Esthetic perception of asymmetric canines treated with space closure in maxillary lateral incisor agenesis

This article assesses the esthetic opinion of the experts involved in dental restoration (general dentists, orthodontists, prosthodontists) and laypeople. Differences in esthetic opinion among the studied groups are assessed.

A questionnaire was constructed based on four photographs. A quantitative esthetic appreciation using a numerical scale was requested from four groups of observers. The final sample consisted of 434 participants: 142 laypeople, 141 general dentists, 100 orthodontists, and 51 prosthodontists. The photographs presented were based on the same lips and modified from the same intraoral photograph with asymmetric canines: the right canine was smaller than the left canine and had a lower gingival margin. A mirror image of the right canine was digitally made to create symmetry.

There were statistically significant differences (P < 0.05) in the assessments made across the different groups of observers. For all questions, the laypeople assigned significantly higher scores (P < 0.05) than the orthodontists and prosthodontists. However, there was no significant difference between groups, and all the groups considered the photograph with the larger canines to be more esthetic. The dental professionals and the laypeople disagreed the most regarding their assessment of the least esthetic image.

There were differences between the four observer groups in their scoring of the photographs from 0 to 10 relative to the more pleasing esthetics of closure of space with asymmetric canines. However, there were no differences in the results when evaluating each type of canine relative to the form. The canine with the most prominent shape was considered to be more esthetic by all the groups.