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ABSTRACT ZET

Introduction: To evaluate smile esthetics, goldenproportions have been suggested in the literature, asone possible mathematic analysis tool to define, tomeasure and to analyze beauty.

Aim:The aims of this study are to evaluate whethergolden proportions can be perceived in orthodonti-cally treated patients by judgment of orthodontists,general dentists and laypeople and to exhibit diffe-rences among these groups in terms of age, sex andprofession.

Subjects and Method: The smiles of 16 orthodon-

tically treated patients were evaluated by 30 ortho-dontists, 30 dental practitioners and 30 laypeople. 5smiles with golden proportions and 11 smiles withoutgolden proportions were graded by the participantsaccording to the specified categories as bad (Category1), average (Category 2) and good (category 3). Thestatistical analyses were performed by using bothdescriptive and non-parametric tests.

Results: From 5 golden smiles, one smile (S4) wasgraded highest to be in category 1, 3 smiles (S1, S6,S13) were graded highest to be in category 2 andone smile (S9) was graded highest to be in category3. There were significant differences between thegrading of the smiles and the type of participants forboth golden smiles and non-golden smiles.

Giri: Altn Oran gzellii lmek ve analiz etmek iin

kullanlan matematiksel bir yntemdir. Literatrde

glmseme estetiini deerlendirmek iin Altn Oran

kullanlmas nerilmektedir.

Ama: Bu almann amac ortodontik tedavisi

tamamlanm bireylerin glmsemelerinde altn oran-

larn varlnn ortodontistler, di hekimleri ve deiik

meslek sahibi halktan insanlar tarafndan alglanmas-

nn incelenmesi ve bu gruplar arasnda ki farkllklarn

ya, cinsiyet ve meslek asndan deerlendirilmesi-

dir.

Bireyler ve Yntem: Ortodontik tedavi gren 16hastann glmseme fotoraf 30 ortodontist, 30

dihekimi ve 30 salk meslei dndaki birey tara-

fndan incelenmitir. 16 fotorafn 5inde altn oran

mevcuttur. Bireyler fotoraflar; kt (kategori 1),

averaj-orta (kategori 2) ve iyi (kategori 3) eklinde

deerlendirmitir. Non-parametrik testler kullanlarak

istatistiksel analiz yaplmtr.

Bulgular: Altn Orana sahip 5 glmsemeden S4

kategori 1de en yksek skoru almtr. S1, S6 ve S13

kategori 2de ve S9 kategori 3te en yksek skoru

almtr. Hem altn orana sahip olan ve olmayan

glmsemeler arasnda, hem de katlmclar arasnda

istatistiksel olarak nemli farkllklar bulunmutur.

Hacettepe Di Hekimlii Fakltesi Dergisi

Cilt: 32, Say: 1, Sayfa: 55-64, 2008

Perception of Golden Proportions in

Orthodontically Treated Smiles

Ortodontik Tedavi Gren BireylerdeGlmsemenin Altn Oran

Ynnden Deerlendirilmesi

*Hakan EL DDS, PhD, **A. Sinan TRKYILMAZ PhD, *lken KOCADEREL DDS, PhD****Sabriye Elif SAGUN

*Heepe Uivesiy Fuy of Deisy Depme of Ohodois**Heepe Uivesiy Isiue of Popuio Sudies****Sude Heepe Uivesiy Fuy of Deisy

ARATIRMA (Research)

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IntrODUctIOn

Golden proportion has been suggested as

one possible mathematic analysis tool to define,

to measure and to analyze beauty1,2. As well as

using the golden proportions to define facial

beauty, it has also been suggested that it can be

used to evaluate smile esthetics3,4.

Lombardi9 was the first to propose the ap-

plication of the golden proportion in dentistry.

Ricketts3 developed a caliper to measure the ex-

istence of golden proportions in the dentition.

Preston16; instead of using the exact proportions,

considered the 0.61 0.63 range to be the gold-

en ratio. Alternatively, Manshid et al.17 examined

the golden ratio within the 0.55 0.64 range.

The golden proportion is also recommended in

some textbooks as a guideline to establish maxil-

lary anterior teeth esthetics16,18-21.

Current literature about this subject describes

the esthetic elements of the dentition either us-ing the golden proportions3,5,9 or with other ele-

ments like the lip line, smile arc, upper lip cur-

vature, lateral negative space, smile symmetry,

frontal occlusal plane, dental components and

gingival components.6-14

Smile esthetics in treated and non-treated

patients has also been evaluated by judgments

of specialists and laypeople according to specific

criteria.22-25 However, none of these studies havetaken the golden proportions into account.

Therefore, the aims of this study are to evalu-

ate whether golden proportions can be perceivedin orthodontically treated patients by the judg-

ments of orthodontists, dental practitioners and

laypeople and to exhibit differences among these

groups in terms of age, sex and profession.

SUBJEctS anD MEtHOD

Sixteen patients (9 female, 7 male) with a

mean age of 15.4 1.20 years who received

nonextraction orthodontic treatment were evalu-

ated in order to define the existence of golden

proportions in their maxillary anterior teeth. Fa-

cial frontal photographs were taken from each

patient during smiling at a constant object-to-

lens distance using a digital camera (Nikon Photo

Products, Tokyo, Japan) with the same settings.

Photographs were then imported to Adobe Pho-

toshop CS (Adobe Systems Inc., San Jose, CA,

USA) image editing program. Golden propor-

tions for smile photographs were evaluated by

one investigator using the same software. The

photographs were cropped with the same dimen-

sions so that only the smiles were visible. The

following golden proportion criteria for smile

photographs were evaluated by one investigator

using the same image processing software:

1. The width of the maxillary central and

maxillary lateral incisors,

2. The width of the maxillary canine as seen

on frontal smile photograph and the width of thelateral incisors,

KEYWORDSSmile Esthetics, golden proportion, smile evaluation

ANAHTARKELMELERGlmseme, estetik, altn oran, glmseme

deerlendirilmesi

Conclusions: Golden proportions alone have beenfound that they do not create a significant differencein perception of smile esthetics. Smiles that includeboth the observational and the golden proportioncriteria are probably perceived more esthetically. Ageand gender are not differentiating fa

Sonular: Glmseme estetiinin alglanmasnda altnoranlarn tek bana belirgin bir farkllk oluturmadgrlmtr. Hem gzlemsel hem de altn oran kriter-lerini tayan glmsemelerin daha estetik olarak alg-lanmaktadr. Ya ve cinsiyet glmseme estetiininalglanmasnda nemli bir farkllk oluturmamtr.

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3. The distance between the distals of the

two upper lateral incisors and the distals of the

two central incisors,

4. The distance between the buccal surfaces

of the upper first bicuspids and the distals of thetwo lateral incisors,

5. width of the smile (the distance between

the commissure and the midline) and the total

width of the central incisor, lateral incisor and

canine as seen on frontal smile photographs.

The golden proportions were evaluated with-

in the range of 0.55 to 0.64 and 0.61 to 0.63

instead of using the exact 0.618 ratio. 15 days

later sixteen images were remeasured under thesame conditions by another investigator to estab-

lish the validity of measurements. The examina-

tions indicated a correlation of 0.96 for the two

measurements.

Evaluation of the smiles revealed five patients

(S1, S4, S6, S9 and S13 (Figure 1)) within the

range of 0.55 to 0.64 and from among this five,

only one patient (S9) was within the range of

0.61 to 0.63. Therefore, these five patients (3female, 2 male) were selected as the golden pro-

portion group (GPG). The remaining 11 patients

(6 female, 5 male) were selected as the non-gold-

en proportion group (NGPG).

After selecting the sample group, a poster

reflecting all 16 smiles was prepared using the

Adobe Photoshop CS computer program. The

GPGs photographs were placed in between the

NGPGs photographs in a mixed manner. Onlyone investigator of this study knew which photo-

graphs belonged to the GPG. Each photograph

was given a rank number starting from 1 and

ending at 16 (S1, S2, S3 etc.). Also a form was

prepared where rows were labeled with the rank

number of the smiles in concordance with the

poster and the columns were labeled categoriz-

ing the grades as Bad, Average and Good.

The study sample consisted of randomly se-

lected 30 orthodontists (20 female, 10 male), 30general dentists (15 female, 15 male) and 30 lay-

people (15 female, 15 male) with a total of 90

(50 female, 40 male) people. The ages of the

participants varied from 23 to 43 years old with

a mean age of 28.66 4.58 years. Of these 90

participants, 62 (68.9%) people were below 30

years of age and 28 (31.1%) people were above

30 years of age.

Poster presentation was shown one by oneto all of the participants and they were asked to

fill out the forms to rate the beauty of the smiles.

Sufficient time was given to each participant to

evaluate the smiles freely and to revise the scores

they have given.

The scores of the participants were trans-

ferred to SPSS 12.0 program (SPSS Inc., Chi-

cago, IL, USA). To describe the scores (bad,

average and good) to the program, each score

was given a numerical value; as for 1 being thebad (category 1), 2 being the average (category 2)

and 3 being the good (category 3).

The analyses were performed by using both

descriptive and non-parametric tests. The level

of significance was established as p< 0.05 for all

statistical tests.

rESUltS

Standard smile photographs of 16 patientswho were treated with a non-extraction treat-

FIGURE I

Smiles used in the present study. S1, S4, S6, S9 and S13 belongto the GPG. S2, S3, S5, S7, S8, S10, S11, S12, S14, S15 and S16

belong to the NGPG

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ment approach were measured according to the

specified golden proportion criteria. The results

of grades given by participants and chi-square

test are presented on Table I.

52 participants (20 orthodontists, 15 generaldentists, 17 laypeople) graded S9 with a score

of 3. S11 and S14 were found to be the least

desirable smiles. S3 and S7 received high scores

also, although they were not in the GPG. From

5 golden smiles, one smile (S4) was graded the

highest to be in category 1, 3 smiles (S1, S6,

S13) were graded the highest to be in category 2

and one smile (S9) was graded the highest to be

in category 3 (Figure 2).

According to Pearsons chi-square test, a sig-

nificant difference was found between the type

of participant and the grade of the smile for S1

(2=31.2, p=0.00), S4 (2=11.44, p=0.022), S5

(2=10.18, p=0.038), S8 (2=18.86, p=0.001),

S12 (2=13.48, p=0.009) and S16 (2=15.59,

p=0.004) (Table I). No significant difference was

found between the type of participant and the

grade of smile for the remaining smiles. In the

GPG group, no significant difference was found

for S6 (2=2.97, p=0.564), S9 (2=1.78, p=0.776)

and S13 (2=8.87, p=0.065). (Table I)

The results of Kruskal-Wallis and Mann Whit-

ney U tests are given on Tables II and III. When

the grading of smile is considered for gender,

significant differences were only found for S13

(z=-1.98, p=0.048) and S14 (z=-2.02, p=0.044)

(Table II). Table III shows the gender differences

of participants separately for each group. No

significant gender differences were found in thegrading of smiles in the orthodontists and the

general dentists group. The only significant differ-

ence was found for S13 (z=-2.69, p=0.007) and

S14 (z=-2.32, p=0.020) for the laypeople group.

Significant differences were also observed for S4

(z=-3.15, p=0.002), S5 (z=-2.33, p=0.020) and

S16 (z=-2.75, p=0.006) when the age groups are

taken into account (Table II). However, the type

of participant has been found to create a more

significant difference in terms of perception.

DIScUSSIOn

Our patients primary reason for seeking

orthodontic treatment is often to improve his/

her dental and/or facial esthetics26. When orth-

odontic treatment alone is planned, it is utmost

important to provide a pleasing smile for a pa-

tient since this final esthetic outcome may be his/

her benchmark for the assessment of treatment

success. Many studies have been conducted on

smile esthetics9-13,24,25 revealing several criteria.

Among these criteria, golden proportions have

been proposed to the literature to evaluate smiles

in a quantitative way3,4,9,15. However, the percep-

tion of these proportions by diversely educated

groups of people has never been evaluated for

the patients who have received an orthodontic

treatment.

The mean age of orthodontic patients used

for this study was 15.4 1.20 years. It is known

that with the aging process exposure of maxil-

lary incisors decrease while smiling28,29. So this

factor was eliminated by selecting a young group

of patients for smile evaluation.

When taking photographs from the patientsfor a smile study, it is important to differentiate

between a posed and a spontaneous smile. A

posed smile is reproducible and can be used as

a reference position13 while a spontaneous smile

causes the upper lip to elevate more12. At least

three photographs were taken from each pa-

tient in order to obtain the posed smiles. Golden

proportions used in this study were specified ac-

cording to the studies of Levin15 and Ricketts3.

However, instead of using the exact proportions,the ranges used in Preston (0.610.63)16 and

Manshid (0.550.64)17 studies were utilized be-

cause none of the smiles reflected all five golden

proportions in exact 0.618 value.

Perception of golden proportions was evalu-

ated in 2 dimensions in the present study. First

one is the direct perception of the smile itself.

The second one is the perception of the smile

within the subgroups of the participants, which

are the type of participants, the gender and theage group. Moreover, the perceptions of the

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TABLE I

The Frequency and percent distribution of grading of 16 smiles by type of participants and Chi-square test results*

Gde of

Smie

Ohodoiss

(%)

De

Piioes

(%)

lypeope

(%)

to

(%)2 p

S1 (GPG)

(1) 10 (33.3) 8 (26.7) 5 (16.7) 23 (25.6)

31.23 0.000 *(2) 15 (50) 21 (70) 6 (20) 42 (46.7)

(3) 5 (16.7) 1 (3.3) 19 (63.3) 25 (27.8)

S2 (nGPG)

(1)

(2)

(3)

4 (13.3)

16 (53.3)

10 (33.3)

4 (13.3)

22 (73.3)

4 (13.3)

4 (13.3)

21 (70)

5 (16.7)

12 (13.3)

59 (65.6)

19 (21.1)

4.31 0.365

S3 (nGPG)

(1) 2 (6.7) 1 (3.3) 7 (23.3) 10 (11.1)

10.65 0.310(2) 10 (33.3) 17 (56.7) 13 (43.3) 40 (44.4)

(3) 18 (60) 12 (40) 10 (33.3) 40 (44.4)

S4 (GPG)(1) 8 (26.7) 17 (56.7) 13 (43.3) 38 (42.2)

11.44 0.022 *(2) 15 (50) 12 (40) 8 (26.7) 35 (38.9)

(3) 7 (23.3) 1 (3.3) 9 (30) 17 (18.9)

S5 (nGPG)

(1) 12 (40) 17 (56.7) 8 (26.7) 37 (41.1)

10.18 0.038 *(2) 14 (46.7) 11 (36.7) 12 (40) 37 (41.1)

(3) 4 (13.3) 2 (6.7) 10 (33.3) 16 (17.8)

S6 (GPG)

(1) 1 (3.3) 2 (6.7) 4 (13.3) 7 (7.8)

2.97 0.564(2) 17 (56.7) 14 (46.7) 16 (53.3) 47 (52.2)

(3) 12 (40) 14 (46.7) 10 (33.3) 36 (40)

S7 (nGPG)

(1) 2 (6.7) 3 (10) 8 (26.7) 13 (14.4)

6.18 0.186(2) 13 (43.3) 10 (33.3) 10 (33.3) 33 (36.7)

(3) 15 (50) 17 (56.7) 12 (40) 44 (48.9)

S8 (nGPG)

(1) 20 (66.7) 14 (46.7) 8 (26.7) 42 (46.7)

18.86 0.001*(2) 10 (33.3) 16 (53.3) 16 (53.3) 42 (46.7)

(3) 0 (0) 0 (0) 6 (20) 6 (6.7)

S9 (GPG)

(1) 2 (6.7) 3 (10) 3 (10) 8 (8.9)

1.78 0.776(2) 8 (26.7) 12 (40) 10 (33.3) 30 (33.3)

(3) 20 (66.7) 15 (50) 17 (56.7) 52 (57.8)

S10 (nGPG)

(1) 3 (10) 3 (10) 9 (30) 15 (16.7)

6.64 0.156(2) 13 (43.3) 15 (50) 13 (43.3) 41 (45.6)

(3) 14 (46.7) 12 (40) 8 (26.7) 34 (37.8)

S11 (nGPG)

(1) 25 (83.3) 20 (66.7) 23 (76.7) 68 (75.6)

5.88 0.209(2) 5 (16.7) 6 (20) 6 (20) 17 (18.9)

(3) 0 (0) 4 (13.3) 1 (3.3) 5 (5.6)

S12 (nGPG)

(1) 8 (26.7) 19 (63.3) 10 (33.3) 37 (41.1)

13.48 0.009 *(2) 17 (56.7) 7 (23.3) 10 (33.3) 34 (37.8)

(3) 5 (16.7) 4 (13.3) 10 (33.3) 19 (21.1)

S13 (GPG)

(1) 5 (16.7) 12 (40) 15 (50) 32 (35.6)

8.87 0.065(2) 16 (53.3) 13 (43.3) 12 (40) 41 (45.6)

(3) 9 (30) 5 (16.7) 3 (10) 17 (18.9)

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smiles are also examined according to whether

they are golden or not.

S9 was found to be the highest scored smile

among all the other smiles and the measure-

ments revealed that the evaluated golden pro-

portions existed in between the 0.61-0.63 range.Therefore, it was called the Ultimate Smile. Ac-

cording to the results of the Pearsons chi-square

tests for S9, it can be observed that the distri-

bution of scoring was homogeneous between

different groups of participants (Table I). Espe-

cially orthodontists gave the highest score to S9

with 20 participants. This could be an expected

result as orthodontic training not only consists

of tooth aligning but also a good knowledge of

smile, dental and facial esthetics. Also for dentalpractitioners and laypeople, S9 was again one

of the highest rated smiles. From this result, it is

impossible to say that golden proportions within

a narrow range can be perceived similarly by dif-

ferent types of participants. If there were more

than one of these smiles, it would be possible to

evaluate the validity of this assumption. When

carefully examined in Figure 1, S9 not only in-cludes the golden proportions in a narrow range

but also other components of smile esthetics such

as parallelism of maxillary incisal edge curvature

to the curvature of the lower lip30, high-low-high

contour of the gingiva over central incisors, later-

al incisors and canines32, upward lip curvature29,

display of molars on both sides with no buccal

corridors32 and symmetrical alignment of dental

elements33. These elements are also very impor-

tant for assessing smile esthetics and may havecontributed to the high scores for S9.

S14 (nGPG)

(1) 19 (63.3) 19 (63.3) 17 (56.7) 55 (61.1)

0.71 0.950(2) 10 (33.3) 10 (33.3) 11 (36.7) 31 (34.4)

(3) 1 (3.3) 1 (3.3) 2 (6.7) 4 (4.4)

S15 (nGPG)

(1) 12 (40) 12 (40) 17 (56.7) 41 (45.6)

2.31 0.680(2) 17 (56.7) 17 (56.7) 12 (40) 46 (51.1)(3) 1 (3.3) 1 (3.3) 1 (3.3) 3 (3.3)

S16 (nGPG)

(1) 5 (16.7) 11 (36.7) 2 (6.7) 18 (20)

15.59 0.004 *(2) 14 (46.7) 15 (50) 11 (36.7) 40 (44.4)

(3) 11 (36.7) 4 (13.3) 17 (56.7) 32 (35.6)

* S, GPG and NGPG indicate Smile, Golden Proportion Group and Non-Golden Proportion Group, respectively.

FIGURE 2

Difference between type of participants and the grading of the smiles for the GPG group

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A homogeneous distribution can also be

observed for the grading of S3 and S7 by the

participants, as seen on S9. Although S3 and

S7 do not fit into the golden proportion criteria

specified for this study, it can be seen that theycontain some components of an esthetic smile.

However, S3 and S7 do not illustrate a molar-to-

molar display and the smile arc is flatter than S9.

These factors may have caused them to be in the

lower ranks compared to S9.

S11 and S14 were found to be the lowest

graded smiles. Again, the distribution of the grad-

ing by the participants was homogeneous (Table

I). Reduced maxillary anterior teeth display and

dark buccal corridors14 for S11 and irregular gin-

gival contour34 for S14 are the major probable

reasons for these smiles to get such scores. It

should be noted that they also do not reflect the

golden proportions.

When all the GPG smiles are taken into con-

sideration, one smile (S4) was graded highest to be

in category 1, 3 smiles (S1, S6, S13) were graded

highest to be in category 2 and one smile (S9) was

graded highest to be in category 3 (Figure 2). It isan interesting finding that 19 out of 30 laypeople

graded S1 with a score of 3 where orthodontists

and dental practitioners have found it an average

smile. S1 is a flattened smile with more gingival

display on the left side compared to the right. It is

reported that smile arcs were flatter in orthodon-

tically treated patients than in untreated people

with normal occlusions, which caused an unaes-

thetic appearance9,35. Although golden propor-

tions existed in the range of 0.55-0.64 for S4, 38

participants (8 orthodontists, 17 dental practitio-

ners, 13 laypeople) gave a score of 1. Thick lower

lip covers the incisal edges of maxillary anterior

teeth slightly in S4. This condition was found to

be less esthetic than the patients whose lower lip

slightly touched or did not touch the incisal edges

of the maxillary anterior teeth28.

Gender was not found to be a differentiating

factor when grading the smiles (Table II). Signifi-cant differences were found for S13 and S14 only.

However, they were only a little lower than the

establishedp value (p=0.048 for S13, p=0.044

for S14, Table II). This significant difference was

probably created by laypeople as can be seen on

Table III. More or less, all of the orthodontistsare aware of the guides to a better smile as doc-

umented by many authors. Therefore, it is not

surprising that no significant gender differences

existed between the female and male orthodon-

tists. As for dental practitioners, this assumption

can also be considered to be valid. However, lay-

people chosen for this study were representing a

wide variety of professions and it is an interesting

finding that there was only significant gender dif-

ference for S13 and S14.

Age was also examined in the present study

as to whether it is a differentiating factor or not

for perception. Ages of the participants varied

from 23 to 43 years. 30 years was selected as

mid-range and two groups were formed as below

30 and over 30 years. As can be seen in Table

2, in most of the smiles evaluated; no significant

difference was observed in terms of perception.

20 orthodontists, 20 dentists and 20 laypeopleevaluated the smile photographs of patients in a

study by Roden-Johnson et al.25. They have con-

cluded that orthodontists, dentists and laypeople

evaluated the smiles differently. Similarly, Kokich

et al. 39 demonstrated that general dentists, ort-

hodontists, and laypeople detected specific dental

discrepancies at varying deviations. In the present

study, the highest number of significant difference

in terms of perception was found for the type of

participants (Table II). This result may be due to

the different statistical methods used.

Smile esthetics is a multifactorial concept.

Therefore, it is unwise to plan the treatment

depending on one variable. Although using the

golden proportions to create more esthetic smiles

is suggested in some textbooks, this study shows

that golden proportions do not create a difference

in perception. All of the components of smile es-

thetics should be considered at the beginning ofthe treatment. As orthodontists, we may like or

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TABLE II

The Kruskall-Wallis and Mann Whitney U tests for results of grading of smiles by type of participant, gender and age groups*

type of Piip Gede age Goup

K-W 2 p MW Z p MW Z p

S1 16,92 0,000 * -0,32 0,753 -1,07 0,284

S2 2,17 0,337 -0,74 0,460 -0,38 0,705

S3 5,88 0,053 -1,57 0,117 -0,38 0,701

S4 7,14 0,028 * -0,07 0,948 -3,15 0,002 *

S5 8,52 0,014 * -0,03 0,979 -2,33 0,020 *

S6 1,61 0,447 -1,73 0,083 -0,70 0,481

S7 3,17 0,205 -0,03 0,975 -1,57 0,117

S8 13,09 0,001 * -0,05 0,956 -1,29 0,197

S9 1,63 0,443 -0,91 0,364 -0,20 0,842

S10 5,02 0,081 -1,85 0,064 -0,51 0,612

S11 2,92 0,232 -1,12 0,265 -0,49 0,625

S12 7,63 0,022 * -0,19 0,851 -1,19 0,235

S13 8,71 0,013 * -1,98 0,048 * -0,71 0,476

S14 0,48 0,788 -2,02 0,044 * -0,36 0,717

S15 2,00 0,369 -1,59 0,111 -0,15 0,878

S16 15,24 0,000 * -0,31 0,759 -2,75 0,006 *

* See Table 1 for denitive abbreviations

TABLE III

The Mann Whitney U test results for Grading of Smiles by gender within each type of participant*

Gede Diffeee fo OhodoissGede Diffeee fo De

PiioesGede Diffeee fo lypeope

MW Z p MW Z p MW Z p

S1 -0,72 0,470 -0,47 0,640 -0,44 0,663

S2 -0,05 0,961 -1,39 0,164 -0,33 0,738

S3 -0,81 0,416 -0,21 0,830 -1,18 0,239

S4 -0,74 0,458 -0,50 0,616 -0,33 0,739

S5 -1,54 0,123 -1,35 0,178 -0,49 0,627

S6 -0,30 0,761 -1,95 0,051 -0,60 0,549S7 -0,25 0,805 -0,16 0,870 0,00 1,000

S8 -0,27 0,788 0,00 1,000 -0,55 0,583

S9 -0,43 0,671 -0,76 0,447 -0,80 0,425

S10 -0,22 0,827 -1,87 0,062 -1,20 0,231

S11 -1,36 0,173 -0,25 0,803 -0,31 0,757

S12 -0,59 0,554 -0,32 0,753 -0,44 0,660

S13 -0,95 0,343 -0,76 0,445 -2,69 0,007*

S14 -1,96 0,050 -0,94 0,350 -2,32 0,020*

S15 -0,15 0,879 -1,86 0,063 -0,50 0,616

S16 -0,05 0,962 -0,14 0,891 -0,33 0,741

* See Table 1 for denitive abbreviations

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dislike the result of a treatment but the final judg-

ment belongs to our patients, to their parents and

to the people around them. As mentioned by the

famous Irish novelist, Margaret Wolfe Hungerford,

Beauty is in the eye of the beholder.

cOnclUSIOnS

1. Golden proportions alone do not create a

significant difference in perception of smile es-

thetics.

2. Smiles that include both the observational

and the golden proportion criteria are probably

perceived more esthetically.

3. There is not a homogeneous distributionin perception for both golden smiles and non-

golden smiles for different type of people.

4. Age and gender are not differentiating fac-

tors in perceiving smile esthetics.

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CORRESPONDING ADRESS

Dr. Hakan EL

Hacettepe University Faculty of Dentistry Department of Orthodontics Sihhiye, 06100 Ankara-TURKEYPhone: +90 312 305 2290 Fax: +90 312 309 1138. E-mail: hakanel@hacettepe.edu.tr

Geli Tarihi : 26.06.2007 Received Date : 26 July 2007

Kabul Tarihi : 17.01.2008 Accepted Date : 17 January 2008

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