Purpose: This study aims to compare the effect of various smile parameters (buccal corridor, gummy smile, midline to face discrepancy, with and without upper lip filling) on the perception of smile attractiveness by applying the digital modification of images judged by one hundred and eighty laypersons from different Middle East populations.
Materials and Methods: A frontal photo of a woman’s smile is manipulated with Photoshop to modify each smile parameter gradually into 3 grades. The total number of smiles to be assessed is 18. One hundred and eighty participants divided into 3 groups (n=60: 30 men and 30 women): Lebanese, Syrian, and Egyptian laypersons are invited to assess the smile attractiveness before and after modification In addition, each evaluator must indicate which feature she or he finds most attractive in a face. Analysis of repeated measures variances followed by univariate analyses and multiple comparisons of Bonferroni are performed.
Results: Eyes and smile are the most attractive elements in the face. For midline to face discrepancy, only Lebanese laypeople and Egyptian women prefer the coincidence of the midline to face compared with other positions with significant difference (p value 0.05). Concerning the buccal corridor, its size does not influence smile attractive (p value> 0.05). Upper lip filling affected the perception of smile aesthetics for the midline (for Syrians and Egyptians).
Conclusion: Sex and culture affect the perception of the smile attractiveness for certain parameters. Alteration of the buccal corridor does not seem to influence the smile attractiveness. Upper lip filling may be advantageous in some cases and unfavorable in others.
Clinical significance: Dentists should take into consideration cultural differences when restoring smile aesthetics.