title: Influence of bimaxillary protrusion on the perception of smile esthetics.
abstract: OBJECTIVE
  To evaluate the impact of bimaxillary protrusion on smile esthetics as perceived by dental professionals and laypersons.
  
  
  METHODS
  One hundred and fifty evaluators, equally distributed into their respective panels (orthodontists, general dentists, and laypersons), participated in this cross-sectional study conducted in April to December 2012 in Riyadh, Saudi Arabia. The patient sample consisted of 14 female patients divided equally into 2 groups: bimaxillary protrusion patients, and patients who have had 4-premolar extraction treatment. Two standardized photographs (frontal and three-quarter close-up smile views), and a lateral cephalogram were taken for each patient. The evaluators were asked to rate the attractiveness of each photo according to a 100-mm visual analog scale. These esthetic ratings were correlated with the patients' cephalometric measurements.
  
  
  RESULTS
  The bimaxillary protrusion group was rated significantly as less attractive than the treatment group by each evaluator panel. Panel comparison showed that laypeople were less receptive of bimaxillary protrusion than dental professionals. Frontal and three-quarter views of the same smiles were not similarly rated for esthetic perceptions. Correlational analysis revealed that the dentoalveolar measurement with the highest significant negative correlation to the smile esthetics was the upper incisors to palatal plane (U1-PP) angle.
  
  
  CONCLUSIONS
  Patients with bimaxillary protrusion were found to be less attractive than patients who were treated for the condition. This was especially evident among the laypersons. An increase in the upper incisor inclination, as well as a decrease in the interincisal angle compounds the bimaxillary effect.
authors: Dental Department, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail. terki.k.m@gmail.com.
authors: Terki K
authors: TK
authors: Almutairi
authors: Sahar F
authors: SF
authors: Albarakati
authors: Abdullah M
authors: AM
authors: Aldrees
mesh_terms: D001291:Attitude of Health Personnel; D002508:Cephalometry; D003430:Cross-Sectional Studies; D004954:Esthetics; D005260:Female; D006801:Humans; D008437:Maxilla / Q000033:anatomy & histology*; D010465:Perception; D012529:Saudi Arabia; D012904:Smiling; D014070:Tooth / Q000033:anatomy & histology*
references: Community Dent Oral Epidemiol. 1992 Aug;20(4):214-20
references: 1526107
references: Am J Orthod Dentofacial Orthop. 1993 Sep;104(3):240-50
references: 8362785
references: J Orthod. 2011 Jun;38(2):107-12
references: 21677102
references: Angle Orthod. 1970 Oct;40(4):284-318
references: 4917993
references: Saudi Med J. 2010 May;31(5):512-9
references: 20464040
references: Am J Orthod. 1983 Jan;83(1):38-43
references: 6571770
references: Eur J Orthod. 2011 Aug;33(4):450-6
references: 21041837
references: Am J Orthod Dentofacial Orthop. 2006 Jan;129(1):8-16
references: 16443472
references: J Am Dent Assoc. 1979 Feb;98(2):209-12
references: 284066
references: Am J Orthod Dentofacial Orthop. 2004 Dec;126(6):739-46
references: 15592224
references: Angle Orthod. 2005 May;75(3):333-9
references: 15898369
references: Am J Orthod Dentofacial Orthop. 2005 Mar;127(3):343-50
references: 15775949
references: Angle Orthod. 2003 Aug;73(4):359-64
references: 12940555
references: Am J Orthod Dentofacial Orthop. 2004 Sep;126(3):290-5
references: 15356488
references: J Esthet Dent. 1999;11(6):311-24
references: 10825866
references: Angle Orthod. 2011 Jan;81(1):86-90
references: 20936959
references: SADJ. 2010 Oct;65(9):404-8
references: 21180286
references: Am J Orthod Dentofacial Orthop. 2007 Sep;132(3):307-15
references: 17826598
references: J Am Dent Assoc. 1980 Mar;100(3):345-52
references: 6928165
references: Am J Orthod Dentofacial Orthop. 2009 Dec;136(6):762.e1-14; discussion 762-3
references: 19962590
references: J Esthet Dent. 1997;9(2):76-85
references: 9468856
references: J Orthod. 2004 Sep;31(3):204-9; discussion 201
references: 15489364
references: Br Dent J. 1975 Mar 18;138(6):211-6
references: 1054599
references: Am J Orthod Dentofacial Orthop. 2009 Apr;135(4 Suppl):S61-71
references: 19362268
references: Angle Orthod. 2011 Jan;81(1):153-61
references: 20936969