Esthetic Impact of Alignment on Smile Components and Attractiveness

Aim: This study evaluated changes in smile components and attractiveness following orthodontic treatment, focusing on aligning and decrowding in patients with Angle’s Class I malocclusion. Objectives included comparing pre and post-treatment smile esthetics, assessing key smile components (e.g., smile arc, lip line, buccal corridors), and measuring perceived attractiveness using a visual analog scale (VAS). Methods: The study involved 62 patients (38 males, 24 females) with maxillary anterior crowding ≥5 mm. Frontal smiling photographs were taken before and after treatment using a standardized protocol. Smile components, including horizontal (e.g., commissure width, buccal corridor width) and vertical parameters (e.g., incisal visibility, gingival display), were analyzed using MAKHTER Facial Analysis Software. Dichotome variables (smile arc, lip line, smile symmetry) were also evaluated. Smile attractiveness was assessed by a panel of 10 raters using a VAS, with statistical analysis performed via paired t-tests. P < 0.05 was considered as significant. Results: Results showed significant improvements in the smile arc, with consonant arcs increasing from 50% to 90.6% post-treatment. Horizontal and vertical parameters improved slightly but not significantly. Smile attractiveness significantly increased across all rater groups (p < 0.001), with laymen and orthodontists noting the greatest improvements. The findings highlight the importance of a consonant smile arc and proper incisor positioning for aesthetic outcomes. However, the lack of significant changes in buccal corridor width and dental midline discrepancy underscores the need for careful treatment planning. Conclusion: Aligning and decrowding enhance smile aesthetics, particularly in smile arc and overall attractiveness. Future studies with larger samples and longer follow-ups are recommended.