Aesthetic assessment of maxillary lateral and canine implant-supported crowns by laypersons and orthodontists

Authors

  • Nina Sabel Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
  • Erika Toft Public Dental Service, Region Västra Götaland, Göteborg, Sweden
  • Erica Johansson Public Dental Service, Region Västra Götaland, Göteborg, Sweden
  • Julia Naoumova Specialist Clinic for Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Göteborg, Sweden; Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

DOI:

https://doi.org/10.2340/aos.v83.40738

Keywords:

Aesthetics, prom, dental appearance, laypeople, orthodontics, implant

Abstract

Introduction: The objectives of this study were to evaluate how laypersons and orthodontists evaluate and rank aesthetic parameters of an implant-supported crown (ISC) on the canine position (ISC-C) and lateral position (ISC-L).

Methods: A digital survey of 11 cases, 5 ISC-C, 5 ISC-L and 1 control case without ISC, was distributed to 207 laypersons and 296 orthodontists. All cases included one extraoral photograph and three intraoral photographs. The respondents were asked to identify the ISC and to evaluate the aesthetic parameters regarding colour of the implant (CI), shape of the implant (SI) and gingival colour around ISC (GCI). Differences within and between the groups were tested using Chi-2-test and Independent-Samples t-test.

Results: All invited laypersons and 184 orthodontists (62% response rate) answered the survey. Orthodontists (89%) more correctly identified the ISC, regardless of its position, than laypersons (50%) (p < 0.001). Both laypersons (54%) and orthodontists (23%) rated higher proportions of acceptance of CI, SI and GCI in favour for the ISC-L than ISC-C (laypersons: 40%, orthodontists: 10%) (p < 0.001). Assessing each parameter separately, orthodontists rated higher for ISC-L, compared to the ISC-C (p < 0.001). In general, laypersons and orthodontist ranked tooth colour (mean, standard deviation [SD]:8.0,1.5 and 9.0, 1.0) and tooth shape (mean, SD: 8.0, 1.7 and 8.8, 1.2) as aesthetically higher than the gingival colour (mean, SD: 7.2, 2.2 and 8.0, 1.7) (p > 0.001). 

Conclusion: Laypersons and orthodontists consider the ISC-L as aesthetically more preferable, compared to the ISC-C. 

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References

Polder BJ, Van’t Hof MA, Van Der Linden FPGM, et al. A meta‐analysis of the prevalence of dental agenesis of permanent teeth. Community Dent Oral Epidemiol. 2004;32(3):217–226. https://doi.org/10.1111/j.1600-0528.2004.00158.x DOI: https://doi.org/10.1111/j.1600-0528.2004.00158.x

Bergendal B. When should we extract deciduous teeth and place implants in young individuals with tooth agenesis?(Author abstract)(Report). J Oral Rehabil. 2008;35(s1):55. https://doi.org/10.1111/j.1365-2842.2007.01829.x DOI: https://doi.org/10.1111/j.1365-2842.2007.01829.x

Becker A, Chaushu S. Etiology of maxillary canine impaction: a review. Am J Orthod Dentofacial Orthop. 2015;148(4):557–567. https://doi.org/10.1016/j.ajodo.2015.06.013 DOI: https://doi.org/10.1016/j.ajodo.2015.06.013

Cooke J, Wang HL. Canine impactions: incidence and management. Int J Periodontics Restorative Dent. 2006;26(5):483–491.

Borssén E, Holm AK. Traumatic dental injuries in a cohort of 16-year-olds in northern Sweden. Endod Dent Traumatol. 1997;13(6):276–280. https://doi.org/10.1111/j.1600-9657.1997.tb00055.x DOI: https://doi.org/10.1111/j.1600-9657.1997.tb00055.x

Kokich VO, Jr., Kinzer GA. Managing congenitally missing lateral incisors. Part I: Canine substitution. J Esthet Restor Dent. 2005;17(1):5–10. https://doi.org/10.1111/j.1708-8240.2005.tb00076.x DOI: https://doi.org/10.1111/j.1708-8240.2005.tb00076.x

Josefsson E, Lindsten R. Treatment of missing maxillary lateral incisors: a clinical and aesthetic evaluation. Eur J Orthod. 2019;41(3):273–278. https://doi.org/10.1093/ejo/cjy061 DOI: https://doi.org/10.1093/ejo/cjy061

Kiliaridis S, Sidira M, Kirmanidou Y, et al. Treatment options for congenitally missing lateral incisors. Eur J Oral Implantol. 2016;9(Suppl 1):S5–24.

Thiruvenkatachari B, Javidi H, Griffiths SE, et al. Extraction of maxillary canines: esthetic perceptions of patient smiles among dental professionals and laypeople. Am J Orthod Dentofacial Orthop. 2017;152(4):509–515. https://doi.org/10.1016/j.ajodo.2017.02.015 DOI: https://doi.org/10.1016/j.ajodo.2017.02.015

Beamish AJ, Foster JJ, Edwards H, et al. What’s in a smile? A review of the benefits of the clinician’s smile. Postgrad Med J. 2019;95(1120):91–95. https://doi.org/10.1136/postgradmedj-2018-136286 DOI: https://doi.org/10.1136/postgradmedj-2018-136286

Reis HT, Wilson IM, Monestere C, et al. What is smiling is beautiful and good. Eur J Soc Psychol. 1990;20(3):259–267. https://doi.org/10.1002/ejsp.2420200307 DOI: https://doi.org/10.1002/ejsp.2420200307

Godinho J, Gonçalves RP, Jardim L. Contribution of facial components to the attractiveness of the smiling face in male and female patients: a cross-sectional correlation study. Am J Orthod Dentofac Orthop. 2020;157(1):98–104. https://doi.org/10.1016/j.ajodo.2019.01.022 DOI: https://doi.org/10.1016/j.ajodo.2019.01.022

Tjan AHL, Miller GD, The JGP. Some esthetic factors in a smile. J Prosthetic Dent. 1984;51(1):24–28. https://doi.org/10.1016/S0022-3913(84)80097-9 DOI: https://doi.org/10.1016/S0022-3913(84)80097-9

Van der Geld P, Oosterveld P, Van Heck G, et al. Smile attractiveness. Self-perception and influence on personality. Angle Orthod. 2007;77(5):759–765. https://doi.org/10.2319/082606-349 DOI: https://doi.org/10.2319/082606-349

Singh VP, Uppoor AS, Nayak DG, et al. Black triangle dilemma and its management in esthetic dentistry. Dent Res J. 2013;10(3):296.

Alkhatib MN, Holt R, Bedi R. Age and perception of dental appearance and tooth colour. Gerodontology. 2005;22(1):32–36. https://doi.org/10.1111/j.1741-2358.2004.00045.x DOI: https://doi.org/10.1111/j.1741-2358.2004.00045.x

Abu Alhaija ESJ, Al-Nimri KS, Al-Khateeb SN. Self-perception of malocclusion among North Jordanian school children. Eur J Orthodon. 2005;27(3):292–295. https://doi.org/10.1093/ejo/cjh094 DOI: https://doi.org/10.1093/ejo/cjh094

Shaw WC. Factors influencing the desire for orthodontic treatment. Eur J Orthod. 1981;3(3):151–162. https://doi.org/10.1093/ejo/3.3.151 DOI: https://doi.org/10.1093/ejo/3.3.151

Sheats RD, McGorray SP, Keeling SD, et al. Occlusal traits and perception of orthodontic need in eighth grade students. Angle Orthodontist. 1998;68(2):107.

Dong JK, Jin TH, Cho HW, et al. The esthetics of the smile: a review of some recent studies. Int J Prosthodont. 1999;12(1):9–19.

Pollini A, Morton D, Arunyanak SP, et al. Evaluation of esthetic parameters related to a single implant restoration by laypeople and dentists. J Prosthet Dent. 2020;124(1):94–99. https://doi.org/10.1016/j.prosdent.2019.08.017 DOI: https://doi.org/10.1016/j.prosdent.2019.08.017

Chang M, Odman PA, Wennström JL, et al. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodon. 1999;12(4):335.

Meijndert L, Meijer HJ, Stellingsma K, et al. Evaluation of aesthetics of implant-supported single-tooth replacements using different bone augmentation procedures: a prospective randomized clinical study. Clin Oral Implants Res. 2007;18(6):715–719. https://doi.org/10.1111/j.1600-0501.2007.01415.x DOI: https://doi.org/10.1111/j.1600-0501.2007.01415.x

Pinho S, Ciriaco C, Faber J, et al. Impact of dental asymmetries on the perception of smile esthetics. Am J Orthod Dentofacial Orthop. 2007;132(6):748–753. https://doi.org/10.1016/j.ajodo.2006.01.039 DOI: https://doi.org/10.1016/j.ajodo.2006.01.039

Machado AW, Moon W, Gandini LG, Jr. Influence of maxillary incisor edge asymmetries on the perception of smile esthetics among orthodontists and laypersons. Am J Orthod Dentofacial Orthop. 2013;143(5):658–664. https://doi.org/10.1016/j.ajodo.2013.02.013 DOI: https://doi.org/10.1016/j.ajodo.2013.02.013

Al Taki A, Khalesi M, Shagmani M, et al. Perceptions of altered smile esthetics: a comparative evaluation in orthodontists, dentists, and laypersons. Int J Dent. 2016;2016:7815274. https://doi.org/10.1155/2016/7815274 DOI: https://doi.org/10.1155/2016/7815274

Miller CJ. The smile line as a guide to anterior esthetics. Dent Clin N Am. 1989;33(2):157–164. https://doi.org/10.1016/S0011-8532(22)01184-3 DOI: https://doi.org/10.1016/S0011-8532(22)01184-3

Kokich VO, Kokich VG, Kiyak HA. Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations. Am J Orthod Dentofacial Orthop. 2006;130(2):141–151. https://doi.org/10.1016/j.ajodo.2006.04.017 DOI: https://doi.org/10.1016/j.ajodo.2006.04.017

Kokich V, Kiyak H, Shapiro P. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthetic Dent. 1999;11(6):311–324. https://doi.org/10.1111/j.1708-8240.1999.tb00414.x DOI: https://doi.org/10.1111/j.1708-8240.1999.tb00414.x

Johnston CD, Burden DJ, Stevenson MR. The influence of dental to facial midline discrepancies on dental attractiveness ratings. Eur J Orthod. 1999;21(5):517–522. https://doi.org/10.1093/ejo/21.5.517 DOI: https://doi.org/10.1093/ejo/21.5.517

Parekh SM, Fields HW, Beck M, et al. Attractiveness of variations in the smile arc and buccal corridor space as judged by orthodontists and laymen. Angle Orthodontist. 2006;76(4):557–563.

Parrini S, Rossini G, Castroflorio T, et al. Laypeople’s perceptions of frontal smile esthetics: a systematic review. Am J Orthod Dentofacial Orthop. 2016;150(5):740–750. https://doi.org/10.1016/j.ajodo.2016.06.022 DOI: https://doi.org/10.1016/j.ajodo.2016.06.022

Furhauser R, Florescu D, Benesch T, et al. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–644. https://doi.org/10.1111/j.1600-0501.2005.01193.x DOI: https://doi.org/10.1111/j.1600-0501.2005.01193.x

Belser UC, Grutter L, Vailati F, et al. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J Periodontol. 2009;80(1):140–151. https://doi.org/10.1902/jop.2009.080435 DOI: https://doi.org/10.1902/jop.2009.080435

Schneider U, Moser L, Fornasetti M, et al. Esthetic evaluation of implants vs canine substitution in patients with congenitally missing maxillary lateral incisors: are there any new insights? Am J Orthod Dentofacial Orthop. 2016;150(3):416–424. https://doi.org/10.1016/j.ajodo.2016.02.025 DOI: https://doi.org/10.1016/j.ajodo.2016.02.025

Hedmo C, Lindsten R, Josefsson E. Laypeople and dental professionals’ perception of the aesthetic outcome of two treatments for missing lateral incisors. Clin Exp Dent Res. 2022;8(1):262–269. https://doi.org/10.1002/cre2.504 DOI: https://doi.org/10.1002/cre2.504

Kinzer GA, Kokich VO. Managing congenitally missing lateral incisors. Part III: single‐tooth implants. J Esthetic Restorat Dent. 2005;17(4):202–210. https://doi.org/10.1111/j.1708-8240.2005.tb00116.x DOI: https://doi.org/10.1111/j.1708-8240.2005.tb00116.x

Robertsson S, Mohlin B, Thilander B. Aesthetic evaluation in subjects treated due to congenitally missing maxillary laterals. A comparison of perception in patients, parents and dentists. Swed Dent J. 2010;34(4):177–186.

Dueled E, Gotfredsen K, Trab Damsgaard M, et al. Professional and patient-based evaluation of oral rehabilitation in patients with tooth agenesis. Clin Oral Implants Res. 2009;20(7):729–736. https://doi.org/10.1111/j.1600-0501.2008.01698.x DOI: https://doi.org/10.1111/j.1600-0501.2008.01698.x

Senty EL. The maxillary cuspid and missing lateral incisors: esthetics and occlusion. Angle Orthodontist. 1976;46(4):365–371.

Christell H, Birch S, Bondemark L, et al. The impact of Cone Beam CT on financial costs and orthodontists’ treatment decisions in the management of maxillary canines with eruption disturbance. Eur J Orthod. 2018;40(1):65–73. https://doi.org/10.1093/ejo/cjx039 DOI: https://doi.org/10.1093/ejo/cjx039

Dourado GB, Volpato GH, de Almeida-Pedrin RR, et al. Likert scale vs visual analog scale for assessing facial pleasantness. Am J Orthod Dentofacial Orthop. 2021;60:844-852. https://doi.org/10.1016/j.ajodo.2020.05.024 DOI: https://doi.org/10.1016/j.ajodo.2020.05.024

Oliveira PL, Motta AF, Guerra CJ, et al. Comparison of two scales for evaluation of smile and dental attractiveness. Dent Press J Orthod. 2015;20(2):42–48. https://doi.org/10.1590/2176-9451.20.2.042-048.oar DOI: https://doi.org/10.1590/2176-9451.20.2.042-048.oar

Cracel-Nogueira F, Pinho T. Assessment of the perception of smile esthetics by laypersons, dental students and dental practitioners. Int Orthod. 2013;11(4):432–444. https://doi.org/10.1016/j.ortho.2013.09.007 DOI: https://doi.org/10.1016/j.ortho.2013.09.007

Pinho T, Bellot-Arcís C, Montiel-Company JM, et al. Esthetic assessment of the effect of fingival exposure in the smile of patients with unilateral and bilateral maxillary incisor agenesis. J Prosthodont. 2015;24(5):366–372. https://doi.org/10.1111/jopr.12216 DOI: https://doi.org/10.1111/jopr.12216

De-Marchi LM, Pini NI, Ramos AL, et al. Smile attractiveness of patients treated for congenitally missing maxillary lateral incisors as rated by dentists, laypersons, and the patients themselves. J Prosthet Dent. 2014;112(3):540–546. https://doi.org/10.1016/j.prosdent.2014.01.019 DOI: https://doi.org/10.1016/j.prosdent.2014.01.019

Parkin NA, Freeman JV, Deery C, et al. Esthetic judgments of palatally displaced canines 3 months postdebond after surgical exposure with either a closed or an open technique. Am J Orthod Dentofacial Orthop. 2015;147(2):173–181. https://doi.org/10.1016/j.ajodo.2014.10.026 DOI: https://doi.org/10.1016/j.ajodo.2014.10.026

Armbruster PC, Gardiner DM, Whitley JB, Jr., et al. The congenitally missing maxillary lateral incisor. Part 1: esthetic judgment of treatment options. World J Orthod. 2005;6(4):369–375.

Witt M, Flores-Mir C. Laypeople’s preferences regarding frontal dentofacial esthetics: tooth-related factors. J Am Dent Assoc. 2011;142(6):635–645. https://doi.org/10.14219/jada.archive.2011.0245 DOI: https://doi.org/10.14219/jada.archive.2011.0245

Brough E, Donaldson AN, Naini FB. Canine substitution for missing maxillary lateral incisors: the influence of canine morphology, size, and shade on perceptions of smile attractiveness. Am J Orthod Dentofacial Orthoped. 2010;138(6):705.e1–705.e9. https://doi.org/10.1016/j.ajodo.2010.04.027 DOI: https://doi.org/10.1016/j.ajodo.2010.04.027

Qualtrough AJ, Burke FJ. A look at dental esthetics. Quintessence Int. 1994;25(1):7–14.

Josefsson E, Bjerklin K, Lindsten R. Self-perceived orthodontic treatment need and prevalence of malocclusion in 18- and 19-year-olds in Sweden with different geographic origin. Swed Dent J. 2010;34(2):95–106.

Thilander B. Orthodontic space closure versus implant placement in subjects with missing teeth. J Oral Rehabil. 2008;35(Suppl 1):64–71. https://doi.org/10.1111/j.1365-2842.2007.01826.x DOI: https://doi.org/10.1111/j.1365-2842.2007.01826.x

Mishra SK, Chowdhary N, Chowdhary R. Dental implants in growing children. J Indian Soc Pedod Prev Dent. 2013;31(1):3–9. https://doi.org/10.4103/0970-4388.112392 DOI: https://doi.org/10.4103/0970-4388.112392

Nahhas RW, Valiathan M, Sherwood RJ. Variation in timing, duration, intensity, and direction of adolescent growth in the mandible, maxilla, and cranial base: the Fels longitudinal study. Anat Rec (Hoboken). 2014;297(7):1195–1207. https://doi.org/10.1002/ar.22918 DOI: https://doi.org/10.1002/ar.22918

Mack MR. Perspective of facial esthetics in dental treatment planning. J Prosthetic Dent. 1996;75(2):169–176. https://doi.org/10.1016/S0022-3913(96)90095-5 DOI: https://doi.org/10.1016/S0022-3913(96)90095-5

Lee H, Chalmers N, Brow A, et al. Person-centered care model in dentistry. BMC Oral Health. 2018;18(1):198. https://doi.org/10.1186/s12903-018-0661-9 DOI: https://doi.org/10.1186/s12903-018-0661-9

Kim SH, Hwang S, Hong YJ, et al. Visual attention during the evaluation of facial attractiveness is influenced by facial angles and smile. Angle Orthodontist. 2018;88(3):329–337. https://doi.org/10.2319/080717-528.1 DOI: https://doi.org/10.2319/080717-528.1

Published

2024-06-12