Many variables affecting smile esthetics and attractiveness have been evaluated. However, the influence of the interaction of several variables is not as well known. Furthermore, patients and dental professionals might view smile esthetics differently. Therefore, the purpose of this research was to evaluate the influence of the smile arc in conjunction with the amount of maxillary gingival display on the perception of smile attractiveness by orthodontists, dentists, and laypersons. Methods A frontal intraoral photograph of ideally aligned teeth was modified using image-processing software. Photos showing 7 smile arcs, from flat to vaulted, were obtained, and these were combined with photos showing 4 different amounts of maxillary gingival display. The attractiveness of the 28 images of different smiles was evaluated by 3 groups of raters (orthodontists, dentists, and laypersons), each consisting of 70 persons. Results Both smile arc (P <0.05) and gingival display amount (P <0.001) had statistically significant influences on the perception of smile attractiveness. Smile attractiveness scores with reference to gingival display amount showed a statistically significant (P <0.001) difference between the rater groups. A significant (P <0.05) interaction between smile arc and gingival display amount was observed. Conclusions Examining other components influencing the perception of smile attractiveness might help clinicians develop more satisfying treatment plans for their patients.
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