CORRELATION BETWEEN MAXILLARY ANTERIOR TOOTH SIZE RATIO AND SMILE ESTHETICS INDEX IN ORTHODONTICS PATIENTS: A CROSS-SECTIONAL ANALYSIS

Authors

  • Sari Kurniawati Department of Orthodontics, Faculty of Dentistry, Universitas Brawijaya
  • Nur Masita Silviana Department of Orthodontics, Faculty of Dentistry, Universitas Brawijaya
  • Astika Swastirani Department of Orthodontics, Faculty of Dentistry, Universitas Brawijaya
  • Yustisian Goretti Nauli Department of Orthodontics, Faculty of Dentistry, Universitas Brawijaya

Keywords:

anterior teeth size ratio, maxillary teeth, orthodontics, smile aesthetics, smile index

Abstract

Introduction: Aesthetics smile is a crucial aspect of physical appearance that significantly influences self-confidence. The proportion of maxillary anterior teeth size plays an essential role in forming a harmonious smile. The Smile Index serves as a parameter to measure smile characteristics from the frontal dimension.Aim: to determine the relationship between the maxillary anterior teeth size ratio and Smile Index in orthodontic patients at the FKG UB Clinical Laboratory.Methods: This cross-sectional analytical study utilized 32 samples of study models and photometry from orthodontic patients aged 17-30 years who met the inclusion criteria. The anterior teeth size ratio (central incisor, lateral incisor, and canine) was measured using calipers on study models by dividing mesiodistal width by cervicoincisal height. The Smile Index was measured through frontal photometry by dividing intercommissural width by interlabial distance during smiling. Data were analyzed using the Spearman correlation test and simple linear regression with a 95% confidence level.Result: The mean size ratio was 0.88±0.02 for central incisors, 0.87±0.02 for lateral incisors, 0.93±0.02 for canines, and 6.98±0.25 for Smile Index. There was no significant difference between right and left anterior teeth size ratios (p>0.05). Correlation tests showed no significant relationship between central incisor size ratio and Smile Index (r=-0.83; p=0.651), lateral incisor (r=0.33; p=0.858), or canine (r=-0.79; p=0.667). Overall, the anterior teeth size ratio showed no significant relationship with Smile Index (p=0.908).Conclusion: There is no relationship between the maxillary anterior teeth size ratio and Smile Index in orthodontic patients. Anterior teeth do not show a significant relationship either individually or collectively with Smile Index values. This finding suggests that smile aesthetics could be influenced by multiple factors beyond tooth dimensions alone, including soft tissue characteristics and facial proportions.

References

Pine C, Chi D, Ramos-Gomez F, Hunt N. The hidden impact of oral health on children’s lives. Global Report; 2022.

Aaliyah DA, Hatta I, Sari GD, Azizah A, Wibowo D. Hubungan tingkat keparahan maloklusi dengan kualitas hidup terkait kesehatan gigi dan mulut remaja SMA di Banjarmasin. Jurnal Kedokteran Gigi. 2024;8(2):102–107.

Machado AW. 10 commandments of smile esthetics. Dental Press Journal of Orthodontics. 2014;19(4):136–157.

Alfirdaus AY. Pengaruh lengkung senyum pada estetis senyum. Universitas Muhammadiyah Surakarta; 2020.

Alsaigh H, Alrashdi M. Morphometric analysis of tooth morphology among different malocclusion groups in a Hispanic population. 2023:1–8.

Ward DH. Proportional smile design: Using the recurring esthetic dental proportion to correlate the widths and lengths of the maxillary anterior teeth with the size of the face. Dental Clinics of North America. 2015;59(3):623–638.

Chou JC, Nelson A, Katwal D, Elathamna EN, Durski MT. Effect of smile index and incisal edge position on perception of attractiveness in different age groups. Journal of Oral Rehabilitation. 2016;43(11):855–862.

Ackerman MB, Ackerman JL. Smile analysis and design in the digital era. Journal of Clinical Orthodontics. 2002;36(4):221–236.

Sari ESI. Hubungan rasio lebar dan tinggi gigi anterior atas dengan persepsi estetik (berdasarkan Orofacial Esthetic Scale yang divalidasi). Universitas Indonesia; 2016.

Melo M, Ata-Ali F, Huertas J, Cobo T, Shibli JA, Galindo-Moreno P, Ata-Ali J. Revisiting the maxillary teeth in 384 subjects reveals a deviation from the classical aesthetic dimensions. Scientific Reports. 2019;9(1):1–9.

Wilson NHF. Essentials of esthetic dentistry: Principles and practice of esthetic dentistry. 1st ed. London: Elsevier; 2015.

Naini FB. Facial aesthetics: Concepts and clinical diagnosis. Oxford: Wiley-Blackwell; 2011.

Bartlett D, O’Toole S. Tooth wear and aging. Australian Dental Journal. 2019;64(Suppl 1):S59–S62.

Desai S, Upadhyay M, Nanda R. Dynamic smile analysis: Changes with age. American Journal of Orthodontics and Dentofacial Orthopedics. 2009;136(3):310.e1–310.e10.

Grover N, Kapoor D, Verma S, Bharadwaj P. Smile analysis in different facial patterns and its correlation with underlying hard tissues. Progress in Orthodontics. 2015;16(1).

Sabbah A. Smile analysis: Diagnosis and treatment planning. Dental Clinics of North America. 2022;66(3):307–341.

Sarver DM, Ackerman MB. Dynamic smile visualization and quantification: Part 2. Smile analysis and treatment strategies. American Journal of Orthodontics and Dentofacial Orthopedics. 2003;124(2):116–127.

Alqahtani A, et al. Comparison of maxillary anterior teeth dimensions in different malocclusion groups. 2021.

Sah SKU, Zhang HD, Chang T, Dhungana M, Acharya L, Chen LL, Ding YM. Maxillary anterior teeth dimensions and proportions in a central mainland Chinese population. Chinese Journal of Dental Research. 2014;17(2):117–124.

Charruel S, Perez C, Foti B, Camps J, Monnet-Corti V. Gingival contour assessment: Clinical parameters useful for esthetic diagnosis and treatment. Journal of Periodontology. 2008;79(5):795–801.

Mayun IGARU. Perbandingan penilaian senyum yang estetis menggunakan konsep golden proportion, recurring esthetic dental (RED), dan golden percentage. Jurnal Kedokteran Gigi Terpadu. 2023;5(2):52–56.

Davis NC. Smile design. Dental Clinics of North America. 2007;51(2):299–318.

Fekonja A. Morphological diversity of permanent maxillary lateral incisors and their impact on aesthetics and function in orthodontically treated patients. Diagnostics. 2022;12(11).

Magat G, Uzun S. Evaluation of root and root canal morphology of mandibular and maxillary canine teeth in Turkish subpopulation by cone beam computed tomography using two classification systems. BMC Oral Health. 2024;24(1).

Zawawi KH, Malki GA, Al-Zahrani MS, Alkhiary YM. Effect of lip position and gingival display on smile and esthetics as perceived by college students with different educational backgrounds. Clinical, Cosmetic and Investigational Dentistry. 2013;5:77–80.

Desai S, Upadhyay M, Nanda R. Dynamic smile analysis: Changes with age. American Journal of Orthodontics and Dentofacial Orthopedics. 2009;136(3):310.e1–310.e10.

Tjan AHL, Miller GD, The JGP. Some esthetic factors in a smile. Journal of Prosthetic Dentistry. 1984;51(1):24–28

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Published

2026-07-27

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Original Research