Esthetic perception of maxillary lateral incisor agenesis treatment by canine mesialization

The objective of this study was to evaluate perception of the smile in maxillary lateral incisor agenesis (MLIA) cases treated by mesialization of a canine.

Nine images were digitally modified from the same frontal intraoral photograph to simulate various treatment options for space closure in MLIA. A questionnaire was submitted to laypersons (303), general dentists (215), prosthodontists (55) and orthodontists (81). Statistical tests with a significance level of P<0.05 were used.

The views of MLIA treatment judged to be most attractive showed unilateral dental and gingival reshaping. All study groups considered the simple dental reshaping of the mesial edge of the canine to be attractive. In the analysis of the images grouped together for both unilateral and bilateral MLIA, the view showing dental and gingival reshaping was considered the most attractive whereas unmodified mesialization was considered the least attractive.

Regarding the space closure treatments, although all groups regarded simple dental reshaping of the canine to be attractive, the dental professionals considered gingival and crown reshaping to be more esthetic. In contrast, laypersons were not significantly responsive to this dental and gingival modification as compared to only slight reshaping of the mesial edge of the cusp of the mesialized canine in MLIA.