Alteration of gingival exposure and its aesthetic effect.

This study analyzed the computerized variations of gingival exposure (GE) in unattractive smiles and evaluate the aesthetic effect to determine the acceptable range of GE for attractiveness. Images of the frontal posed smile of 50 juvenile women were evaluated in terms of attractiveness by doctors and laypersons separately to select the most unaesthetic one. And the most unaesthetic smile was modified with Photoshop in 2 ways-lowering upper lip and lifting lower lip-and the same evaluators were asked to reevaluate the changed images. We found that the smile with the most significant GE was selected as the most unaesthetic one. The attractiveness ratings were significantly lower in the doctors' group than in the laypersons' group (P < 0.05). The acceptable range of GE in the doctors' group was 0.54 to 2.23 mm, and in the laypersons' group, it was 0.09 to 2.35 mm. Among the many contributors to an attractive smile, GE alteration is the principal one, but not the only, and although 0- to 2.3-mm GE is just an acceptable range; there is an attractive GE degree or point for every individual. Gingival exposure alteration must be balanced against the others in clinical treatment, especially in maxillofacial surgery for the gummy smile.