Zorlu M, Camcı H. The relationship between different levels of facial attractiveness and malocclusion perception: an eye tracking and survey study. Prog Orthod 2023; 24: 29.

While a worsening of the ideal smile had a smaller impact on aesthetic perceptions in an individual with low facial attractiveness, it had a significant negative impact on a person with high facial attractiveness.

The study investigated the relationship between levels of facial attractiveness and the perception of different types of malocclusion. A preliminary questionnaire was used to assign photographs of three female patients to low, moderate, and high facial attractiveness designations. Seven modified photographs for each smile photograph of each of these three patients were created. The evaluated photographs were: P0: at rest position, P1: ideal smile, P2: - 2-mm (low) smile line, P3: + 4-mm gummy smile, P4: + 6-mm gummy smile, P5: maxillary anterior crowding, P6: median diastema, P7: polydiastema. An eye tracking device and a questionnaire were used to collect data from orthodontists, dentists, orthodontic patients, and laypeople.

Orthodontists and dentists had higher total fixation duration scores than orthodontic patients and laypersons. The maxillary anterior crowding photograph had the lowest visual analysis scale score at each attractiveness level. While a worsening of the ideal smile had a smaller impact on aesthetic perceptions in an individual with low facial attractiveness, it had a significant negative impact on a person with high facial attractiveness. Anterior crowding and diastema had a more negative impact on facial attractiveness than low or high smile lines.