正畸治疗结束女性患者微笑像主观评价相关因素分析

目的通过对治疗结束女性患者微笑像的主观评价，了解影响微笑美学主观评价的相关因素；探讨专业正畸医生与普通人对微笑美学的评价的一致性。方法14-27岁正畸治疗结束女性80名，Ⅰ类骨型、牙齿排列整齐，覆合覆盖正常，磨牙和尖牙关系均为I类关系。拔牙42例，非拔牙38例。收集面下三分之一微笑像，将全部图片随机编号，按照恒定的顺序排列后分发到评价人员手中，分别由10名有经验正畸医生和10名普通人对微笑像做主观评价（VAS）。结果专业正畸医生和普通人对微笑像的评分差异有统计学意义（P〈0．001）；拔牙组和非拔牙组微笑像的美学得分差异不显著。正畸医生与普通人微笑主观评价（VAS评分）与微笑指数呈正相关，与微笑高度、牙龈暴露程度、尖牙宽度比例、可见牙列宽度比例呈负相关。结论拔牙与非拔牙矫治本身对微笑美学主观评分的影响无显著差异，牙龈暴露程度是影响微笑美学主观评分的主要因素。

Analysis of the factors influencing the subjective smile evaluation in females after orthodontic treatment

Objective To understand the factors influencing subjective smile evaluation and investigate the consistence between orthodontists and laypersons on smile evaluation. Methods 80 female patients with skeletal Class Ⅰ facial pattern （aged 14 to 27 years old） were included in the study after finishing orthodontic treatment. All subjects presented with Class Ⅰ canine and molar relationship, normal overbite and overjet and well-aligned teeth. The subjects were divided into extraction （42 subjects） and non-extraction groups（38 subjects）. Posttreatment smile photographs of lower 1/3 of the face were taken. The smile photos were randomly numbered and distributed with a fixed sequence to 10 orthodontists and 10 laypersons for subjective smile evaluation （VAS）. Results Significant difference was noted in smile scores when smile photographs were evaluated by orthodontists and laypersons. （P~0. 001）. No significant difference was found in smile scores when smile photos in extraction group were compared with that in non-extraction group. Correlation analysis indicated that smile index was positively correlated with orthodontists and layperson＇s score, smile height, gingival exposure, canine width ratio, visible dentition width ratio was negatively correlated with their score. Conclusions Extraction or non-extraction decision itself might not significantly affect subjective smile evaluation of a patient. Gingival exposure may play a more important role in subjective evaluation of smile.