Quantification of the esthetics of dentists’ before and after photographs

Rosenstiel, Stephen F.; Pappas, Maria; Teresa Pulido, M.; Rashid, Robert G.

doi:10.1016/j.jdent.2009.05.003

« PreviousJournal of Dentistry
Volume 37, Supplement 1 , Pages e64-e69, 2009

Quantification of the esthetics of dentists’ before and after photographs☆

Division of Restorative and Prosthetic Dentistry, The Ohio State University, College of Dentistry, Columbus, OH 43210-1267, United States

Received 30 March 2009; received in revised form 28 April 2009; accepted 5 May 2009. published online 15 May 2009.

Abstract

Purpose

The purpose of this study was to measure dentists’ before and after restorative treatment photographs to identify four metrics to describe the esthetic improvement: (a) central incisor width-to-height ratio; (b) central-to-lateral incisor width ratio; (c) lateral incisor-to-canine width ratio; and (d) lateral incisor percentage offset.

Materials and methods

Internet searches for “before after” and “veneers” and “prosthodontic” were used to obtain 198 before and after photographs of patient treatments showing the restoration of the six maxillary anterior teeth with porcelain veneers, crowns or a combination. The four metrics were measured using Adobe Photoshop. Groups were compared with repeated measures ANOVA followed by a post hoc Tukey–Kramer test with the variables of “Before or After Treatment”; “Treatment Type” (veneers, crowns or a combination) and “General Dentist or Prosthodontist”.

Results

Mean central incisor width-to-height ratio was 91.7% before treatment, 80.8% after; mean central-to-lateral incisor width ratios were 69.9% and 64.7%; mean lateral incisor-to-canine width ratios were 85.3% and 81.4% and lateral incisor percentage offsets were 9.6% and 8.7%. There were significant (p<0.05) differences for before and after treatment for all variables except central-to-lateral incisor width ratio. Differences between specialist and general dentist were not statistically significant.

Conclusions

On average, esthetic prosthetic treatment resulted in reduced central incisor width-to-height ratio, increased proportional width of the mesially positioned tooth of adjacent anterior teeth and reduced lateral incisor offset. The mean values of treatments by GPs and prosthodontists were not statistically significantly different.