Perception of Orofacial Esthetics Using a Scan-Free Virtual Video Mock-Up: A Comparative Analysis of Self-Evaluation Versus Unknown-People Assessment

Objective: To evaluate perceptions of scan-free virtual video mock-ups using the Orofacial Esthetic Scale (OES), comparing self-assessments and evaluations of anonymized individuals by dental professionals and laypeople. Materials and methods: This study was conducted at the Clinic of Reconstructive Dentistry, University of Zurich. Fifty participants (25 dental professionals and 25 laypeople) were video recorded under standardized conditions while smiling, turning from en face to profile, and speaking to simulate dynamic facial movements. Recordings were obtained using a clinical capture application linked to the device's native rear camera, and AI-generated scan-free virtual video mock-ups were returned within minutes. Each participant rated their own mock-up using the Orofacial Esthetic Scale (OES) and, in randomized order, evaluated five anonymized virtual mock-ups generated from the software library (based on real patient recordings but fully de-identified for privacy protection). Median OES scores were compared using Wilcoxon signed-rank and Mann-Whitney U tests (α = 0.05). Conclusions: Within the limitations of this study, it was concluded that lay participants assigned higher esthetic ratings than dental professionals for virtual video mock-ups of themselves and of unknown individuals. Comparisons between self-evaluation and evaluation of anonymized individuals showed no consistent differences among dentists, while several item-level differences were observed among lay participants. Compared with natural dentition, ratings for tooth color and tooth alignment increased after viewing the virtual mock-up, while other items did not change significantly. Clinical significance: These findings suggest that integrating simplified digital simulations with patient-reported outcome measures enhances communication, aligns expectations, and supports patient-centered shared decision-making in prosthodontic and implant treatment planning.