Analysis of Geometric Proportions on Maxillary Anterior Teeth for Esthetic Smile Design: An In vivo Study

Background and Objectives: The maxillary central incisor is the dominant element of anterior dental composition and hence should be restored or replaced with proper proportion of width and length for better aesthetic results. However, the literature is not clear regarding verifiable guidelines for the determination of proportions of the teeth. The aim of this study was to investigate the existence and suitability of Golden Rectangle, Recurring Aesthetic Dental Proportion, and Golden percentage between the widths of maxillary anterior teeth in individuals with natural dentition, with the aid of digital photographs and computer analysis. Material and Methods: Frontal full-face digital photographs of the subjects (in smile) were made under standardized conditions using a digital camera and a tripod stand was used to place and orient the camera in the standardized position (camera was positioned 1 meter away from the patient; and the lens of the camera was adjusted at the patients' lip level). Imaging software (Adobe Photoshop CS5; Adobe Systems, Inc, San Jose, Calif.) was used to mark the anatomic landmarks and to digitally analyze the photograph. The entire process of proportion analysis was done by a single observer. Results: The RED proportion was not found to exist between the six maxillary anterior teeth. The values suggested in the golden percentage were not applicable on the subjects of this study. However, a slight modification of these percentages can be adopted taking into consideration the ethnicity differences of the subjects in this study. The values obtained were 24%, 15%, 11% in males and 23%, 15%, and 11% in females. Golden rectangle concept can be used for choosing dimensions of maxillary central incisors which are esthetically pleasing. Conclusion: RED proportion is an unsuitable methods to relate the successive widths of the maxillary anterior teeth. The golden percentage theory seems to be applicable to relate the successive widths of the maxillary anterior teeth if percentages are adjusted taking into consideration the ethnicity of the population. Golden rectangle concept is suitable for choosing dimensions of maxillary central incisors which are esthetically pleasing.