Smile aesthetics perception of posterior gingival exposure among periodontists, orthodontists, general practitioners, dental students, and laypeople: a cross-sectional study
DOI:
https://doi.org/10.4322/bds.2026.e4858Abstract
Introduction: The smile is one of the key points in the perception of facial aesthetics and is considered pleasant when there is harmony among the teeth, lips, and gums. However, few studies have focused on the impact of posterior gingival exposure (PGE). Objective: Therefore, the present study aims to evaluate the effect of gingival exposure in the posterior part of the maxilla on the perception of smile aesthetics in a group of periodontists, orthodontists, general dental practitioners (GDP), dental students, and laypeople. Methods: A standardized photograph corresponding to a clinical case without posterior gingival exposure was digitally modified to generate 2, 4, and 6 mm PGE. These were randomized, and the smile aesthetics in the four images were evaluated and scored using a visual analog scale (VAS), where 0 corresponded to aesthetically unacceptable and 100 to the most aesthetically acceptable. The evaluations were carried out by 125 participants, divided into the following groups: GDP, orthodontists, periodontists, dental students, and laypeople. Results: According to results, gingival exposures of 6 mm were considered aesthetically unsatisfactory by most participants (72% periodontists, 68% orthodontists, 84% GDP, 76% dental students, and 52% laypeople). Only 0 mm and 2 mm exposures showed significantly higher values on the VAS scale (p<0.0001). Conclusion: It can be concluded that 6 mm of posterior maxillary gingival exposure negatively influenced the perception of smile aesthetics in all groups, with laypeople assigning higher attractiveness scores than GDP on the VAS scale at 6 mm. In contrast, 4 mm of gingival exposure appears to represent a threshold of aesthetic tolerance, being more readily accepted, particularly by laypeople and dental students.
KEYWORDS
Crown lengthening; Dental esthetic; Orthodontists; Perception; Periodontists.
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Copyright (c) 2026 Lucas Macedo Batitucci Ambrósio, Carina Salas-Gonzalez, Aline de Souza Mendes, Aline de Barros Nobrega Dias Pacheco, Pedro Ferreira Fogaça Neto, Milene Lorrane da Silva, Ana Luiza Lopes Braga, Mayra Laino Albiero, Bruna dos Reis Vieira, Eduardo Gomes de Jesus, Beatriz de Moura Souza, Marcela Iunes da Silveira, Emanuel da Silva Rovai
This work is licensed under a Creative Commons Attribution 4.0 International License.
Brazilian Dental Science uses the Creative Commons (CC-BY 4.0) license, thus preserving the integrity of articles in an open access environment. The journal allows the author to retain publishing rights without restrictions.
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