Laypeople's preferences regarding frontal dentofacial esthetics: tooth-related factors

Researchers have conducted extensive studies regarding dentoalveolar factors that affect anterior dental esthetics; however, there is no consensus regarding laypeople's perspectives on these factors.

The authors conducted a systematic search of electronic databases (MEDLINE, PubMed, Embase, Cochrane Library and Web of Science) until May 2010. They identified and selected articles in which investigators explored anterior dental esthetics from a layperson's perspective, and they assigned methodological scores to the studies.

Seventeen articles met the inclusion criteria. The authors determined laypeople's preferences for tooth shape, tooth size and proportion, and incisor position.

The results of this literature review show that laypeople did not discriminate between square, square-round (basically square with rounded mesioincisal and distoincisal angles) and round incisors or between canine shapes when displayed in photographs of female models. They preferred square-round incisors to square incisors and flat canines (when paired with round incisors) in photographs of male models. Most laypeople appeared to prefer unworn dentitions, small teeth in photographs of female models and large teeth in photographs of male models, width-to-length ratios in central incisors between 75 and 85 percent, and tooth-to-tooth proportions between the lateral and central incisors between 50 and 74 percent. Laypeople discerned a 10° angulation of one or both central incisors as being less attractive. Significant discrepancies in perceptions existed for incisal edges. Most laypeople preferred an overbite of 2.0 millimeters, with some leeway (around 2 mm). The authors noted that laypeople had a preference for no diastemas.

Laypeople have varying degrees of sensitivity to certain esthetic issues. Thus, clinicians can expect their patients to be more attentive to some dental esthetic factors than to others.