Noura M Alhassani and Moosa Abuzayda
A perfect smile improves the self-confidence, personality; social life and psychology by improving self-image with enhanced self-esteem of the patient. While not every person is born with a perfect and attractive smile, qualities such as straightness, cleanliness or whiteness of teeth may come to mind. Thanks to developments in the field of cosmetic dentistry, people can change the smile they were born with into a smile they love. Several treatment modalities have been proposed to restore the aesthetic appearance of the dentition such as chemical bleaching or full crowns which was considered the most predictable and durable aesthetic correction of anterior teeth. However, this approach is undoubtedly most invasive with substantial removal of large amounts of sound tooth substance and possible adverse effects on pulp and periodontal tissues. Smiles can be improved by veneering teeth using a relatively conservative technique. The appearance of veneers and smile design has not been previously investigated in the UAE. This study aimed to assess the aesthetic preferences of different smile designs rated by a group of prosthodontics residents and specialists.
A questionnaire was devised asking about demographic details such as age and gender of the participant, educational country as well as clinical experience before and after graduation. Images of ten cases that had ceramic veneers fitted on their anterior teeth were included in the questionnaires. There were two images for each case: smiling with lips shown and close-up with retracted lips and cheeks. Each case had 7 questions and the respondents were asked to evaluate and compare the dental aesthetics patterns of porcelain laminate veneer for each case. Each question had a 5 point Likert rating scale from poor to excellent. Images of veneers were taken from patients treated in Ministry of Health Centers in UAE and private dental clinics in Sharjah and Dubai. All patients were over 18 years old and had a minimum of two and up to a maximum of ten porcelain laminate veneers in the maxillary and/or mandibular anterior region placed more than 6 months previously. Patients were not included if any of the following conditions were present, teeth indicated for restoration (for example with a crown) and the presence of advanced dental caries. A questionnaire was distributed among 25 clinicians, they were selected from UAE recognized Specialists in prosthodontics and prosthodontics residents from Hamdan Bin Mohamed College of Dental Medicine. The specialists were recruited from the DHA/ MOH/CPQ database. The participants were therefore not a random sample but a convenience sample and not representative of the residents or specialist prosthodontics’ in Dubai or in the UAE. A Total of 10 Cases Were Evaluated by Each Clinician. The Different Clinical Situations Were as Follows: Figure 1: A, case1, Gummy smile with visible lower teeth; B, case2, Flat incisal plane not following the lower lip line; C, case3, Square teeth with flat incisal plane; D, case4, Half-crwns visible; E, case5, Midline discrepancy, case6, Incisal plane following lower lip line; B, case7, Good incisal curvature following the lower lip line with very white teeth; C, case8, visible papillae following the lower lip curvature and no contact with lower lip; D, case9, Long teeth contacting the lower lip; E, case10, Gingivitis The participants evaluated the appearance of the patient smile, veneer shape, contour and shade, the length/width ratio of the teeth, the relationship of incisal edges to the lower lip, the relationship of the soft tissue around the teeth and the tooth display and lip position when smiling.
A Total of 10 Cases Were Evaluated by Each Clinician. The Different Clinical Situations Were as Follows:
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