Aesthetic perception of smile in long face pattern patients who underwent maxillary impaction with miniplates or orthognathic surgery

J Stomatol Oral Maxillofac Surg. 2022 Oct;123(5):498-504. doi: 10.1016/j.jormas.2022.05.015. Epub 2022 May 13.

Abstract

Introduction: The gummy smile is perceived in 10% of the population aged 20 to 30 years old, and it causes an aesthetic imbalance in the smile. This study investigated the existence of differences in the aesthetic perception of the smile after correcting the gummy smile using two different techniques: orthognathic surgery for maxillary impaction and miniplate-aided orthodontic impaction.

Methods: Photographs of 16 Long Face Pattern female patients were evaluated by 56 oral and maxillofacial surgeons, 56 orthodontists, and 56 laypeople before and after the treatment with one of the two techniques. These photographs were standardized using the Photoshop program, randomly organized, and then presented to the evaluators via the Google Meeting® application in the PowerPoint® program. To evaluate the attractiveness of the smile, the Visual Analogue Scale (VAS) was used. To analyze the intra and inter-examiner concordances, Spearman's correlation and Kendall's concordance tests were used, respectively. For intergroup comparison, the Friedman test was used, with a 5% significance level.

Results: For all three groups of evaluators, the post-treatment evaluation results were superior to the results before the treatment: surgeons and orthodontists assigned higher scores for surgical cases and laypeople for orthodontic cases.

Conclusion: From a clinical point of view, there was no difference between the results of both techniques with regard to the aesthetic perception of smiles. A gingival exposure ranging from zero to two millimeters was considered the most aesthetic for all evaluators.

Keywords: Corrective orthodontics; Dental aesthetics; Gummy smile; Orthognathic surgery.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Attitude to Health
  • Esthetics, Dental
  • Female
  • Gingiva / surgery
  • Humans
  • Incisor
  • Orthognathic Surgery*
  • Perception
  • Smiling*
  • Young Adult