Dentofacial mini- and microesthetics as perceived by dental students: A cross-sectional multi-site study

Effect of weight satisfaction on adolescent facial and dental satisfaction

PURPOSE

To investigate if facial and dental satisfaction is related to body fat percentage and body weight satisfaction.

METHODS

A self-administered questionnaire was applied to adolescents from a Private School in Southern Brazil containing sociodemographic (sex and age) and self-perception variables. Adolescents were asked about their perceptions concerning dental problems. Body fat percentage was collected using bioelectrical impedance analysis.

RESULTS

A total of 372 adolescents were examined. Most adolescents were satisfied with their dental (81.7%) and facial appearance (87.6%), while 39% of adolescents were satisfied with their body weight. Poisson regression model showed that adolescents who expressed satisfaction with their body weight (PR = 1.12, 95%CI 1.06-1.19) and were satisfied with their dental appearance (PR = 1.24, 95% CI 1.08-1.41) exhibited a positive association with facial satisfaction. Adolescents dissatisfied with dental color (PR = 0.88, 95%CI 0.80-0.97), those reporting dental pain (PR = 0.88, 95%CI 0.80-0.97), and individuals with obesity (PR = 0.91, 95%CI 0.83-0.99) demonstrated a decrease in facial satisfaction. Adolescents aged 16 to 19 years (PR = 1.08, 95% CI 1.01-1.15) and those satisfied with their facial appearance (PR = 1.20, 95%CI 1.01-1.43) exhibited a higher prevalence of dental satisfaction. Conversely, adolescents dissatisfied with dental color (PR = 0.74, 95% CI 0.66-0.82) and those with misaligned teeth (PR = 0.63, 95%CI 0.55-0.73) reported lower levels of dental satisfaction. Parametric g-formula analysis found that the association between body fat and facial satisfaction was mediated by body weight satisfaction (p = 0.001).

CONCLUSIONS

While dental satisfaction was not influenced by corporeal characteristics, facial satisfaction was influenced by dental and body weight satisfaction. Obese adolescents had low facial satisfaction.

Microesthetics in orthodontics: A systematic review and meta-analysis

BACKGROUND

Microesthetics in orthodontics, which focuses on subtly and precisely enhancing a patient's smile's esthetics, has seen a rise in popularity in recent years. The objective of this systematic study was to assess our present understanding of orthodontic microesthetics.

METHODS

A thorough search was done using the terms "microesthetics in orthodontics," "aesthetic orthodontics," "orthodontic aesthetics," and "orthodontic smile design" across different databases. Articles published between 2011 and 2022 were considered for selection in this review.

RESULTS

Five studies were selected for the review. The meta-analysis found a statistically significant and clinically relevant improvement in microesthetic parameters due to orthodontic treatment. The odds ratio estimate was 0.32 (95% confidence interval (95% CI): 0.28 to 0.37), suggesting a noticeable effect of orthodontic treatment on microesthetic parameters. The forest plot also showed an overall risk ratio of 0.57 (95% CI: 0.53 to 0.61) and a risk difference of -0.28 (95% CI: -0.31 to -0.24) for noticeable versus negligible effects of orthodontic treatment on microesthetic parameter in patients. The heterogeneity was significant among the studies, with a Chi-square value of 15.34 (P = 0.004) and 14.79 (P = 0.005) for the odds ratio and risk difference, respectively, indicating a moderate level of heterogeneity.

CONCLUSION

The results of this study's review and meta-analysis point to a statistically significant and clinically meaningful difference in the microesthetic parameters between individuals who received orthodontic treatment and those who did not. The heterogeneity statistics, however, indicates significant variation between research studies.

REGISTRATION

This review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42022397219).

Esthetic Perception of Different Clinical Situations of Maxillary Lateral Incisor Agenesis According to Populations with Dental and Non-Dental Backgrounds: A Systematic Review and Meta-Analysis

Treatment of unilateral or bilateral maxillary lateral incisor agenesis is challenging, time-consuming, expensive, and requires careful treatment planning, predictability, and esthetics. This review aimed to identify differences in esthetic perception among orthodontists, general dentists, differentiated dentists, and laypersons, which may interfere with treatment options. EBSCO, PubMed, ScienceDirect, Cochrane Library databases, and Google Scholar were searched using keyword pairing and a Boolean expression, "(congenitally missing OR agenesis OR hypodontia) AND (maxillary lateral incisors) AND (esthetic perception OR smile) AND (laypersons OR dental professional OR general dentist OR orthodontists)." Reviews and case studies were excluded. A total of 13 studies were selected for qualitative analysis (adapted ROBINS-I) and 11 were selected for meta-analysis (p < 0.05) after being sub-grouped into "Opening vs. Closure" and "No remodeling vs. Dental remodeling vs. Dental and gingival remodeling" groups. A meta-analysis evaluated the magnitude of the difference between groups based on differences in means and effect sizes (α = 0.05; 95% CI; Z-value 1.96), revealing that the esthetic perception of maxillary lateral incisor agenesis treatment remains controversial even among professionals. Gingival remodeling was not valued compared to isolated dental remodeling. Studies lack rigorously comparable methodologies. Discussion with the patient is pertinent in doubtful situations, as the best treatment option remains unclear, and overtreatment should be avoided.

Patterns of Facial Profile Preference in a Large Sample of Dental Students: A Cross-Sectional Study

The objective of this study was to explore dental students’ facial profile preferences in a large sample of students. Nine hundred and nineteen dental students of four dental schools were involved. As part of a larger study on dentofacial esthetics, six photo series consisting of one unaltered and four altered variants of the same female profile were distributed among the students. The altered features were ones that are esthetically significant according to the literature. The students had to indicate the photo in each series that they preferred. The data were analyzed in a regression model in which preference in the given photo series was the dependent variable and gender, grade of studies, and dental school were the factors. Eight hundred and sixty-one students (93.7%) responded. Gender and dental school were not associated with the observed preferences, but the grade of studies was associated for three of the modified parameters: chin prominence, the sagittal position of the maxillary dental arch, and the simultaneous modification of the prominence of the chin and the nose. This study has confirmed several earlier observations, and new observations have also been made. We have demonstrated that the anteroposterior position of the maxillary incisors may be an important determinant of profile esthetics, even if this position does not influence the situation of the soft tissues and if the forehead cannot be used as a reference. We have also shown that the harmony between the nose and the chin overrides the importance of their individual dimensions.

Esthetic Smile Perception Among Dental Students at Different Educational Levels

Purpose

To evaluate the perception of six esthetic components of the smile among dental students and whether such a perception was influenced by different education levels and gender.

Materials and Methods

This was an analytical cross-sectional study. A self-administered questionnaire was applied to all students (n=182) at clinical levels (year four and five) to evaluate a total of 6 ideal images (smile arc [SA], buccal corridor [BC], gingival display [GD], midline diastema [MD], crown length [CL] and width [CW]). In addition, students were asked to evaluate 20 altered images of these ideal images. A 10-point visual analogue scale was used to assess the ideal images, with the right end of the scale labeled “attractive smile” and represented by the number 10 and the left end of the scale labeled “unattractive smile” and represented by the number 0. The opposite scoring was applied for the altered esthetics smile images. Descriptive statistics was run to report sample characteristics, and the Mann-Whitney U-tests were performed to compare clinical levels and gender on aspects of esthetic smile.

Results

The response rate was 80% (77 females and 68 males). Students at level five scored statistically significantly (p<0.001) higher towered attractive esthetic smile in ideal SA, while students at level four scored statistically significantly (p=0.016 and 0.006, respectively) higher towered attractive esthetic smile in ideal GD and CL. At altered smile esthetics images evaluation, fifth year dental students scored statistically significantly (p=0.030, 0.026 and 0.028, respectively) higher towered unattractive esthetic smile in two altered images of SA and one of BC. In contrast, fourth year dental students scored statistically significantly (p=0.022, 0.048, 0.027, respectively) higher towered unattractive esthetic smile in one altered image of GD, midline diastema and crown width. Males in year four were more likely to score higher than females for ideal images meanwhile females in year five scored higher than males towards attractive smile in ideal images. Males and females differences in scoring ideal images on both levels were generally non-significant (P>0.05) although males were statistically significantly to score higher than females towards unattractive images in both levels (p<0.05).

Conclusion

Dental students at the fifth-year level of study had higher perception of esthetic components of smile than those at the fourth-year level. At each level of study, female dental students apparently had higher perceptions of smile esthetics than males.