Analysis of soft tissue display during enjoyment smile. Part II: elder Caucasians

Esthetic parameters in elder patients are essential in esthetic oral rehabilitation. To date, no study has quantified the amount and frequency of soft tissue display in the papilla area in patients over 50 years of age. Photographic examination of 42 fully dentate patients with a mean age of 59 years was performed during enjoyment smile. Digital processing and measurement of the tooth, gingiva, and papilla display revealed that over 90% of subjects displayed soft tissue in the papilla area of the anterior teeth and first premolar during enjoyment smile regardless of their sex. The frequency of the display in descending order follows: maxillary lateral incisor (96%), central incisor (94%), canine (94%), first premolar (91%), second premolar (85%), and first molar (39%). The mean amount of papilla display was 3.4 mm (0 to 10 mm). There was no significant difference in the amount of papilla display between sexes for anterior teeth, premolars, or first molar (P = .97, P = .79, and P = .48, respectively). Elder caucasians showed significantly less gingiva in the area of the premolars and molars but not in the anterior region. The amount of papilla display is significantly less in elder caucasians in the anterior and premolar region. The mean amount of soft tissue display decreased with age but the frequency of papilla display was more than 90% in the anterior region and greater than 70% in the premolar region, suggesting that pink esthetics is an issue in patients over 50 years of age.