The Impact of Dental Midline on Asymmetric Faces: Perspective of Laypersons and Dentists

Abstract

Background: The objective was to determine if asymmetric facial features, nasal and chin deviations, affect the perception of attractiveness of a dental midline angulation, and if it is consistent among both dentists and laypeople. It was also analyzed if factors, such as the sex, age group of the participants and the dentist’s area of operation are relevant in their assessment. Methods: A cross-sectional study, approved by the Ethics Committee of Fernando Pessoa University. From a symmetrical facial model (SFM) image, a natural-looking asymmetrical face was created. Based on this asymmetric facial model six images were created, with different directions and degrees of inclination of the dental midline. In total, 236 laypersons and 242 dentists completed the online questionnaire where they rated the self-perception of attractiveness of the eight images (VAS scale from 0 to 10). Non-parametric comparisons (IBM© SPSS Statistics vs. 27.0, p < 0.05). Results: The results showed a significant difference in the perception of attractiveness between laypeople and dentists. This finding was consistent regarding every image, except for the SFM. The factors, sex of the people participating and dentist’s area of operation, seemed only to contribute to a significant difference in the perception when it came to the SFM. The perceived attractiveness of the images, for dentists and laypersons, did not differ by age group of the participant, apart from images 6 and 8. Conclusions: Dentists are more rigorous about dental midline inclinations than laypersons. The perception of attractiveness was affected by the age group and sex of the participants and the dentist’s area of operation.

The impact of dental midline angulation towards the facial flow curve on the esthetics of an asymmetric face: Perspective of laypeople and orthodontists

“…8,10,12 Based on the results of the present study, in cases with a transverse facial asymmetry dental professionals is better to position the dental midline according to the curve of the face, in order to improve facial attractiveness by making facial asymmetry less perceptible. 15,17,18 This outcome can be explained by the fact that a straight-centered midline can transmit a sense of symmetry, balance, and harmony on a symmetrical face, but this can have the opposite result in an asymmetrical face, as a centered midline can make the visual comparison between the two halves of the face more obvious, unveiling the asymmetric structures of the face. A dental midline angulated towards the asymmetry of the lower third of the face seems to assist in preserving facial harmony, even if the occlusal plane is following the commissural lines of the lips, that in a case of an asymmetry is not parallel with the interpupillary line.…”

“…2,5 During the treatment planning for a restorative, an orthodontic, or for an interdisciplinary treatment, positioning of the dental midline is of paramount importance as it consists one of the most commonly used starting points for the design of the smile. 16,17 For a correct smile analysis is very important the clinician to reach to a Note: Different superscript letters in each row for each group of observers show statistical differences ( p < 0.05).…”

“…15,16 Recently scientific literature has been focused on the impact of the position of the dental midline in patients with facial asymmetries, especially in facial structures that are located in the middle of the face, as their discrepancy can interfere particularly with the perception of the dental midline. 15,17,18 However, the way that the asymmetrical facial features in combination with the orientation of the dental midline can influence the perception of the smile, demands further investigation, in order to find out how these deviations can become less noticeable.…”

The Influence of Social Network Content on the Perception of Smiles—A Randomized Controlled Trial

“…The human face is a portion of the body that is frequently exposed and becomes apparent during interpersonal contact. Even without spoken communication, it gives us a lot of information, such as gender, age, identity, interests, feelings, attractiveness, or origin [ 2 ]. The perception of attractiveness varies from person to person and determining what is beautiful is mostly a subjective process.…”

“…Numerous studies have been undertaken about how laypeople and professionals in dental medicine interpret smiles [ 1 , 2 , 3 , 4 , 5 ]. Kokich et al found that orthodontists, doctors of dental medicine, and laypeople have different perceptions of specific dental esthetic discrepancies [ 3 ].…”