS

As the asymmetry of the face was increased, facial attractiveness was further decreased both for laypersons and orthodontists. For each one of the modified images, when the dental midline was following the curve that was formed from the inclination of the simulated asymmetry of the face, the smile attractiveness scores were significantly higher compared to a straight dental midline.

CONCLUSION

Facial asymmetries derived from the inclination of the nose, the chin and the commissural line of the lips can significantly affect the smile attractiveness. An orientation of the dental midline towards the facial asymmetry in order to follow the facial curve, can be beneficial for the smile attractiveness compared to a perpendicular to the face dental midline. During the design of a smile, clinicians have to take into consideration deviations in facial midline, in order their restorations to be in harmony with the rest of the face.

CLINICAL SIGNIFICANCE

During the design of a smile, clinicians have to take into consideration deviations in the facial midline, in order their restorations to be in harmony with the rest of the face.

Determining the widths of the maxillary anterior teeth for esthetics: comparison of the Mondelli and Albers formulas, esthetic proportion, and golden ratio

The purpose of this study was to compare various formulas for idealized proportions of the maxillary incisors to the actual dimensions of natural teeth. The Mondelli formula 1 (MF1), Mondelli formula 2 (MF2), Albers formula (AF), esthetic proportion (EP) for width and height of anterior teeth, and golden ratio (GR) were calculated for a total of 50 dental students (30 women and 20 men) who participated in the study. The following measurements were obtained directly in the participant's mouth with a digital caliper: the mesiodistal and incisogingival dimensions of the maxillary central incisors, lateral incisors, and canines; the intercanine distance; and the smile width. The participants were photographed, and the smile width was also measured on the photographs. The MF1 and MF2 were each calculated twice, using both direct measurements and photographic measurements. The projected central incisor widths calculated using the MF1, MF2, and AF were compared among themselves and against the actual measurements using analysis of variance and Fisher test for multiple comparisons (α = 0.05). The EP and GR were analyzed using descriptive statistics. There was a statistically significant difference between all of the widths projected by the formulas and the actual widths of the central incisors (P < 0.05). Whether calculated from a direct or a photographic measurement, the incisor widths projected by the MF1 and MF2 were statistically similar to each other (P > 0.05). The EP values were similar to those reported in the literature. Only 2% of the participants had an incisor width ratio (central incisor/lateral incisor) that matched the GR of 1.618, while 86% fell within the range of 1.2 to 1.4. Overall, the proportions calculated with the MF1, MF2, AF, EP, and GR did not exactly match the actual dimensions of natural teeth. The formulas and the proportions available in the literature can assist in esthetic planning, but the individual characteristics of each patient and expertise of the dentist should guide treatment for each case.

Effective approach for improving a gummy smile : Upward movement of the maxillary occlusal plane using midpalatal miniscrews and a modified transpalatal arch

PURPOSE

Correction of a gummy smile by orthodontic treatment alone has recently become feasible with the use of miniscrews. However, the optimal treatment mechanics remain unclear. Here we cephalometrically evaluated jaw and tooth displacement in cases where a gummy smile was improved using a level anchorage system (LAS).

METHODS

Sixteen patients underwent orthodontic treatment using an LAS consisting of a modified transpalatal arch and midpalatal miniscrews. Cephalometric pretreatment and posttreatment measurements were compared using the paired t‑test to determine significant skeletal and dental changes. The Mann-Whitney U test was used for nonparametric data. Spearman's rank correlation coefficient was used to evaluate correlations between different variables and the vertical change in prosthion position which was used to indicate the amount of gingival exposure.

RESULTS

The changes noted after treatment were intrusion of the maxillary first molars (P < 0.001) combined with only minor extrusion of the mandibular first molars. Suppressed extrusion of the mandibular first molars was significantly correlated with greater upward movement of the prosthion (r = 0.676, P < 0.01). Upward movement of the prosthion was also significantly correlated with intrusion of the maxillary and mandibular incisors, anterior upward movement of the maxillary occlusal plane, and an increase of the SNP angle.

CONCLUSIONS

Treatment involving the combined use of miniscrews and a modified transpalatal arch resulted in intrusion of the maxillary first molars and maxillary incisors and consequently elevated the maxillary occlusal plane. The results of this study suggest that intruding the maxillary occlusal plane and minimizing mandibular molar extrusion were effective to induce autorotation of the mandible and to improve a gummy smile.

A comparative study of the use of digital technology in the anterior smile experience

OBJECTIVES

this study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations.

METHODS

Sixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index.

RESULTS

Based on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction.

CONCLUSION

Digitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.

Influence of orthodontic bracket prescription on smile attractiveness in patients with different sagittal skeletal patterns: A 3-dimensional cross-sectional study

INTRODUCTION

The objective of this study was to evaluate the influence of orthodontic bracket prescription on smile attractiveness.

METHODS

Three women were chosen according to their sagittal skeletal pattern: skeletal Class I, II, or III malocclusion. For each, 3 smiling pictures were taken in frontal, oblique, and lateral views. The maxillary arch was then scanned, and a 3-dimensional digital model was constructed on the OrthoAnalyzer software. The information of 3 orthodontic prescriptions, namely Roth, MBT, and Ricketts, was simulated after the virtual placement of orthodontic brackets on 10 maxillary teeth. The simulations were then superimposed on the smile photographs in the 3 views, creating a total of 27 images. Groups of orthodontists, dentists, and laypeople rated the attractiveness of each smile using the visual analog scale.

RESULTS

This study included 167 evaluators: 54 orthodontists, 54 dentists, and 59 laypersons. In terms of orthodontic prescription, MBT esthetic scores were 4% lower than Roth scores (P <0.001), and Ricketts scores were 13.6% lower than Roth scores (P <0.001). In terms of skeletal pattern, Class II and III scores were 15.0% and 16.4% lower than Class I scores, respectively (P <0.001). Regarding the smiling view, oblique view scores were 3.1% lower than frontal view scores (P = 0.031), whereas lateral view scores were 8.4% lower than frontal view scores (P <0.001). In contrast to gender and age, the specialty of the evaluators significantly affected the esthetic rating of the smiles.

CONCLUSIONS

The attractiveness of a smile is affected by the prescription of the brackets. The Roth prescription tends to obtain the most favorable esthetic scores, especially in sagittal smiling images. Profile smiles with excessively proclined incisors are considered unattractive. Different views of the same smile do not get similar esthetic scores because sagittal views are rated the most severely.

Malocclusion or laterorhinia: Which one impacts aesthetic facial perception the most?

INTRODUCTION

This study aimed to evaluate the perception of facial attractiveness when nose and teeth, together or isolated, present different degrees of disharmony. The secondary objective was to compare the perception of laypersons with that of dentists.

MATERIALS AND METHODS

This cross-sectional observational study included 112 individuals (58 laypersons and 54 dentists) that evaluated 6 manipulated images of the face of the same model, scoring their attractiveness using 10 cm Visual Analogue Scales (VAS), with least and most attractive at the left and right anchors, respectively. The images contained manipulations performed only on the nose (laterorhinia) and mouth (misaligned teeth), as follows: (1) standard photograph, with symmetrical nose + aligned teeth; (2) 2 mm nasal deviation + aligned teeth; (3) 4 mm nasal deviation + aligned teeth; (4) symmetrical nose + misaligned teeth; (5) 2 mm nasal deviation + misaligned teeth and (6) 4 mm nasal deviation + misaligned teeth. We used the repeated measures ANOVA test and Tukey's post-test for intra-group comparison of the images. The independent t-test was used for inter-group comparison of each image.

RESULTS

In the laypersons' group, the highest grades were given to images with aligned teeth and the lowest to misaligned teeth (smallest mean difference = 2.88 cm). For this group, there was no statistically significant difference (P-values ranged from .988 to 1.000) between scores of the three images in which teeth were aligned (range of 7.70-7.78 cm). In the group of dentists, highest grades were given to images with aligned teeth and the lowest to misaligned teeth. Difference between images 3 and 4 was not statistically significant (P = .204). All other differences between any image of straight teeth and any image with misaligned teeth were significant and the smallest mean difference between the two groups of images was 1.87 (P = .039). However, in the images with aligned teeth, there was also a statistically significant difference with higher scores to the images with symmetrical nose in contrast with those with significant laterorhinia (mean difference = 1.03 cm).

CONCLUSION

Teeth disharmonies had a more negative impact on the aesthetic perception of the face than did nose deviations, for both dentists and laypersons.

Favorable Outcome Perception in Facial Selective Neurectomy

OBJECTIVE

Facial selective neurectomy (SN) improves facial function by denervation of muscles antagonistic to the smile in nonflaccid facial paralysis (NFFP) patients. This study aims to assess whether and which objective facial function metrics affect favorable SN outcome in NFFP patients, as perceived by facial nerve (FN) practitioners.

STUDY DESIGN

Retrospective cohort study.

SETTING

NFFP patients who underwent SN at the facial nerve center.

METHODS

Standardized preoperative and postoperative facial photographs of patients undergoing SN were analyzed using clinician-graded measures (eFACE) and automated facial measurement (Emotrics). Favorable outcome was ranked subjectively by 3 independent FN practitioners. Correlations between objective metrics and favorable subjective outcome were examined.

RESULTS

Fifty-eight SN cases were included. Oral commissure excursion with smile, interlabial distance, and lower lip movement were all considered statistically significantly important for favorable outcome perception. Each +1 mm of smile excursion increases the odds of a favorable outcome by 75.4% (odds ratio [OR]: 1.754). Each +1 mm of interlabial distance asymmetry decreases the odds of a favorable outcome by 24.7% (OR: 0.753). Each +1-point change in lower lip movement eFACE score increases the odds of a favorable outcome by 2.7% (OR: 1.027).

CONCLUSION

Several smile metrics contribute to favorable SN outcome perception among FN practitioners. Smile excursion, interlabial distance, and lower lip movement were significant predictors of success. These observations may be extrapolated to other facial reanimation interventions and serve surgeons and patients during counseling and expectation management, and during surgery.

Can group membership modulate the social abilities of autistic people? An intergroup bias in smile perception

Autistic adults struggle to reliably differentiate genuine and posed smiles. Intergroup bias is a promising factor that may modulate smile discrimination performance, which has been shown in neurotypical adults, and which could highlight ways to make social interactions easier. However, it is not clear whether this bias also exists in autistic people. Thus, the current study aimed to investigate this in autism using a minimal group paradigm. Seventy-five autistic and sixty-one non-autistic adults viewed videos of people making genuine or posed smiles and were informed (falsely) that some of the actors were from an in-group and others were from an out-group. The ability to identify smile authenticity of in-group and out-group members and group identification were assessed. Our results revealed that both groups seemed equally susceptible to ingroup favouritism, rating ingroup members as more genuine, but autistic adults also generally rated smiles as less genuine and were less likely to identify with ingroup members. Autistic adults showed reduced sensitivity to the different smile types but the absence of an intergroup bias in smile discrimination in both groups seems to indicate that membership can only modulate social judgements but not social abilities. These findings suggest a reconsideration of past findings that might have misrepresented the social judgements of autistic people through introducing an outgroup disadvantage, but also a need for tailored support for autistic social differences that emphasizes similarity and inclusion between diverse people.

Smile aesthetics in Pakistani population: dentist preferences and perceptions of anterior teeth proportion and harmony

BACKGROUND

This study aimed to evaluate dentist perceptions of attractive smiles in the Pakistani population, considering different dental proportions.

METHODS

Maxillary casts and digital images were used to create symmetrical representations of anterior teeth. dentists' preferences for good and bad teeth proportions, width/height ratios, and various dental proportions (golden, recurring esthetic dental (RED), golden percentage, Preston, and local/observed) were assessed using one sample and paired t-test. The Chi-square test was used to determine the gender disparities and factors affecting smile attractiveness. A p-value of ≤ 0.05 was taken as significant.

RESULTS

The RED proportion emerged as the preferred choice for normal-sized teeth, with specialists and general dentists favoring it over the golden proportion. For tall teeth, the golden proportion was predominantly preferred. The golden percentage received limited preference for aesthetic smile construction.

CONCLUSIONS

The smiles created using the principles of RED proportion were opted as the most attractive by local dentists. Factors such as tooth arrangement, color, and midline were highlighted as essential considerations in aesthetic smile construction.

Influence of education level and gender of dental students on perception of dental aesthetics

BACKGROUND

Fulfilling aesthetic norms is an imperative of modern society. Accordingly, aesthetics has found its important role in dental medicine. The aim was to study whether there is a difference in the perception of tooth shade change and anatomical variations of anterior maxillary teeth among dental students depending on the level of education, gender, and experience in assisting in a dental office.

METHODS

The research was conducted among dental students via the Google Forms platform. Students evaluated the aesthetic acceptability of a smile on the unaltered, reference photograph (RP) and on the other 28 photographs in which the tooth shade (lighter and darker teeth), length (shortened central incisors, elongated, and beveled lateral incisors, elongated canines) and position (atypical and typical rotations and diastemas) of the upper maxillary teeth were altered by digital manipulation. The 1-10 assessment scale was used. Statistical analysis comprised one-way Kolmogorov-Smirnov test, X2 tests, t-test, and 3-way MANOVA.

RESULTS

In the research 208 students participated, 113 were preclinical students, 104 assisted in dental office and 175 were females. There were no significant effects of gender regarding length and position modifications (p > .05), while women were stricter in evaluation of lighter shade (p < .05). Clinical students were stricter in evaluating all manipulated photographs (MP) except those towards darker shade modifications, while assisting in a dental office or having a dentist in close family showed no significant effects (p > .05).

CONCLUSIONS

With a higher level of targeted academic education, dental students sharpen their ability to notice deviations from the aesthetic norms of a smile.

Relationships between perception of black triangles appearance, personality factors and level of education

This analytical cross-sectional study evaluated the perception of black triangles (BT) and examined the relationships between the perception of BT, personality factors, different educational backgrounds and demographic factors. 435 participants were included and divided into four groups: dentists, clinical (4th and 5th year) dental students, pre-clinical (3rd year) dental students, and laypeople. Participants' perception of the attractiveness of smile profiles of maxillary and mandibular anterior dentition with BT was rated using a ten-point VAS scale with 0 being the least, and 10 being the most attractive smile profile. The personality was assessed using the NEO-FFI personality questionnaire. The smile profile with multiple large BT was rated the least attractive for the maxillary (mean = 3.6) and mandibular (mean = 3.9) tested profiles. The smile profile without BT was rated the most attractive for the maxillary (mean = 9.1) and mandibular (mean = 8.8) tested profiles. The dental professionals perceived the maxillary smile profile with multiple large BT as less attractive than the non-dental participants (t = - 2.715, P = 0.007). Being a male, having dental education, having lower Neuroticism scores, as well as having higher Openness, Agreeableness, Conscientiousness, and Extraversion scores predicted and contributed more towards perceiving various tested smile profiles as more attractive. These findings show that black triangles negatively impacts the perception of smile attractiveness, and that personality traits and having dental education impact the perception of smile attractiveness for smiles with black triangles.

The association between self-esteem and aesthetic component of smile among adolescents

OBJECTIVES

Self-esteem plays a crucial role during adolescence in a shaping of an individual's overall well-being and confidence. The aim of this study was to explore the relationship between the self-esteem in adolescents and their smile aesthetics, as well as to assess the alignment of opinions on this matter between adolescents and dentists.

METHODS

Sample included 413 students in Split-Dalmatia County, aged 13 to 18 (60% females). Data on demographic issues, orthodontic history, and desire for orthodontic treatment were collected by the self-administrated questionnaire. Coopersmith's Self-Esteem Inventory was also used. Smile aesthetics was assessed by each participant and dentist independently using an Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN AC).

RESULTS

Self-esteem was higher in adolescents who rated their smile aesthetics equally to the dentist than in those who considered their aesthetics to be worse than the dentist (18.5 vs. 16; P = 0.011). The multiple linear regression revealed that the self-esteem of adolescents was positively related to undergone previous orthodontic treatment (β = 1.286, P = 0.020) while negatively related to the female gender (β = -2.531, P ≤ 0.001) and IOTN AC assessed by dentist (β = -0.356, P = 0.015). It was not related to educational level or desire for orthodontic treatment.

CONCLUSION

The self-esteem in adolescence is influenced the most by gender, but the orthodontic treatment and better smile aesthetics might also contribute.

Aesthetic treatment planning simplified using digital smile design: A case report

Digital smile design (DSD) plays an essential role in the planning of aesthetic treatments. However, most digital smile designing software programmes are expensive and require specialised training and skill for effective implementation. This paper illustrates the use of Adobe Photoshop and Microsoft PowerPoint, which are economical and user friendly for planning aesthetics in a clinical case.

The influence of different tooth proportions obtained using digital smile design on the perception of smile esthetics

OBJECTIVE

The aim of this study is to examine the effect of designs using different esthetic dental proportions made with a digital smile design program on the esthetic perception of individuals of different ages, genders and educational statuses.

MATERIALS AND METHODS

Different smile designs were made on facial photos taken of a female and male model using a smile design program. Four different dental proportions (golden proportion [GPR], golden percentage [GPE]), Preston proportion [P] and recurring esthetic dental proportion [RED]) and two different tooth shapes (oval and square) were used. Images with 16 different smile designs were presented to 4th and 5th-year students of a faculty of dentistry, dentists, specialist dentists and laypersons for scoring.

RESULTS

The gender of the participants did not affect the scores given (p > 0.05), and participants over the age of 30 and lay people had higher scores (p < 0.05). The GPR design was scored lower than RED when all designs were subdivided by tooth shape and gender (p < 0.001).

CONCLUSIONS

The esthetic perceptions of people of different ages and dentistry education levels may differ from each other. Using the GPR when designing a digital smile may not be suitable for both genders.

CLINICAL SIGNIFICANCE

If esthetic dental proportions are to be utilized when designing a smile, it may be more appropriate to use the P and RED proportions instead of the GPR. In addition, if the patients whose smiles will be designed are young and have received dental education, it should be considered that their esthetic expectations may be high. Trial registration ClinicalTrials.gov Identifier: NCT0567043.

What is in a smile: The role of evaluation goal and response labels in facial muscle responses to prejudiced groups

Based on the assumption that valence is permanently linked to facial responses, we expected that the corrugator muscle is contracted faster in response to overweight persons than to slim persons, whereas we expected faster contractions of the zygomaticus muscle in response to slim persons rather than to overweight persons. To detect such differences, we conducted experiments with different versions of a facial stimulus-response compatibility task that required participants to respond with the two facial muscles to photos of overweight or slim persons. Contrary to the assumption that valence is permanently linked to facial responses, in Experiments 1 and 2, social categories (overweight vs. slim persons) did not influence the response latencies assessed by electromyography. Whereas in Experiments 1 and 2, neutral labels were used for the muscle responses, in Experiment 3, affective response labels (smile vs. frown) were used. In Experiment 3, faster responses with the corrugator to overweight than to slim persons and with the zygomaticus to slim than to overweight persons were obtained. The influence of task and response label is consistent with the theory of event coding that suggests a more flexible link between valence and action.

The surgical outcomes of anterior segmental osteotomy in Asian skeletal class II patients

PURPOSE

Anterior segmental osteotomy (ASO) following the surgery-first approach is a long-established treatment modality to resolve lip protrusion in patients with skeletal class II patterns. However, the indications and effectiveness of ASO still remain uncertain. The objective of this study is to investigate the effectiveness of ASO in Asian skeletal class II patients by evaluating the skeletal and soft tissue changes and analyzing pre-treatment variables that determine successful outcomes in occlusal as well as esthetic aspects.

METHODS

The lateral cephalograms of 44 skeletal class II patients who underwent ASO and orthodontic treatment for resolving lip protrusion were retrospectively collected. Hard and soft tissue variables of two groups, normalized (NG) and unnormalized (UNG) ANB after treatment were compared and analyzed. The rotational effect of the anterior segment on the hard and soft tissue was also investigated.

RESULTS

ASO was successful in correcting the skeletal class II relationship and lip protrusion (ΔANB - 2.3°, 4-5 mm lips retraction) in most cases. However, for patients with severely camouflaged skeletal class II incisors involving a large ANB and SNA, a large ANB still remained post-treatment. The study also found that rotation of the upper and lower anterior segments further augmented the amount of lip retraction.

CONCLUSIONS

ASO was found to successfully correct ANB of skeletal class II patients under the following conditions (ANB 5.3° ± 1.5°, SNB 77.3° ± 4.5°, U1 to FH 115° ± 7.5, L1 to FH 48.0° ± 4.6). However, patients with larger ANB and SNA values may require bi-maxillary surgery. In addition, ASO has limitations in correcting gummy smile in cases of extreme maxillary excess. For patients requiring a large amount of lip retraction, rotation of the anterior segment may be beneficial in conjunction with bi-maxillary surgery.

Neuromodulator Injection for Gummy Smile

SUMMARY

Neuromodulators have become a treatment of choice for the management of excess gingival show, or "gummy smile." There have been many proposed algorithms for the optimal placement and dosage of neuromodulator to inject in these locations. The authors aim to clarify these points and provide surgeons with a reliable way to manage the gummy smile that results from hyperactive muscles of the midface.

Creating an Extraordinary Outcome With Ordinary Digital Planning

A patient was dissatisfied with her previous extensive dental treatment and wanted a comfortable bite with less gingival display for a more attractive smile. This article describes a systematic approach that was used in diagnosis, planning, and treatment sequencing to effectively manage the esthetic, functional, and biomechanical concerns involved in the case while minimizing risks. Digital planning enhanced interdisciplinary communication making the outcome more efficient and predictable.

Defining Standard Values for FaceReader Facial Expression Software Output

BACKGROUND

FaceReader is a validated software package that uses computer vision technology for facial expression recognition which has become increasingly popular in academic research to expedite, scale, and decrease the cost of facial emotion analysis. In this study, we compare FaceReader analysis to human evaluator interpretation in order to define standard values for the software output.

METHODS

Randomly generated facial images produced by generative adversarial networks were analyzed using FaceReader and by survey participants (n=496). The age, facial emotion, and intensity of emotion as determined by the software and survey participants were recorded. Results were analyzed and compared.

RESULTS

80 randomly generated images (20 children, 20 young adult, 20 middle aged, and 20 elderly; 38 male and 42 female) were included. Analysis of correlation between most common expression identified by FaceReader and the primary emotion detected by surveyors showed strong correlation (κ = 0.77, 95% CI = 0.64-0.91). On analyzing this correlation by age group, there was fair correlation in children (κ = 0.40, 95% CI = 0.078-0.72), perfect correlation in young adults (κ = 1.0, 95% CI = 1.0-1.0), strong correlation in middle aged adults (κ = 0.79, 95% CI = 0.53-1) and near perfect in elderly adults(κ = 0.9 , 95% CI = 0.7-1.0).

CONCLUSIONS

We provided the first study defining the expected average values generated by FaceReader in generally smiling images. This can be used as a standard in future studies.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Unveiling why race does not affect the mask effect on attractiveness: but gender and expression do

Studies show that surgical face masks can have both positive and negative effects on attractiveness. Race has been implicated as a moderator of the size of this mask effect. Here, the moderating effects of expression, race and gender are explored. The mask effect was more positive for males than for females, for neutral faces than for smiling faces, and there were differences between the races. Further, the effect of unmasked attractiveness was partialled out for each image, which removed the race effects, but the gender and expression effects remained. It is suggested that racial differences previously observed in the mask effects are a consequence of differences in attractiveness of the faces sampled from those races. Re-analysis of previous research that showed race effects also demonstrates how they are better explained as attractiveness effects rather than race effects. This explanation can provide order to the different findings observed across the literature.

A deepfake-based study on facial expressiveness and social outcomes

Artificial intelligence (AI)-generated media is used in entertainment, art, education, and marketing. AI-generated faces or facial expressions using deepfake-based technologies might also contribute to nonverbal behavior studies. As a proof of concept, in this research, we test the replicability of past results regarding the positive effects of facial expressiveness (e.g., gazing, nodding, and smiling) on social outcomes. Because the facial expressions when listening to someone (i.e., nonverbal immediacy) encompass several behaviors that are typically related (i.e., smiling while nodding), the effect of combinations of these behaviors is challenging to study. We thus test the effect of facial expressiveness (gazing, nodding, and smiling vs. none) on first impression judgements in a job interview setting using AI-generated experimental video material. We measure how competent, warm, and favorably independent observers (n = 823) perceive the targets (n = 159) showing AI-generated facial expressions. Our results replicate past research showing that the more targets are facially expressive, the more they are perceived favorably. Apart from supporting evidence of the importance of facial expressiveness for conveying a positive impression, we show the benefits of relying on AI-generated experimental video material for the study of nonverbal behavior.

Customized planning of the visible maxillary arch width in harmony with interparopia width and smile width for female facial aesthetics

BACKGROUND

The visible maxillary arch width (VAW) is an important aesthetic-determining feature. To date, there is no well-established methodology to determine the aesthetically optimal VAW in customized treatment planning.

METHODS

In this study, the common traits of the dentofacial configuration were investigated in most attractive Asian and Caucasian female smiles. The smiling photo of a subject was digitally modified based on combined variations of VAW, smile width (SW), transverse facial dimensions (TFD), and vertical facial dimensions. These modified photos were assessed for aesthetics. The aesthetically essential parameters were identified, and their mathematic correlations and reference ranges were determined for different vertical facial patterns. Using the obtained results, a mathematic guidance was constructed for customized smile designing. The applicability of this guidance was tested in Asian females.

RESULTS

The most attractive Asian and Caucasian female smiles have intraracial and interracial commonalities in the VAW-to-TFD ratios. The interparopia width (IPD) predominated over facial widths in determining well-matched VAW and SW. For optimal smile aesthetics, the VAW and SW were correlated as simulated by the formula 1.92 IPD ≤ VAW + 2.3 SW ≤ 2.17 IPD, plus the VAW-to-IPD ratio within 0.54 to 0.62 and the SW-to-IPD ratio within 0.61 to 0.71, ranges tailored to vertical facial patterns. This constitutes a mathematic guidance for customized planning of the aesthetically optimal VAW. This guidance was preliminarily validated to be applicable to Asian females.

CONCLUSIONS

The VAW-to-TFD ratios were essential for Caucasian and Asian female smile aesthetics. The mathematic guidance could serve as a reference for customized smile designs for Asian females.

High depressive symptomatology reduces emotional reactions to pictures of social interaction

Individuals with severe depressive symptoms present diminished facial expressions compared to healthy individuals. This reduced facial expression, which occurs in most depressive patients could impair social relationships. The current study sought to investigate whether pictures with social interaction cues could elicit different modulations of facial expressions and mood states in individuals with depressive symptoms compared to healthy individuals. A total of 85 individuals were divided into depressive and non-depressive groups based on their beck depression inventory scores. Participants viewed pictures containing neutral (objects), affiliative (people interacting socially), and control (people not interacting) scenes. Electromyographic signals were collected during the entire period of visualization of the blocks, and emotional questionnaires were evaluated after each block to assess sociability and altruism (prosocial states). In non-depressed individuals, affiliative pictures increased the activity of the zygomatic muscle compared to both neutral and control pictures and reduced fear of rejection compared to neutral pictures. During the visualization of the affiliative block, zygomatic major muscle activation was higher and fear of rejection was lower in the non-depressive individuals than in the depressive. These effects reflected the low expressions of smiling and sociability to affiliative pictures in depressive individuals. These findings highlight the importance of smiling and prosocial states in social interactions, especially in these individuals.

An investigation of the modulatory effects of empathic and autistic traits on emotional and facial motor responses during live social interactions

A close relationship between emotional contagion and spontaneous facial mimicry has been theoretically proposed and is supported by empirical data. Facial expressions are essential in terms of both emotional and motor synchrony. Previous studies have demonstrated that trait emotional empathy enhanced spontaneous facial mimicry, but the relationship between autistic traits and spontaneous mimicry remained controversial. Moreover, previous studies presented faces that were static or videotaped, which may lack the "liveliness" of real-life social interactions. We addressed this limitation by using an image relay system to present live performances and pre-recorded videos of smiling or frowning dynamic facial expressions to 94 healthy female participants. We assessed their subjective experiential valence and arousal ratings to infer the amplitude of emotional contagion. We measured the electromyographic activities of the zygomaticus major and corrugator supercilii muscles to estimate spontaneous facial mimicry. Individual differences measures included trait emotional empathy (empathic concern) and the autism-spectrum quotient. We did not find that live performances enhanced the modulatory effect of trait differences on emotional contagion or spontaneous facial mimicry. However, we found that a high trait empathic concern was associated with stronger emotional contagion and corrugator mimicry. We found no two-way interaction between the autism spectrum quotient and emotional condition, suggesting that autistic traits did not modulate emotional contagion or spontaneous facial mimicry. Our findings imply that previous findings regarding the relationship between emotional empathy and emotional contagion/spontaneous facial mimicry using videos and photos could be generalized to real-life interactions.

Evaluation of the impact of orthodontists' smile with malocclusions on social media and professional credibility

OBJECTIVES

This study assessed laypeople's perceptions of orthodontist credibility based on malocclusions and whether these views affect their choice to seek treatment. Eye-tracking technology and questionnaires were utilized.

MATERIALS AND METHODS

Ninety-five lay raters, through eye tracking and a questionnaire, assessed 12 images of orthodontists with malocclusions. Malocclusions were categorized by the Index Of Treatment Need (IOTN) as grade 1 (near ideal), 3 (anterior crowding), and 5 (with diastemas). Fixation points were recorded, and credibility was gauged via questionnaires. A Mentimeter word cloud was generated.

RESULTS

IOTN 1 orthodontists were viewed as more credible than IOTN 3 (p < 0.001) and 5 (p < 0.001). Raters were more willing to receive treatment from IOTN 1 orthodontists. The focus for IOTN 1 was between eyes and mouth, while IOTN 3 and 5 were on the mouth. "Crooked teeth" and "spacing" were predominant in word clouds for IOTN 3 and 5.

CONCLUSION

Orthodontists with an IOTN grade 1 rating were perceived as more competent, reliable, and professional, thus making it more likely for laypeople to choose them as their preferred providers.

CLINICAL RELEVANCE

The smiles of professionals play a significant role in laypeople's decision to choose them as their orthodontist, and strategic utilization of social media can effectively deliver health information to a larger audience in a faster and more direct manner.

Upper lip characteristics and associated excessive gingival display etiologies in adults: Race and sex differences

BACKGROUND

This cross-sectional study aimed to examine upper lip (UL) and smile characteristics and soft tissue excessive gingival display (EGD) etiologies (hypermobile upper lip [HUL], altered passive eruption [APE], and short upper lip [SUL]) in a nondental adult population and to analyze interracial (Black and White) and intersex differences.

METHODS

Community participants, non-Hispanic Blacks (NHB) and non-Hispanic Whites (NHW), were recruited and examined for UL vertical dimensions at rest and maximum smile and for HUL, APE, and SUL. Associations between gingival display (GD) or EGD and UL anatomical characteristics, HUL, APE, and SUL were analyzed.

RESULTS

Participants included 66 NHB and 65 NHW adults. Ergotrid height (greater among NHW; p = 0.019) averaged 14.0 mm. Upper lip vermilion length (ULVL), total UL length, internal lip length, total UL length during smile, and UL mobility averaged 8.6, 22.5, 23.1, 16.6, and 5.9 mm, respectively (all significantly greater in NHB; p ≤ 0.012). SUL prevalence was 4.6%, found only among NHW. Lip length change from rest to smile (LLC) averaged 26.2% (significantly greater in females; p = 0.003). HUL prevalence was 10.7% (NHB 13.1%, NHW 3.5%; p = 0.024). NHB had significantly greater GD (p ≤ 0.017). EGD and APE prevalence (6.9% for both) showed significant interracial and intersex differences (p ≤ 0.014). Multivariate logistic regression analyses indicated that LLC and HUL were the most consistently significant EGD determinants.

CONCLUSIONS

UL anatomical and functional characteristics and soft tissue-related EGD etiologies exhibit significant interracial and intersex differences, with UL mobility/hypermobility being the most consistently significant determinant of GD.

Does supercharging with cross-face nerve graft enhance smile in non-flaccid facial paralysis patients undergoing selective neurectomy?

BACKGROUND

Cross face nerve grafting (CFNG) is a well-established nerve transfer technique in facial reanimation; however, no study has assessed outcome of supercharging the smile with CFNG in patients with synkinesis. The goal of this study was to examine the smile outcome in non-flaccid facial paralysis (NFFP) patients after supercharging with CFNG during selective neurectomy.

METHODS

NFFP patients who underwent CFNG with end-to-side coaptation to a smile branch on the paralyzed side during selective neurectomy were retrospectively identified and their charts were reviewed. Pre-operative and post-operative facial function was assessed with the electronic clinician-graded facial function tool (eFACE), and an automated computer-aided facial assessment tool (Emotrics). Smile metrics were compared pre-operatively, in early post-operative time (EPO, <6 months), and late post-operative time (LPO, >9 months) when CFNG contribution would be expected.

RESULTS

Thirteen cases were performed between June 2019 and December 2021. No objective smile metrics improved following supercharging with CFNG. Oral commissure excursion improved by 1.23 points in eFACE (p = .812), and by 0.84 in Emotrtics (p = .187) from EPO to LPO. EFACE dynamic score was improved by 0.08 points from EPO to LPO (p = .969).

CONCLUSIONS

Using CFNG for supercharging the smile during selective neurectomy in NFFP patients may not enhance smile. Longer term results following supercharging and long term natural history of selective neurectomy should be assessed.

Understanding the Relationship Between Facial Nerve Branch Sacrifice and Selective Neurectomy Outcome

Introduction: While there is great interest in selective neurectomy (SN) for patients with synkinesis, outcomes can be inconsistent. Objective: To examine the relationships between intraoperative facial nerve branch transection and both postoperative outcome and functional deficits. Methods: SN cases, with minimal follow-up of 4 months, were retrospectively identified between 2019 and 2021; outcome was assessed using FaCE instrument, eFACE and Emotrics. Correlations between intraoperative facial nerve branch preservation or transection, and functional outcome and new functional deficits were examined. Results: Fifty-six cases were performed: 88% were females, and median age was 53 years (range 11-81). Mean follow-up was 19.5 months (range 4-42). Oral commissure excursion improved in patients where all smile branches were preserved, no vertical vector smile branches were transected, and more than three smile antagonist branches were transected. A linear trend between smile antagonist branch sacrifice and favorable smile outcome was found. Lower lip movement was improved in patients in whom more than half of the identified lower lip branches were transected. Thirty percent of patients experienced untoward postoperative functional deficits, from which 47% recovered with interventions. Conclusions: Several correlations between SN intra-operative decisions and outcome were identified; new or worsening functional deficit rate can be high. However, chemodenervation or fillers can help diminish these deficits.

Comparison of pleasant and unpleasant smile characteristics in the perception of the laypeople in an Iranian population

INTRODUCTION

This study aimed to compare the characteristics of pleasant and unpleasant smiles from the perception of laypeople.

METHODS

Two-hundred posed smile photographs were obtained from adult participants with no anomaly, restoration, or severe crowding and spacing in anterior teeth. Photographs were shown to 26 judges to give each photograph a score for attractiveness. Upper and lower quartiles for the most and least rated smiles were determined, and variables including gingival display, smile arc, midline deviation, buccal corridor, smile width, tooth rotation or malposition, diastema, upper and lower vermilion show, and tooth form were measured. Independent-sample t test and Pearson chi-square analysis were used to determine the differences between the pleasant and unpleasant groups for quantitative and qualitative variables, respectively. The linear regression model revealed variables with the most significant impact on the mean score.

RESULTS

All quantitative and qualitative variables except tooth form significantly differed between pleasant and unpleasant smile groups (P <0.05). The consonant smile arc was associated with an increase of 12.59% in mean scores compared with the inconsonant smile arc. Each tooth reported with malposition was correlated with a decrease of 9.37% in the scores. In the same way, each 1-mm increase in midline diastema and occlusal cant coincided with a drop of 8.73% and 3.59% in scores, respectively.

CONCLUSIONS

The results of this study suggested that smile arc, tooth malposition, midline diastema, and occlusal plane canting had the most impact on smile esthetics and should be given priority by orthodontists in the treatment plan of choice.

The effect of instructions and response format on smile judgement

Our study examined the role of instructions, response type, and definition on the judgement of enjoyment and nonenjoyment smiles. Participants viewed symmetric Duchenne, non-Duchenne, and asymmetric smiles. They were instructed to judge the happiness, authenticity, and sincerity of the smiles using either Likert scales or a dichotomous response type. Participants were also either given a definition of the instruction words "happy," "authentic," and "sincere" or not. Results showed that the probability of saying "really (happy/sincere/authentic)" was higher for the symmetric Duchenne than the asymmetric smiles and higher for the asymmetric than non-Duchenne smiles. Changing the instructions given to participants did not override the effect of smile type with the use of Likert scale or dichotomous response. However, with the use of Likert scale, we observed subtilities that were not observed with the use of dichotomous response. When given a definition, in the case of symmetric non-Duchenne smiles, Likert ratings were significantly lower, and participants were more accurate in their judgement on the dichotomous scale. However, no differences were observed for the asymmetric Duchenne and symmetric Duchenne smiles whether a definition was given or not. Symmetric non-Duchenne and asymmetric Duchenne smiles were also viewed longer when a definition was given than when one was not. Nevertheless, considering methodological variations of our study failed to explain the variations in the pattern of results of previous studies, other avenues should be explored, such as the use of dynamic stimuli and a greater variety of encoders. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Social Cognitive Correlates of Contagious Yawning and Smiling

It has been theorized that the contagion of behaviors may be related to social cognitive abilities, but empirical findings are inconsistent. We recorded young adults' behavioral expression of contagious yawning and contagious smiling to video stimuli and employed a multi-method assessment of sociocognitive abilities including self-reported internal experience of emotional contagion, self-reported trait empathy, accuracy on a theory of mind task, and observed helping behavior. Results revealed that contagious yawners reported increases in tiredness from pre- to post-video stimuli exposure, providing support for the internal experience of emotional contagion, and were more likely to provide help to the experimenter relative to non-contagious yawners. Contagious smilers showed stably high levels of self-reported happiness from pre- to post-video exposure, were more likely to provide help to the experimenter, and had increased accuracy on a theory of mind task relative to non-contagious smilers. There were no differences in self-reported trait empathy for contagious versus non-contagious yawners or smilers. Contagious yawning may be related to some basic (i.e., emotional contagion) and advanced (i.e., helping behavior) sociocognitive processes, whereas contagious smiling is related to some advanced sociocognitive processes (i.e., theory of mind and helping behavior).

Analysis of smiling photograph; Operation US-Bangla Air Crash

Human identification may be difficult when there is no antemortem data available. A photograph of the deceased may be valuable in such cases. Digital advancement and inclusion in the lives of ordinary people makes it easier to retrieve clear, high-resolution photos from social media accounts and other places. This paper describes three cases of forensic dental identification from a US-Bangla plane crash in Nepal in which a charred body was positively identified from a smiling photograph provided by the deceased's family. Each case is unique and their identification rests on the availability of pre- and post-mortem information. Thus, the number of concordant points may vary from single to multiple; there is no defined criteria for minimum number of concordance for a positive dental identification.

Chocolate unicorns and smiling teddy biscuits: analysis of the use of child-directed marketing on the packages of Australian foods

OBJECTIVE

The use of food packaging as a vehicle for marketing to children is under investigated. Our objective was to determine the prevalence and types of child-directed promotional techniques used on food packaging in Australia.

DESIGN

Based on existing literature and regulations, we developed a framework to classify on-pack child-directed promotional techniques involving the use of characters and other elements that appeal to children. We analysed the packaging of all products in eight food categories available for sale from supermarkets in 2019 and recorded the use of child-directed promotions on pack. We assessed the number and proportion of products displaying child-directed promotional techniques overall and assessed the healthiness of products using child-directed promotions against four indicators of healthiness to provide summary data overall and for the manufacturers who most frequently employed child-targeted strategies.

SETTING

Data were collected from the FoodSwitch database in Sydney, Australia.

RESULTS

901/8006 (11·3 %) products displayed one or more child-directed on-pack element. Most frequent was on foods for infants and young children (n 315), confectionery (n 283), snack foods (n 172) and dairy (n 168). Personified characters were the most commonly used element (n 512). Products using child-directed promotional techniques scored poorly on all four indicators of healthiness: mean health star rating 2·34 (out of 5); 81 % ultra-processed and 6·1 % and 4·5 % products eligible to market to children under Western Pacific and Mexican nutrient profiling schemes, respectively.

CONCLUSIONS

Australian children are targeted by promotional techniques on the packaging of unhealthy food products. Stronger regulation of these techniques is warranted to protect children's health.

Reliability of the novel cleft lip and palate smile esthetic index (CLP-SEI)

BACKGROUND/OBJECTIVES

The aim of this research was to determine the reliability of a novel index for the assessment of smile esthetics in patients with cleft lip and/or palate (CL ± P) at the end of their multidisciplinary treatment, for use in clinical and academic settings.

MATERIALS AND METHODS

Five orthodontists, five periodontologists, five general practitioners, five dental students, and five laypeople rated the smiles of 10 patients with CL ± P twice at a 2 weeks interval. The rating scale consisted of four main categories: 1. nasolabial esthetics, 2. gingival esthetics, 3. dental esthetics, and 4. overall esthetics. A total of 15 parameters were rated. Intra- and inter-rater agreements were calculated using SPSS.

RESULTS

The inter-rater agreement varied between good and excellent whereby the orthodontists, periodontists, general practitioners, dental students, and laypeople obtained agreement scores of 0.86, 0.92, 0.84, 0.90, and 0.89, respectively. The intra-rater agreement was good with agreement scores of 0.78, 0.84, 0.84, 0.80, and 0.79, respectively.

LIMITATIONS

Smile esthetics were rated on static pictures, not in real life or by video recordings in a young adult population.

CONCLUSIONS/IMPLICATIONS

The cleft lip and palate smile esthetic index is a reliable tool for the assessment of smile esthetics in patients with CL ± P.

Orofacial Uses of Botox in Dentistry and their Associated Risks: A Population-Based Cross-Sectional Study in Saudi Arabia

BACKGROUND

Various healthcare professionals, including dentists, provide botulinum toxin (Botox) for cosmetic and therapeutic treatment. In dentistry, it has multiple uses, such as gummy smile, bruxism, sialorrhea, muscle spasm, and orofacial pain, yet unwanted side effects may arise.

AIMS

This study aimed to investigate the participants' perspective regarding the scope of Botox in dentistry and its associated risk, provider involvement, and factors affecting the choice of which healthcare professions administer Botox injections in Saudi Arabia.

METHODS AND MATERIALS

A cross-sectional study using an online self-administered survey distributed through social media accounts among adults living in the Makkah region of Saudi Arabia. Four hundred male and female adults were invited to participate. Descriptive statistics and the Chi-square test were used in the study.

RESULTS

A total of 256 responses were collected from 204 females and 51 males with a mean age of 33.86 (SD = 10.5) years. Collected data demonstrated knowledge of various Botox indications, which include wrinkle reduction (216 (84.4%)), treatment of muscle spasms (186 (72.7%)), and management of gummy smile (178 (69.5%)). Regarding the side effects, participants chose infections (182 (71.1%)), bruising (180 (70.3%)), and drooping in the eye (176 (68.7%)). Participants selected family and friends as the primary source of their information on Botox treatment. The majority preferred a plastic surgeon, followed by an oral maxillofacial surgeon, to provide the Botox treatment.

CONCLUSIONS

The usage of Botox therapy in the field of dentistry has increased significantly. Participants had an acceptable level of knowledge regarding the use of Botox in esthetic practices but lacked knowledge of the therapeutic scope of Botox therapy. The majority of participants had no doubt about the medical professionals administering Botox. It is advised to educate the public about the extent of Botox treatment and offer a trustworthy source of information required.

Three-dimensional evaluation of social smile asymmetry in patients with unilateral impacted maxillary canine: a 3D stereophotogrammetry study

OBJECTIVE

This study aimed to evaluate social smile asymmetry in patients with unilateral impacted maxillary canine on 3D stereophotogrammetric images.

MATERIAL AND METHODS

The 3D social smile images of participants with unilateral impacted maxillary canine (n:20) and without impaction as a control group (n:20) were included. The images were recorded with a hand-held 3D stereophotogrammetry device (Fuel3D® Scanify®) and Geomagic Essentials 2 reverse engineering software were used for analyses. After the orientation process of the 3D records, the tissues around the smile area were divided into five morphological regions: cheek, upper lip lateral and medial, and lower lip lateral and medial. The deviation margins in the negative and positive directions for the 95% mesh rate and the total percentages of meshes between - 0.5- and + 0.5-mm deviations were calculated. ICC, paired samples t test, independent samples t test, and the Mann-Whitney U test were used for statistical analyses.

RESULTS

In individuals with impacted canine, the amount of maximum positive deviation in the upper lip medial was 5.64 mm ± 1.46 and maximum negative deviation was - 4.6 mm ± 1.17. In the control group, mean of deviation limits for all parameters was less than 1.19 mm ± 2.62, while in individuals with unilateral impacted maxillary canine, the maximum value was 8.34 mm ± 2.23. The mesh percentage between - 0.5 and 0.5-mm deviations was over 95% in all morphological areas in the control group, while in the impacted canine group, the number of meshes within the specified deviation limits was less than 95%.

CONCLUSION

Individuals with unilateral impacted maxillary canine exhibit greater asymmetry in social smile compared to the control group, with the asymmetry being most prominent near the corners of the mouth and cheeks.

CLINICAL RELEVANCE

Amount of asymmetry was higher in impaction group compared to the control group in social smile. The quantification of a possible smile asymmetry due to the impacted canine is crucial for the diagnosis and treatment planning of orthodontic and/or orthognathic cases for ideal aesthetic results. Hence, smile asymmetry should not be overlooked and should be considered in diagnosis and treatment planning.

Digital Smile Design: Utilizing Novel Technologies for Ultimate Esthetics

Digital smile design allows dental providers to digitally strategize treatments prior to performing irreversible procedures. Through the integration of various digital records, a comprehensive digital replica of the patient can be produced in which crucial facets of the patient's oral health and smile are captured. This article discusses the benefits of digital smile design and identifies key smile design and facial harmony principles when designing a patient's smile. Such principles as central incisor ratio, recurring esthetic dental (RED) proportions, facial flow, axial angulations, and more are discussed.

The reciprocal relationship between smiles and situational contexts

ABSTRACTSmiles provide information about a social partner's affect and intentions during social interaction. Although always encountered within a specific situation, the influence of contextual information on smile evaluation has not been widely investigated. Moreover, little is known about the reciprocal effect of smiles on evaluations of their accompanying situations. In this research, we assessed how different smile types and situational contexts affected participants' social evaluations. In Study 1, 85 participants rated reward, affiliation, and dominance smiles embedded within either enjoyable, polite, or negative (unpleasant) situations. Context had a strong effect on smile ratings, such that smiles in enjoyable situations were rated as more genuine and joyful, as well as indicating less superiority than those in negative situations. In Study 2, 200 participants evaluated the situations that these smiles were perceived within (rather than the smiles themselves). Although situations paired with reward (vs. affiliation) smiles tended to be rated more positively, this effect was absent for negative situations. Ultimately, the findings point toward a reciprocal relationship between smiles and contexts, whereby the face influences evaluations of the situation and vice versa.

Influence of social media and corrected smile photographs in patients with malocclusion

INTRODUCTION

The increased use of social networking sites, such as Instagram (Meta Platforms, Menlo Park, Calif), has been silently affecting facial satisfaction among patients. However, the potential of Instagram to motivate participants for orthodontic treatment when used with an adjunct, a photograph editing software, is yet to be assessed.

METHODS

From the initial 300 participants, 256 were included and randomly divided into an experimental group (participants were asked to provide their frontal smiling photograph) and a control group. The photographs received were corrected using photograph editing software and were shown along with other ideal smile photographs in an Instagram account to the experimental group, whereas the control group participants had access to only the ideal smile photographs. After browsing, the participants were given a modified version of the Malocclusion-Related Quality of Life Questionnaire.

RESULTS

Questions assessing the general perception about one's smile, comparison with peers, desire to undergo orthodontic treatment, and the role of socioeconomic status showed a statistically significant difference (P <0.05) as most of the control group participants were unsatisfied with their teeth, had less desire to undergo orthodontic treatment and did not feel family's financial income to be a hurdle, contrary to the experimental group participants. A statistically significant difference (P <0.05) was also seen in assessing external acceptance, speech difficulties, and the influence of Instagram on orthodontic treatment, whereas the influence of photograph editing software did not show the same.

CONCLUSIONS

The study concluded that the experimental group participants were motivated to undergo orthodontic treatment after viewing their corrected photograph.

Effect of smile on facial attractiveness before and after orthodontic treatment in females with more attractive and less attractive facial background

INTRODUCTION

One of the goals of orthodontic treatment is to improve facial esthetics. This study aimed to determine the effect of smile on facial attractiveness before and after orthodontic treatment in females with "more attractive" and "less attractive" facial backgrounds. In addition, changes in facial attractiveness after orthodontic treatment were examined.

METHODS

Frontal rest and smile photographs of 60 female patients (mean age, 26.32 years) before and after orthodontic treatment were included in 4 separate online questionnaires. The link for each questionnaire was sent to 40 layperson raters (20 females, 20 males). They were asked to give a score from 0 to 100 on the basis of the visual analog scale for the attractiveness of each image. Then the data were collected and analyzed.

RESULTS

The mean score of the pretreatment smile was significantly smaller than the frontal rest view, and the difference was significantly greater in the "more attractive" group (P = 0.012). After treatment, the smiling view was significantly more attractive than the frontal rest view, and the difference was significantly greater in the "less attractive" group (P = 0.014). In addition, the attractiveness of both smiling and rest views increased significantly after orthodontic treatment, and these changes were significantly greater in the "more attractive" group (P <0.001 and P = 0.011).

CONCLUSIONS

An unesthetic pretreatment smile negatively impacted facial attractiveness, and orthodontic treatment significantly improved facial attractiveness. These negative and positive effects were greater in more attractive facial backgrounds.

Infants' responses to masked and unmasked smiling faces: A longitudinal investigation of social interaction during Covid-19

During the COVID-19 pandemic, face masks became an effective hygienic measure to reduce infection rates. Given the relevance of facial expressions for social interactions, the question arises how face masks affect early social interactions. The current longitudinal study investigated how covering parts of the face might impact infants' responses to others' emotional expressions. Infants who were born during the pandemic were examined at three measurement points at the age of 6, 10 and 14 months. After displaying a neutral facial expression an experimenter smiled at infants while either wearing a mask (mask condition) or not wearing a mask (no mask condition). Infants' change in affect (i.e., negative, neutral, positive) from the neutral to the test phase (i.e., smiling experimenter) was evaluated. Results showed that at 6 and at 10 months infants' behavior did not differ between conditions, whereas at 14 months infants were more likely to show a change from neutral/negative affect to positive affect in the no mask condition than in the mask condition. Moreover, at 14 months infants were less likely to respond positively to the experimenter's smile (across conditions) than at 6 and at 10 months. These findings broaden our understanding of potential effects of mask wearing on the development of face processing and affective communication. Overall, they indicate a developmental trend according to which infants' processing and response to others' positive emotions becomes more selective and differentiated with increasing age.