A Photographic Assessment of Smile by Modifying Crown Height, Width and Angulation of Maxillary Lateral Incisor among Orthodontic Patients of Karachi, Pakistan
Authors:   Department of Orthodontics, Jinnah Medical and Dental College, Karachi, Pakistan., Pervez Hana , Sattar Anam ,   Department of Orthodontics, Dow International Dental College, Karachi, Pakistan., Iqbal Marium ,   Department of Operative Dentistry, Jinnah Medical and Dental College, Karachi, Pakistan., Nagani Nasreen Iqbal ,   Clear Path Orthodontics, Lahore, Pakistan., Shabbir Sadia ,   Department of Orthodontics, Jinnah Medical and Dental College, Karachi, Pakistan., Sultan Hareem ,   Department of Orthodontics, Dow International Dental College, Karachi, Pakistan., Zafar Khadija ,   Department of Orthodontics, Jinnah Medical and Dental College, Karachi, Pakistan., Javed Zainab ,   Department of Operative Dentistry, Jinnah Medical and Dental College, Karachi, Pakistan.
Published: January 2024

Abstract: Background: Smile aesthetics vary culturally, influenced by media and the Golden Proportion in dental beauty. Challenges arise with missing lateral incisors, treated through composite build-up or canine substitution, highlighting the importance of crown dimensions and the need for clinician expertise in personalized treatments. Objectives: The objective of the study is to evaluate the influence of altering height, width and angulation of maxillary lateral incisors on the perception of smile. Materials and Methods: This cross-sectional study was conducted at OPD of Jinnah Medical and Dental College, Karachi from January 2020 to June 2020, on 120 orthodontic patients (44 males and 76 females) aged between 15 and 35 years. Photoshopped photographs of an ideal smile were shown to the participants. In an ideal smile photo, the width of lateral incisor was 62% of the width of maxillary central incisors. The pictures showed to the participants had modifications in terms of crown heights, width and angulation of only maxillary lateral incisor without doing any changes to the other maxillary teeth. The responses of the participants were graded on the basis of perception of attractiveness. Result: Mean score for height, width and angulation changes were obtained. The highest score by males was given to lateral incisor whose length was increased by 1mm (6.87±2.21) and in females; the highest score was given to lateral incisor which is modified by adding 0.5 mm increment (6.98±1.05). Both males and females preferred narrow lateral incisors as esthetically attractive. The mean highest scores for the decrease in width given by males were 6.52±2.52 and 6.8±2.217 by females, respectively. Both males (6.37±2.18) and females (6.64±1.81) preferred 10 degrees of mesial angulation of lateral incisor as more esthetically pleasing. Changes in distal angulation of more than 5 degrees are considered unattractive by both genders. Mean values were 6.04±2.15 for males and 6.00±1.99 for females. Conclusion: In conclusion females are more concerned to the change in height, while in terms of width both genders preferred narrower maxillary lateral incisors over wider ones. Both genders perceived a 10 degree mesially angulated lateral incisor as more attractive.