Aesthetic perception of gingival smiles

Abstract Introduction Dentists have shown interest in learning new techniques to create more attractive smiles, but with little concern for understanding the reasons why the patient is dissatisfied. Objective To evaluate the aesthetic perception of laypersons in dentistry in comparison with general practitioner dentists and periodontists regarding the gingival smile, and to compare this aesthetic perception between the male and female genders. Methodology A photograph of a standard smile was taken and was digitally modified to create the periodontal conditions of a gingival smile from 0.5 mm to 2.5 mm. The photographs were judged by 150 individuals (25-65 years of age), 81 female and 69 male, divided into three groups: 50 laypersons, 50 general practitioners and 50 periodontists. The evaluation was performed using a visual analog scale. The statistical evaluation tests used were the Pearson Chi squared test, Student's t-test, ANOVA and Newman-keuls. Result The aesthetic perceptions among the professionals are similar, and they observe more subtle changes in the aesthetics of the smile than the laypersons observe. The general practitioners and periodontists were similarly sensitive to changes generated in the gingival smile when these reached 1.5 mm, while laypersons only perceived them when these changes reached 2.5 mm. There was no significant difference in the aesthetic perception of male and female evaluators in any of the groups. Conclusion The aesthetic perception of the gingival smile between general practitioner dentists and periodontists was similar, and dental professionals were more demanding than the layperson. There was no difference between female and male aesthetic perceptions.摘要：研究背景：牙医群体始终致力于学习新技术以打造更具吸引力的笑容，但却极少关注患者对笑容不满意的根本原因。研究目的：本研究旨在对比牙科普通民众、全科牙医（general practitioner dentists）与牙周科医师（periodontists）对牙龈微笑（gingival smile）的审美感知差异，并分析不同性别评估者之间的审美感知区别。研究方法：拍摄一张标准微笑照片，通过数字化编辑生成牙龈暴露量介于0.5mm至2.5mm的系列牙龈微笑状态照片。共计招募150名年龄在25~65岁之间的受试者，其中女性81名、男性69名，分为三组：普通民众组50名、全科牙医组50名及牙周科医师组50名。评估采用视觉模拟评分法（visual analog scale）开展。统计学检验选用皮尔逊卡方检验（Pearson Chi squared test）、学生t检验（Student's t-test）、方差分析（ANOVA）及纽曼-科尔斯检验（Newman-keuls）。研究结果：专业牙医群体的审美感知水平相近，且相较于普通民众，他们能够识别出更细微的微笑美学变化。当牙龈暴露量变化达1.5mm时，全科牙医与牙周科医师均可感知到该美学变化；而普通民众仅在牙龈暴露量变化达到2.5mm时才能察觉到差异。三组内的男性与女性评估者之间，审美感知均无显著统计学差异。研究结论：全科牙医与牙周科医师对牙龈微笑的审美感知相似，牙科专业人士较普通民众对微笑美学的要求更为严苛。不同性别的评估者之间审美感知无显著差异。