Comparative evaluation of esthetic perception of black spaces in patients with mandibular incisor extraction

To evaluate the degree of perception of laypersons, dental professionals, and students with regard to the esthetics of the smile in cases of mandibular incisor extractions with the presence of black spaces between them. Changes were made to a front-view intraoral photograph of occlusion treated by means of a mandibular incisor extraction, simulating various configurations of black spaces between mandibular incisors. For this purpose, a specific image manipulation program was used (Photoshop CS3). After digital manipulation the photographs were printed on photographic paper and attached to a questionnaire and distributed to laypersons, dental professionals, and students (n = 90). To evaluate the degree of esthetics, an attractiveness scale was used, in which a score of 0 would represent "hardly attractive," 5 "attractive," and 10 "very attractive." The differences between examiners were checked using the Mann-Whitney test. All of the statistics were performed with a confidence level of 95%. The results demonstrated that dentistry professionals, students, and laypersons were capable of identifying cases with and without black spaces. In all groups evaluated, with the increase in black spaces the scores assigned were statistically lower (P < .05). It could be concluded that black spaces occurring after mandibular incisor extraction had a negative repercussion on dental esthetics for the dentist, the dental student, and the layperson.