The effects of maxillary incisor positions and chin prominences on the perception of lateral smiling profile attractiveness among orthodontists and laypersons

Abstract

Objective: To evaluate the ideal anteroposterior position of incisors in lateral smiling profiles with different chin prominences and to relate these positions to nose and chin landmarks based on the perceptions of orthodontists and laypersons. Methods: A lateral smiling profile image of a female subject was adjusted to create five levels of chin prominence (–6, –3, 0, +3, +6 mm). For each level, the anteroposterior positions of the maxillary incisors were adjusted across five positions (–4, –2, 0, +2, +4 mm). Thirty-six orthodontists and 36 laypersons rated the attractiveness of each profile using a visual analog scale. The maxillary incisor position (U1) was measured relative to the external nose and chin landmarks (E-lines). Differences in perceptions between orthodontists and laypersons were analyzed. Results: For profiles with 6 and 3 mm chin retrusion, the most favored incisor positions were the 2 mm retrusion and unaltered positions, respectively. For the unaltered chin prominence, orthodontists preferred unaltered incisors, while laypersons favored 2 mm protrusion. Conversely, for 3 and 6 mm chin protrusion, both groups preferred 4 and 2 mm protrusion, respectively. The distance between U1 and the E-line is the most attractive images ranged from 8.5 to 11.5 mm. Based on the regression model, an optimal U1-E-line distance of 8.95 mm was recommended. Conclusions: The preferred incisor position is influenced by chin prominence, with the incisor position shifting in the same direction as the chin. The U1 E-line can be a useful clinical tool for determining the proper incisor positioning. Esthetic perceptions were generally consistent between orthodontists and laypersons.