title: Laypersons' esthetic perception of various computer-generated diastemas: a pilot study.
abstract: BACKGROUND
  Managing excess anterior spacing is a common problem in dental practice. During orthodontic or restorative treatment planning, clinicians must decide how to distribute this space. However, few reports are available in the dental literature about the attractiveness and esthetic impact of anterior spaces other than midline diastemas.
  
  
  OBJECTIVE
  The purpose of this study was to compare the esthetic perception of 4 different anterior diastemas, including simian diastemas (symmetrical diastemas between lateral incisor and canine), diastemas suggested by Frush and Fisher (asymmetrical diastemas between lateral incisor and canine and between central and lateral incisor), and by Lombardi (slight midline diastema and 2 larger diastemas between central and lateral incisors), and a midline diastema.
  
  
  METHODS
  A picture of a young woman's smiling face was modified by using photoediting software to create the 4 previously mentioned diastemas. The resulting pictures were presented to laypersons questioned in French public places. The participants were asked to rank the pictures from most to least attractive, then to rate them with a mark from 1 to 10.
  
  
  RESULTS
  One hundred and five participants completed the questionnaire. The median ranks and scores attributed to the pictures from most to least attractive were as follows: simian diastemas, 1 and 8; Frush and Fisher diastemas, 2 and 7; Lombardi diastemas, 3 and 5; and midline diastemas, 4 and 4, respectively. The hierarchy (simian diastemas>Frush and Fisher diastemas>Lombardi diastemas>midline diastemas) could be established statistically for the scores (P=.03, P<.001, and P<.001, respectively) but not for the ranks when adjusting on subjects' sex and age (P=.11, P=.03, and P=.06, respectively).
  
  
  CONCLUSIONS
  The results showed an esthetic hierarchy of anterior diastemas. The negative perception of anterior diastemas seems to mainly be related to the presence and width of a midline diastema. These results can guide clinical decisions for patients with excess anterior spacing.
authors.affiliation: Fellow Teacher, Department of Prosthodontics, Faculty of Dentistry, Bordeaux Segalen University; Private practice, Toulouse, France; Assistant Lecturer, Department of Biomaterials (URB2i, EA4462), Clinical Research Unit, Faculty of Dentistry, Paris Descartes University; Doctural student, Paris North 13 University; Teacher, Conservative Dentistry and Endodontics, APHP, Dentistry Service, Charles Foix Hospital.
authors.forename: Ali
authors.initials: A
authors.lastname: Noureddine
authors.affiliation: Private practice, Toulouse, France; Lecturer, Department of Prosthodontics, Faculty of Dentistry, Bordeaux Segalen University; Private practice, Bordeaux, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Fron Chabouis
authors.affiliation: Fellow Teacher, Department of Prosthodontics, Faculty of Dentistry, Bordeaux Segalen University; Private practice, Toulouse, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Parenton
authors.affiliation: Lecturer, Department of Prosthodontics, Faculty of Dentistry, Bordeaux Segalen University; Private practice, Bordeaux, France. Electronic address: lasserre.jean-francois@wanadoo.fr.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Lasserre
mesh_terms: D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D003481:Cuspid / Q000473:pathology; D003970:Diastema / Q000473:pathology*; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012737:Sex Factors; D055815:Young Adult