Private practice, London, UK; and Former Visiting Student, Division of Prosthodontics and Restorative Dentistry, Faculty of Dentistry, McGill University, Montréal, Quebec, Canada.
Implant Fellow, Department of Reconstructive Dentistry, School of Dental Medicine, Faculty of Medicine, University of Bern, Berne, Switzerland; and Research Associate, Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montréal, Quebec, Canada.
J Prosthet Dent. 2017 Dec;118(6):717-724. doi: 10.1016/j.prosdent.2017.04.032. Epub 2017 Sep 1.
An objective definition of the characteristics that render a smile esthetically acceptable in the eye of laypeople is lacking.
The purpose of this systematic review was to identify, appraise, and synthesize the available evidence on the opinion of laypeople regarding the dentogingival characteristics that render a smile esthetically acceptable. The evidence was collected by surveying with standardized digitally modified smile images.
Four databases were used to search English language studies published between January 1996 and December 2015. This was complemented by a manual search of 8 dental journals. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, 2 independent reviewers extracted the relevant characteristics of lay evaluators, the images evaluated, and the outcomes measure. Included studies were assessed in agreement with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Outcomes were treated as a continuous variable, and when more than 1 article provided information on a parameter, the weighted arithmetic mean was calculated.
After 8851 articles were screened, 20 studies were included. Those studies addressed 20 different dentogingival esthetic parameters. The total number of participants interviewed was 3107. According to the Olmos classification, 6 studies had a high level of quality, and 14 studies had a moderate level of quality. The 2 reviewers agreed on all the quality assessments. In the articles reviewed, central incisors clearly played a key role in smile esthetics. Almost all dental, gingival, and occlusal parameters are related to the proportion, shape, and position of central incisors and their relation to the adjacent dental structures.
The present review provides the estimated thresholds of tolerability and ideal values of smile parameters determined by laypeople. This may guide clinicians in evidence-based diagnosis and the planning of dental esthetic treatments.
缺乏一个客观的定义，来描述那些能使外行看起来美观的笑容的特征。
本系统综述的目的是确定、评估并综合现有关于外行对能使笑容美观的牙齿牙龈特征的看法的证据。通过使用标准化的数字修改后的微笑图像进行调查来收集证据。
使用四个数据库搜索了 1996 年 1 月至 2015 年 12 月期间发表的英文研究。此外，还对 8 种牙科期刊进行了手动搜索。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，两名独立的审查员提取了外行评估者、评估的图像和结果测量的相关特征。纳入的研究根据加强观察性研究的报告流行病学（STROBE）标准进行评估。结果被视为连续变量，当超过 1 篇文章提供了某个参数的信息时，计算加权算术平均值。
经过对 8851 篇文章的筛选，共有 20 项研究被纳入。这些研究涉及 20 种不同的牙齿牙龈审美参数。接受采访的参与者总数为 3107 人。根据 Olmos 分类，6 项研究具有较高的质量水平，14 项研究具有中等质量水平。两名审查员对所有质量评估都达成一致。在审查的文章中，中切牙显然在微笑美学中起着关键作用。几乎所有的牙齿、牙龈和咬合参数都与中切牙的比例、形状和位置以及它们与相邻牙齿结构的关系有关。
本综述提供了由外行确定的可容忍度和微笑参数的理想值的估计阈值。这可以指导临床医生进行基于证据的诊断和牙科美学治疗的计划。
