Does the vertical position of maxillary central incisors in men influence smile esthetics perception?

Introduction: The aim of this study was to investigate whether there is any influence on the perception of smile esthetics among orthodontists and laypersons, with regard to different vertical positions of the maxillary central incisors. Methods: Frontal smile photographs digitally altered at full-face view and close-up view of 2 adult men aged between 20 and 30 years were used. Six vertical positions of the central incisors were created, with changes of 0.5 mm. The images were randomly assembled in an album that was presented to 53 orthodontists and 53 laypersons, who evaluated the attractiveness of the images by using visual analog scales. Comparison among the images was performed using 1-way analysis of variance, with Tukey post-hoc test. To compare the distribution of the mean scores between the full-face and close-up smile views, and between orthodontists and laypersons, the Student t test was used. The level of significance was established at 5%. Result: The best evaluations presented the following: (a) the gingival margins of the central incisors corresponded to, or were up to, 1 mm below the line of the canine gingival margins, and (b) the incisal step between the central and lateral incisors was from 1.0 to 2.0 mm. The smiles considered least attractive showed (a) the central incisor gingival margins were 1.0 mm above or 1.5 mm below the canine gingival margins, and (b) no step, or a step of 2.5 mm, between the central and lateral incisors. Conclusion: The results of this study suggested that, in men, slightly extruded central incisors were esthetically more attractive than intruded incisors.