Composite images of upper front teeth--judgment of attractiveness and gender-specific correlation.

UNLABELLED: The esthetic appearance of upper front teeth strongly depends on color, shape, size, width-to-height ratio, and position of teeth. In the past, these single esthetic aspects had been analyzed separately and not as a whole. Thus, the objective of this current study is to investigate the perception of the esthetics of upper front teeth whose image had been manipulated by composite photoimaging. In order to obtain the six composite images, one for each gender and group ("discontent," "average," and "content"), 320 students were photographed. Afterwards, the 6 composite images were rated by 128 independent participants (dentists and laymen), concerning attractiveness and gender. The composite images "average" and "content" were rated significantly more attractive than "discontent" images. The composite images rated as "attractive" were attributed to the female gender by the majority of the participants (61-85%); the "unattractive" images were predominantly (85-75%) related to the male gender. The participants were unable to judge the correct gender yet they assigned attractiveness to be a clearly female attribute. This "bias" can be utilized for the reconstruction upper front teeth, to emphasize the gender of the patient. CLINICAL SIGNIFICANCE: The presented morphing technique can contribute to further study setups considering dental appearance and attractiveness. In the case of restoring upper front teeth, the parameters tooth shape, size, width-to-height ratio, and position of teeth should be individually chosen and can emphasize or dampen the perception of gender.