The Impact of Changes in the Vermilion Show, Smile Arc and Cupid’s Bow Shapes on Smile Attractiveness.

Objective: This study aimed to evaluate the effect of variations in vermilion show, smile arc, and Cupid’s bow shape on the perception of smile attractiveness among orthodontic patients.Materials and Methods: Standardized frontal smile photographs of a female subject were digitally manipulated to produce three variations for each of the following parameters: vermilion show (thin, medium, thick), smile arc (flat, parallel, reverse), and Cupid’s bow shape (shallow, average, sharp). A total of 171 orthodontic patients were asked to rate the attractiveness of each image using a visual analogue scale (VAS). The data were analysed using Chi-square test to determine statistically significant differences in attractiveness ratings among the variations.Results: The parallel smile arc was rated most attractive (73.7%), followed by the flat arc (12.3%), while the reverse arc was least favored (83% extremely unattractive). For the upper vermilion, the thick type was most preferred (55.6%), average moderately (19.3%), and thin least (2.9%) with significant differences. In the lower vermilion, the thick show ranked highest (49.7%), thin next (31.0%), and average lowest (1.8%), though differences were not significant. For Cupid’s bow, the shallow form was most attractive (38.6%), deep moderate (31.6%), and flat least appealing (56.1% extremely unattractive), with no gender-based differences.Conclusion: Smile aesthetics are significantly influenced by the smile arc, vermilion show, and Cupid’s bow shape. A parallel smile arc, thicker vermilion, and shallow Cupid’s bow were perceived as the most attractive combinations. Keywords: Smile attractiveness, smile arc, vermilion show, Cupid’s bow, lip aesthetics, orthodontic perception, facial aesthetics.