Designing a smile requires artistry and analysis. A smile that exposes beautiful natural teeth is one of the greatest assets a person can have. The dentist can render one of the most appreciated services to the patient by means of the restoration or rehabilitation of smile. An optimal esthetic result can be ensured only if the dentist has basic knowledge and understanding of the artistic elements.1 Moreover, the dentist has to understand beauty, harmony and proportion as perceived by the society.2
The subjective element of smile design may require years of experience for the dentist to develop the eye for beautiful smiles. The objective element has been studied by Ward who proposed Recurring Esthetic Dental Proportion3,4,5 that formulates the perfect smile rehabilitating balance and harmony with the face. The successive widths of maxillary anterior teeth have been correlated in terms of Golden proportion6 and more recently, Recurring Esthetic Dental Proportion. The tooth size (width and height) is an important aspect of esthetic reconstruction.7 The maxillary anterior teeth play an important role in dental as well as facial esthetics.8 Hence they must be in proportion to the facial morphology.7,9 Consequently, treatment planning for esthetic restorative dentistry and crown lengthening should be done only after thorough diagnosis of tooth width-to-length ratio in each patient.
The aims of this study were to compare width-to-length ratio of maxillary anterior teeth and evaluate the existence of Recurring Esthetic Dental (RED) Proportion in subjects (both males and females) with smiles considered attractive by the public.
MATERIALS AND METHODS
Fifty male subjects and fifty female subjects in the age group of 21-30 years were selected for this study. For standardization of the study a three member panel comprising of non-dentists was appointed to decide attractive smiles from the selected population. The inclusion criteria required the presence of all anterior teeth without any caries, restoration, incisal wear, mobility or any dentofacial deformity. Patients with history of orthodontic treatment were excluded from the study. The study was explained to each participant and informed consent was taken.
For the measurement of width and height of each tooth, a maxillary impression was taken with irreversible hydrocolloid (Tropicalgin, Zhermack, Italy) and cast in dental stone (Kalstone, Kalabhai, Mumbai, India) under vacuum (Fig. 1). A digital vernier calliper was used to measure the width of each tooth at the widest mesio-distal portion parallel to the incisal edge (Fig. 2). Similarly, the height of each tooth was measured (Fig. 3) at the longest apico-coronal portion (zenith point to incisal edge/tip of canine). The measurements were taken by a single investigator three times with the same method for accuracy. The mean was then calculated and used for analysis.
Standardized photographic images (Fig. 4) were captured by using EOS 1100...