Objectives To evaluate the attractiveness of changes in vertical position of maxillary canines in frontal smiles of different facial types, and to evaluate the esthetic perceptions of orthodontists and laypeople, and the influence of facial type on these perceptions. Materials and Methods Three adult female volunteers were selected as individuals with normal, vertical, and horizontal growth patterns. Frontal posed smile photographs were digitally altered by adjusting vertical positions of the maxillary canines above, below, or coincident with the incisal line in increments of 0.5 mm within a range of 1 mm of extrusion and intrusion. For assessment, a web-based survey was formed with 18 images (six images for each model). A scale was present underneath each image, graded from 0 to 10 (0: unattractive; 10: the most attractive). Images were rated by 233 participants (105 orthodontists; 128 laypeople). Results Orthodontists scored 0-mm images significantly as the highest in all groups. Laypeople scored significantly higher for −0.5 mm images regardless of facial type. The lowest scored images were −1 mm (except for horizontal pattern) and +1 mm images. Mean values of scores given by men were higher (P < .05). Conclusions Orthodontists favored ideal dental alignment and preferred the incisal edges of central and canine teeth to be at the same level. Laypeople preferred a smoother smile arc than orthodontists and found harmony with the soft tissue more attractive. Facial type affected perceptions of the vertical changes of maxillary canines.
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