Perception of Esthetic Impact of Smile Line in Complete Denture Wearers by Different Age Groups

To evaluate esthetic perceptions based on tooth exposure when smiling of patients wearing complete dentures by evaluators in different age groups.

Alterations were made to a front view photograph of a smiling patient wearing complete maxillary and mandibular dentures. Alterations in the smile line were simulated to increase or decrease tooth exposure (increments of 0.5 mm). For this purpose, image manipulation software was used. After manipulation, images were printed on photo paper, attached to a questionnaire, and distributed to individuals in three age groups (n = 150). To evaluate the esthetic perception for each image, a visual analog scale was used, with 0 representing least attractive, 5 representing attractive, and 10 representing very attractive. Differences between examiners were analyzed using the Mann-Whitney test. All statistical analyses were performed with a degree of confidence of 95%.

Two evaluators did not observe any differences between images. The images given the best and worst scores were E and O (alterations of 2 and 7 mm), respectively, in the 15- to 19-year-old group, B and O (alterations of 0.5 and 7 mm), respectively, in the 35- to 44-year-old group, and A and M (no alteration and 6 mm alteration), respectively, in the 65- to 74-year-old group. When the images were presented together (images 1 and 2), the unaltered image was selected by individuals of different age groups as the best, and the image with a change of 7 mm was selected as the worst.

In this study, complete dental prostheses with smile lines that coincided with the cervical margins of the anterior teeth were the most acceptable. Less exposure of the maxillary teeth when smiling corresponded with decreased attractiveness.