The influence of varying maxillary central incisor vertical dimension on perceived smile aesthetics

To evaluate patient perception of the smile focused on analysis of the upper incisors. Cross-sectional study. Department of Clinical and Social Dentistry at Federal University of Paraíba, Jo？o Pessoa, Brazil. The sample consisted of 135 individuals (73 women and 62 men). Images with different characteristics associated with the incisal edges were shown at random and analysed using a Likert scale. Data were analysed using the Chi-square test or Fisher’s exact test with a statistically significant difference (P < 0.05). Smile I (difference of 1.5 mm in relation to the central incisor and lateral) was considered the most aesthetic, while Smile III (no difference in height between the central and lateral incisors) was the least aesthetic. A significant difference was found between perception of smile II (difference of 1 mm in relation to the central incisor and lateral) and age groups (P < 0.005), with 31% (n = 13) of individuals aged 45–64 years considering smile II as not pleasant, 4.4% (n = 2) aged 15–24 years and 8.3% (n=4) aged 25–44 years and 4.4% (n = 2) aged 15–24 years considering the same. A significant difference was also found in relation to educational background of the assessor and smile perception, with smile III (P = 0.0441) and smile IV (P = 0.0053) considered the most aesthetic (P = 0.0116). The smile considered most attractive among the sample was that with 1.5 mm steepness between the central and lateral incisors, while a flat smile arc was considered least attractive