Perception of the esthetic impact of gingival smile on laypersons, dental professionals, and dental students

Objective. The aim of this study was to evaluate perceptions regarding esthetic appearance of the smile in cases of orthognathic surgery for correction of maxillary gingival display. Study Design. Alterations were made to an extraoral front-view photograph of a gingival smile in normal occlusion by repositioning the maxilla to simulate bone tissue removal and gingival exposure. Images were printed on photographic paper attached to questionnaires distributed among laypersons, professionals, and dental students to evaluate degree of esthetics (n = 150). To evaluate degree of esthetics, an attractiveness-scale was used, with 0 representing hardly attractive, 5 attractive, and 10 very attractive. Results. All of the evaluated groups demonstrated that large gingival extension does not always affect esthetic appearance of the smile. Insufficiently visualized maxillary incisors were considered hardly attractive and received statistically lower scores (P < .05). Conclusions. According to esthetic parameters, gingiva play important roles in composition of the smile, but only when they are exposed to a small extent. (Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:448-454)