BACKGROUND: The authors conducted a review to evaluate the magnitude of esthetic impairment that the general public is able to discern with regard to periodontal factors. METHODS: The authors conducted a systematic computerized search of electronic databases (MEDLINE, PubMed, Embase, Cochrane Library and Web of Science) until May 2010. They scrutinized the abstracts of the retrieved articles and identified, selected and assigned methodological scores to those that investigated periodontal factors affecting anterior dental esthetics from a layperson's perspective. RESULTS: Thirty-two articles met the inclusion criteria. The authors determined laypeople's preferences and sensitivities with regard to midline deviation, gingival display and architecture, smile arc and buccal corridors. CONCLUSIONS: The results of the literature review show that most laypeople could detect dental midline deviations of less than 3.0 millimeters, but when made aware of midlines, they preferred those that are coincident with each other and with the facial midline. There appears to be an esthetic range-from 4.0 mm of incisal coverage to 3.6 mm of gingival display-that the general public tolerates, with a preference for the lip at or near the gingival margins of the maxillary central incisors. They preferred consonant smile arcs in both sexes but tolerated flat smile arcs in men more than they did in women. Laypeople preferred minimal buccal corridor. CLINICAL IMPLICATIONS: Laypeople have varying degrees of sensitivity to certain dental esthetic issues. Thus, clinicians can expect their patients to be more attentive to some dental esthetic factors than they are to others.
BACKGROUND: The authors conducted a review to evaluate the magnitude of esthetic impairment that the general public is able to discern with regard to periodontal factors. METHODS: The authors conducted a systematic computerized search of electronic databases (MEDLINE, PubMed, Embase, Cochrane Library and Web of Science) until May 2010. They scrutinized the abstracts of the retrieved articles and identified, selected and assigned methodological scores to those that investigated periodontal factors affecting anterior dental esthetics from a layperson's perspective. RESULTS: Thirty-two articles met the inclusion criteria. The authors determined laypeople's preferences and sensitivities with regard to midline deviation, gingival display and architecture, smile arc and buccal corridors. CONCLUSIONS: The results of the literature review show that most laypeople could detect dental midline deviations of less than 3.0 millimeters, but when made aware of midlines, they preferred those that are coincident with each other and with the facial midline. There appears to be an esthetic range-from 4.0 mm of incisal coverage to 3.6 mm of gingival display-that the general public tolerates, with a preference for the lip at or near the gingival margins of the maxillary central incisors. They preferred consonant smile arcs in both sexes but tolerated flat smile arcs in men more than they did in women. Laypeople preferred minimal buccal corridor. CLINICAL IMPLICATIONS: Laypeople have varying degrees of sensitivity to certain dental esthetic issues. Thus, clinicians can expect their patients to be more attentive to some dental esthetic factors than they are to others.