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The purpose of this study was to identify and compare preferences and perceptions of orthodontists and general dentists when restoring peg-shaped lateral incisors. The investigation sought to summarize these preferences with regard to treatment planning, tooth preparation and interdisciplinary communication. A pair of mailed and electronic surveys was distributed to 1,500 general dentists and orthodontists, respectively. The results indicated that general dentists perceived that general dentists held the primary decision-making responsibility, while orthodontists disagreed (P<0.0001). Orthodontists prioritized the treatment goals of Class I canine relationship and overbite/overjet more significantly than general dentists, whom valued tooth proportions more highly (P<0.0001). General dentists reported receiving significantly less input than orthodontists report seeking (P<0.0001).The consensus of both groups showed that the tooth should be positioned centered mesiodistally and guided by the gingival margins incisogingivally. Both groups agree that orthodontists must improve communication to improve treatment results.

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Objective: This study aimed to determine and compare the esthetic preference of the general public, dentists, orthodontists and prosthodontists in relation to the width of the most anatomically variable tooth in the mouth, the maxillary lateral incisor. Background: The general public today places more importance on facial esthetics than they have in the past and their esthetic preferences are evolving. The smile is a main feature of facial esthetics and its attractiveness is based in part on the size and proportion of the anterior teeth. The lateral incisors are the most variable in size and there is a continuing debate in the literature with conflicting reports about how wide they should be in proportion to their neighboring teeth. Methods: Two sets of seven images of frontal and oblique (three-quarter) smile views were created with Adobe Photoshop Elements 10 by morphing two "Master Smile" images. The seven images within each set had different width proportions of lateral incisors. However, they were identical in every other aspect such as differences in lip thickness or tooth shape to diminish the impact of compounding variables between photographs. A link to an online survey was distributed by email to four groups: laypeople, general dentists, orthodontists and prosthodontists. Subjects taking the survey ranked the seven photographs in each set from the most to the least esthetic based on their personal preference. The results were studied to ascertain whether the general public has an esthetic preference in the width of lateral incisors and, if that preference exists, whether it is different from that of trained dental professionals. Results: In a frontal view of a smile, the global preference for the width of a lateral incisor falls into the range of 62.5-72.5% of the width of the central incisor. The probability that the most preferred choice is 67.5% or greater is 66%. In the frontal view there was no statistically significant difference between professions. Non-Hispanic white respondents preferred slightly more narrow laterals than other ethnicities in the frontal view. Respondents older than forty preferred slightly wider laterals than respondents under forty in the frontal view. In the oblique view, there was a 69% probability that the most preferred choice was the largest option: a lateral incisor 91.5% of the width of the visible width of the central incisor. In the oblique view, the three groups of dental professionals were more likely than the general public to select a wider incisor as the most esthetic option. Conclusion: Preference for smile attractiveness can be significantly influenced by the width of lateral incisors in a frontal and oblique view. Orthodontist, general dentists, and prosthodontists were shown to be in general agreement with the public in preferring a wider lateral incisor viewed from a frontal smile. In an oblique view, their professions had a statistically significant impact on the difference between their choices compared to laypeople in that they preferred a slightly wider lateral incisor. All groups preferred significantly wider laterals than is proscribed by the Golden Proportion.

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