title: Perception of the esthetic impact of mandibular incisor extraction treatment on laypersons, dental professionals, and dental students.
abstract: OBJECTIVE
  To evaluate the degree of perception of laypersons, dental professionals, and dental students regarding dental esthetics in cases with mandibular central incisor extraction.
  
  
  METHODS
  Using a smile photograph of a person with normal occlusion and all teeth, modifications were made to reflect the extraction of a mandibular incisor of various compositions and sizes. For this purpose a program specifically for image manipulation (Adobe Photoshop CS3, Adobe Systems Inc) was used. After manipulation the images were printed on photographic paper, attached to a questionnaire and distributed to laypersons, dental professionals, and dental students (n  =  90) to evaluate the degree of perception and esthetic using a scale of attractiveness, where 0  =  hardly attractive, 5  =  attractive, and 10  =  very attractive. The differences between examiners were checked by the Mann-Whitney test. All the statistics were performed with a confidence level of 95%.
  
  
  RESULTS
  The results demonstrated the skill of the dental professionals and dental students in perceiving the difference between cases of normal occlusion and cases where an incisor was lacking (P < .05). The photograph in which the lateral incisors were shown to be larger than the central incisor was the one that obtained the highest value among the cases of extraction in all groups of evaluators.
  
  
  CONCLUSIONS
  It can be concluded that dental professionals and dental students are more skillful at identifying deviation from normality. In addition, central incisor extraction should always be discarded when there are other treatment options available.
authors.affiliation: Department of Orthodontics, Southwest Bahia University UESB, Bahia, Brazil. matheuspithon@gmail.com
authors.forename: Matheus Melo
authors.initials: MM
authors.lastname: Pithon
authors.forename: Adrielle Mangabeira
authors.initials: AM
authors.lastname: Santos
authors.forename: Felipe Santos
authors.initials: FS
authors.lastname: Couto
authors.forename: Raildo
authors.initials: R
authors.lastname: da Silva Coqueiro
authors.forename: Lívia Maria Andrade
authors.initials: LM
authors.lastname: de Freitas
authors.forename: Ricardo Alves
authors.initials: RA
authors.lastname: de Souza
authors.forename: Rogério Lacerda
authors.initials: RL
authors.lastname: Dos Santos
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003766:Dental Occlusion; D003815:Dentists; D004955:Esthetics, Dental / Q000523:psychology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007180:Incisor; D008297:Male; D008334:Mandible; D023861:Photography, Dental; D018709:Statistics, Nonparametric; D013335:Students, Dental; D014081:Tooth Extraction / Q000009:adverse effects* / Q000523:psychology