ArticleJournal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]2025
Effect of Midline Deviation and Crown Width Disproportion on Perception of Smile Esthetics.
Article in Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Comparative effects of temporary anchorage devices combined with various auxiliary attachments on maxillary molar mesialization with clear aligners: a finite element analysis.BMC oral health · 2026Article
- Effect of Midline Deviation and Crown Width Disproportion on Perception of Smile Esthetics.Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] · 2025Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the effect of maxillary midline deviation and crown width disproportion on the perception of smile attractiveness through full-face images among dentists and laypeople. METHODS AND MATERIALS: A full portrait image of a smiling 25-year-old female, exhibiting good dental alignment, midline position, and tooth size symmetry, was selected as a model for the present study. The original image was digitally modified using photo editing software (Photoshop CC, Version 25.12.0; Adobe) to simulate three different case scenarios of varying levels: Midline deviation (1-4 mm), single crown width disproportion, separately for central incisor, lateral incisor, and canine (1 and 2 mm), and crown width disproportions distributed to anterior teeth (1-4 mm). In total, 15 modified images were displayed randomly to 180 observers (90 laypeople and 90 dentists) including the original image that served as a control. Each observer scored the level of smile esthetics for each image using a visual analog scale ranging from point 0 (unattractive) to 100 (attractive). Bonferroni Test and Partial Eta Squared were utilized for the statistical data analyses (α < 0.05).
resultsAttractiveness scores were significantly lower for the modified smiles with the single crown width disproportion than distributed crown width disproportion and midline deviation (p < 0.001 for each), of which two presented statistically similar attractiveness (p = 0.278). The highest attractiveness scores were obtained for the control image (90.35 ± 5.56
conclusionsDentofacial midline discrepancy had less effect on smile attractiveness compared to crown width disproportions. Midline deviations up to 2 mm were not noticeable for both laypeople and dentists. The deviations of 3 mm were noticeable but still more attractive than the deviations of 4 mm, which were considered the least attractive. A single crown width disproportion was less perceived when moving from the central incisor toward the canine. Distributing the crown width disproportions among anterior teeth can be beneficial for smile attractiveness compared to non-distributed cases. CLINICAL SIGNIFICANCE: Generating symmetrical crown width proportions of the anterior teeth seems more important for smile esthetics than dentofacial midline harmony. Distribution of crown width disproportions among the anterior teeth can enhance smile esthetics.
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