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。     

口腔正畸与颌面部美学

口腔正畸是一门基于美学的临床应用学科，通过调整牙齿移动以及颌骨关系来协调鼻唇颏的相互关系。正畸医生需要在术前对患者的面部软组织正貌和侧貌进行充分的分析，了解可能存在的颌面部对称性、水平向、垂直向问题，可能的影响因素（增龄性变化和代偿性变化对面部形态的影响）以及在牙齿正畸时给颌面部形态带来的变化，以引导矫治方案的设计与正畸治疗的实施，有效提高正畸临床的效果，本文将以正畸医生视角对指导正畸方案设计的美学评价作一综述。     

正畸医生与正畸患者对面部美学的评价及其差别

目的 通过Q分类法来调查正畸医生与正畸患者对面部美学的评价及其差别,同时调查男性与女性对面部美学的评价及其差别。 方法 将96例正畸完成后的患者（男、女各48例）临床照片由20名经验丰富的正畸医生（男7名,女13名）和25例正畸患者（男13例,女12例）用Q分类法进行评价。Kappa检验和McNemar检验用来评估正畸医生和正畸患者之间,以及男女之间对面部美学评价是否一致和其差别。 结果 在对男性面部美观调查中,正畸医师与正畸患者的评价具有较高的一致性,男性与女性的评价具有较高的一致性。在对女性面部美观调查中,正畸医师与正畸患者的评价的一致性较差,男性与女性评价的一致性也较差。 结论 正畸医师与正畸患者对面部美观的评价基本一致;男性与女性对面部美学的评价基本不一致。     

正面微笑的美学研究

微笑是开心时情感的自然流露,越来越多的口腔正畸医生把微笑美作为矫治目标之一.如何才能让患者拥有最自信、最迷人的微笑,成为众多口腔正畸医生所关注的问题.影响微笑美的因素较多,它是水平向和垂直向以及时间等多种因素共同作用的结果.只有充分了解影响和制约微笑美的各种因素,才能真正做到让患者拥有迷人的微笑.本文就正面微笑的美学研究作一综述.     

青少年姿势位微笑与头影测量指标的相关分析

目的对比普通人与正畸医生对姿势位微笑的审美观异同，研究面部软硬组织与姿势位微笑的关系。方法用Canon EOS 50D数码照相机拍摄60名（男30名，女30名）个别正常胎的青少年面部正面照片数张，由正畸医生和普通人用视觉模拟尺度（VAS）评判美的微笑，并测量头颅侧位片的相关数据，最后经SPSS13．0统计软件进行统计学分析。结果1）正畸医生与普通人的微笑主观评分差异有统计学意义；2）正畸医生对姿势位微笑的主观评分高低与SNA角和SNB角呈负相关，与U1-L1角呈正相关；普通人对姿势位微笑的主观评分高低与MP角、PP—MP角和颏唇沟角呈正相关。结论1）正畸医生与普通人对姿势位微笑的审美观有差异，在正畸临床诊治患者的过程中，医患双方需加强沟通；2）正畸医生在诊治患者的过程中应关注患者面部侧貌的凸度及其面下1／3的协调美观。     

微笑美学特征测评软件系统的研发

目的：开发专业性强、实用性好的微笑美学特征微机测评系统,为正畸临床及相关研究提供专业工具。方法：利用数码照相机采集患者休息位及微笑位的正面像;在Windows 2000 Professional环境下应用Microsoft Visual C6.0＋ADO＋Borland C＋＋Builder编译,研发可以对患者正面像进行美学定点测量分析的软件系统。结果：成功研发微笑美学特征测评系统CoSmile MAA1.0版。通过人工定点,自动测量,可以得到29项微笑美学特征的指标。结论：该系统测量数据准确;测量项目丰富;使用方便快捷;数据处理功能完善;兼容性较好。可为正畸医生临床病例的诊断分析、矫治方案制定及疗效评价提供指导,同时也为正畸美学的临床应用奠定理论基础。     

牙列中线偏斜的审美研究进展

面部对称是容貌美观的重要影响因素。在微笑美学的研究中,牙列中线与面中线的一致性与微笑审美评价结果密切相关,直接影响患者微笑的美观程度。由于牙列中线偏斜在普通人群中发生率较高,因此,牙列中线与面中线不一致常作为患者就诊的主诉,同时也是正畸医生在制定治疗计划时需要特殊考虑的一个临床诊断指标和矫治目标。本文将对牙列中线偏斜的流行病学情况、病因学分类、诊断与治疗方法及其对微笑审美的影响作一综述,以期指导临床操作。     

正畸患者对姿势位微笑上唇位置的审美评价

目的调查正畸患者对姿势位微笑时上唇位置高度的主观美学评价,探讨不同年龄、性别正畸求治人群是否存在微笑美学的审美差异,以期为正畸临床提供美学参考依据。方法选取理想男、女姿势位微笑面下1/3照片各1张,利用Photoshop软件对上唇位置进行变动,形成男、女微笑系列图片各11张,设计临床电子调查问卷。随机选择于山东大学口腔医院进行正畸治疗的患者300名,由患者选出最美的姿势位微笑图片3张,进行统计学分析。结果不同年龄组患者对微笑唇位置的审美有显著性差异(P<0.05),相对于青年组,中青年组和中年组更倾向于较低的上唇位置;不同性别组患者对微笑唇位置的审美差异无统计学意义(P>0.05)。结论不同正畸患者对姿势位微笑上唇位置的审美偏好有差异,微笑的审美受到年龄的影响,医生在诊治过程中应充分考虑不同年龄患者的审美期望。     

正畸治疗与颜面微笑美──Dr.Bjorn.V Zachrisson教授讲座后记

微笑是人类共同的语言。和谐自然，怡人的微笑是人体美学的重要部分。在人际交往中它能给人留下良好的最初印象，因而增加了个体在社会中被接受的机会。作为最重要的面部表情，微笑是表达友好、赞同和欣赏的基本方式。国际知名正畸专家，挪威奥斯陆大学的Dr．Bjorn．VZachrisson将此问题提到了学术研究的高度，指出对微笑美的追求应成为正畸治疗的目标之一．他就“正畸学与微笑中的美容因素”于1996年12月25日在我院作了精彩演讲，在座均感耳目一新，受益颇丰。微笑是否符合美容要求不是绝对的，但对其一般描述性特征的了解将有助于在口腔…     

青少年面部组织与微笑相关数据的测量分析

目的：研究面部软硬组织与美的微笑的关系。方法：用数码相机拍摄60名个别正常黯的青少年面部正面像各数张（男30名,女30名）,由正畸医生和普通人用visual analog scale（VAS）评判美的微笑,用微笑网格软件测量微笑照片相关15项数据后经统计学处理。结果：1）经方差分析（F=7．415,P〈0．05）,显示正畸医生与普通人的微笑主观评分有统计学差异。2）经Pearson相关分析,正畸医生对美的微笑的主观评分高低与牙龈暴露量呈负相观（r=0．275,P〈0．05）,与上切牙暴露量呈正相观（r=0．209,P〈0．05）,与上下唇间隙呈负相观（r=0．40,P〈0．05）,普通人对美的微笑的主观评分高低与上切牙暴露量呈正相观（r=0．345,P〈0．05）。3）正畸医生对美的微笑主观评分的影响因素由大到小依次为：牙龈暴露量,上切牙暴露量,上下唇间隙,普通人对美的微笑主观评分的影响因素仅为上切牙暴露量。结论：1）正畸医生与普通人对美的微笑的审美观不一致,正畸临床诊治患者过程中,双方需加强沟通。2）上切牙暴露量是影响正畸医生与普通人对美的微笑主观评分的主要因素,提示正畸医生在诊治患者过程中应注意上切牙位置。     

The Role of the Posed Smile in Overall Facial Esthetics

Objective:To evaluate the role of the posed smile in overall facial esthetics, as determined by laypersons and orthodontists.Materials and Methods:Twenty orthodontists and 20 lay evaluators were asked to perform six Q-sorts on different photographs of 48 white female subjects. The six Q-sorts consisted of three different photographs for each of two time points (pre- and posttreatment), as follows: (1) smile-only, (2) face without the smile, and (3) face with the smile. The evaluators determined a split-line for attractive and unattractive images at the end of each Q-sort. The proportions of attractive patients were compared across Q-sorts using a Wilcoxon signed-rank test for paired data. The evaluators also ranked nine facial/dental characteristics at the completion of the six Q-sorts.Results:Evaluators found the pretreatment face without the smile to be significantly more attractive than the face with the smile or the smile-only photographs. Dissimilar results were seen posttreatment; there was not a significant difference between the three posttreatment photographs. The two panels agreed on the proportion of “attractive” subjects but differed on the attractiveness level of each individual subject.Conclusions:The presence of a malocclusion has a negative impact on facial attractiveness. Orthodontic correction of a malocclusion affects overall facial esthetics positively. Laypeople and orthodontists agree on what is attractive. Overall facial harmony is the most important characteristic used in deciding facial attractiveness.     

Perceptions of Jordanian laypersons and dental professionals to altered smile aesthetics

The purposes of this study were to rate the attractiveness of different smile variables, to compare the perception of Jordanian laypeople, general practitioners, and orthodontists to altered smile aesthetics, and to identify the threshold where different variables begin to impair smile aesthetics. A smiling photograph of a female dental student was selected and digitally manipulated to create changes in buccal corridor space (BCS), the amount of gingival display, and the midline diastema. These altered images were rated by three groups of Jordanians: 200 laypeople (100 females and 100 males), 200 general practitioners (100 females and 100 males), and 160 orthodontists (40 females and 120 males). Smile aesthetics scores were calculated and comparisons between groups were performed using the univariate general linear model. The results showed that profession and gender affected BCS and midline diastema attractiveness ratings (P<0.001). Wide BCSs, a gingival display of more than 2 mm, and the presence of a midline diastema of any size were rated as unattractive by all groups.     

Attractiveness of variations in the smile arc and buccal corridor space as judged by orthodontists and laymen

OBJECTIVE: To evaluate changes in attractiveness on the basis of computerized variations of smile arcs and buccal corridors for male and female smiles judged by orthodontists and laypersons. MATERIALS AND METHODS: Using a visual analog scale in a Web-based survey, orthodontists and laypersons rated the attractiveness of nine digitally altered smile arc and buccal corridor variations of male and female smiles. The variations were accomplished in a clinically relevant manner and based on standards set by experienced orthodontists in a pilot web-based survey. RESULTS: The results indicate that both laypersons and orthodontists prefer smiles in which the smile arc parallels the lower lip and buccal corridors are minimal. Significantly lower attractiveness ratings were found for smiles with flat smile arcs and excessive buccal corridors. Flattening of the smile arc overwhelms the deleterious effects of excessive buccal corridors on attractiveness ratings. CONCLUSIONS: On the basis of the results of this study, care should be taken not to produce an excessively flat smile arc during orthodontic treatment.     

The influence of dental to facial midline discrepancies on dental attractiveness ratings

This study investigated the perception of discrepancies between the dental and facial midlines by orthodontists and young laypeople. A smiling photograph of a young adult female was modified by moving the dental midline relative to the facial midline. Twenty orthodontists (10 males and 10 females) and 20 young adult laypeople (10 males and 10 females) scored the attractiveness of the smile on the original image and each of the modified images using a 10-point scale. The results showed that the images were scored as less attractive both by the orthodontists and laypeople as the size of the dental to facial midline discrepancy increased. The scores were unrelated to the direction of the midline discrepancy (left or right) or to the gender of the judge. Further analysis revealed that the orthodontists were more sensitive than laypeople to small discrepancies between the dental and facial midline. It was estimated that the probability of a layperson recording a less favourable attractiveness score when there was a 2-mm discrepancy between the dental and facial midlines was 56 per cent.     

Upper canine inclination influences the aesthetics of a smile

This current study investigated which angle of canine inclination (angle between canine tooth axis (CA‐line) and the line between the lateral canthus and the ipsilateral labial angle (EM‐line)) is perceived to be most attractive in a smile. The second objective was to determine whether laymen and dental experts share the same opinion. A Q‐sort assessment was performed with 48 posed smile photographs to obtain two models of neutral facial attractiveness. Two sets of images (1 male model set, 1 female model set), each containing seven images with incrementally altered canine and posterior teeth inclinations, were generated. The images were ranked for attractiveness by three groups (61 laymen, 59 orthodontists, 60 dentists). The images with 0° inclination, that is CA‐line (maxillary canine axis) parallel to EM‐line (the line formed by the lateral canthus and the ipsilateral corner of the mouth) (male model set: 54·4%; female model set: 38·9%), or ?5° (inward) inclination (male model set: 20%; female model set: 29·4%) were perceived to be most attractive within each set. Images showing inward canine inclinations were regarded to be more attractive than those with outward inclinations. Dental experts and laymen were in accordance with the aesthetics. Smiles were perceived to be most attractive when the upper canine tooth axis was parallel to the EM‐line. In reconstructive or orthodontic therapy, it is thus important to incline canines more inwardly than outwardly.     

Mechanics to Enhance Facial and Smile Esthetics

The parameters for achievement of treatment success sometimes differ between patients and orthodontists, while patients focus on esthetics, orthodontists usually emphasize occlusal criteria. Although smile esthetics is an extensive topic, clinicians must understand the main principles of an ideal smile in order to use the appropriate orthodontic mechanics to enhance facial and smile esthetics. The objectives of this paper are: 1) to review the two main principles of a beautiful and youthful smile to guide the clinician to visualize the main esthetic goals of orthodontic treatment, and 2) to present two clinical situations where appropriate orthodontic mechanics were used to obtain optimal facial and smile esthetics results.     

Influence of facial type on attractiveness of vertical canine position from the perspective of orthodontists and laypeople

ObjectivesTo evaluate the attractiveness of changes in vertical position of maxillary canines in frontal smiles of different facial types, and to evaluate the esthetic perceptions of orthodontists and laypeople, and the influence of facial type on these perceptions.Materials and MethodsThree adult female volunteers were selected as individuals with normal, vertical, and horizontal growth patterns. Frontal posed smile photographs were digitally altered by adjusting vertical positions of the maxillary canines above, below, or coincident with the incisal line in increments of 0.5 mm within a range of 1 mm of extrusion and intrusion. For assessment, a web-based survey was formed with 18 images (six images for each model). A scale was present underneath each image, graded from 0 to 10 (0: unattractive; 10: the most attractive). Images were rated by 233 participants (105 orthodontists; 128 laypeople).ResultsOrthodontists scored 0-mm images significantly as the highest in all groups. Laypeople scored significantly higher for −0.5 mm images regardless of facial type. The lowest scored images were −1 mm (except for horizontal pattern) and +1 mm images. Mean values of scores given by men were higher (P < .05).ConclusionsOrthodontists favored ideal dental alignment and preferred the incisal edges of central and canine teeth to be at the same level. Laypeople preferred a smoother smile arc than orthodontists and found harmony with the soft tissue more attractive. Facial type affected perceptions of the vertical changes of maxillary canines.