Does the presence of maxillary midline diastema influence the perception of dentofacial esthetics in video analysis?

Objective: To evaluate the influence of a midline diastema on dentofacial esthetic perceptions of orthodontists, restorative dental specialists or prosthodontists, and laypersons in a frontal facial evaluation performed by means of video.

Materials And Methods: Two individuals aged between 20 and 25 years, one of each gender, with presence of a midline diastema were selected. An acrylic resin mockup was made of the maxillary anterior region, simulating ideal conditions of smile esthetics. Four standardized frontal view videos of the complete face were filmed of each individual in the following situations: with the ideal smile (unchanged mockup) and with the presence of midline diastemas of 0.5, 1.0, and 1.5 mm created by the mockup. In all videos, the patient said a certain sentence and, at the end, simulated a posed smile. Dentofacial esthetic perceptions of all four videos of each individual were evaluated by 51 orthodontists, 51 restorative dental specialists or prosthodontists, and 51 laypersons by means of visual analog scales. Data were evaluated using analysis of variance and Tukey post hoc test, with the level of significance set at 5%.

Results: The most attractive videos for all groups of examiners were those without diastema and with a diastema of 0.5 mm, for both the woman and the man. For a diastema of 1 mm or 1.5 mm, the dentofacial characteristics were considered unesthetic.

Conclusions: Diastemas equal to or greater than 1 mm negatively influence dentofacial esthetics in a frontal facial evaluation performed by means of video.