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Editor’s Choice

David L. Turpin, Editor-in-Chief

Smile esthetics: Perceptionand comparison of treated anduntreated smilesErdal Isiksal, Serpil Hazar, and Sercan Akyalcin

Most clinicians know how demanding some parentscan be in their expectations for improving their child’ssmile. When evaluating smile esthetics, there is stillsome controversy about the significance of arch formand buccal corridors. Does extraction treatment resultin constriction of the dental arches and increased buccalcorridors? And if this occurs, does it affect a person’ssmile? This research team gathered panels of orthodon-tists, plastic surgeons, artists, general dentists, dentalprofessionals, and parents to rate smiling photographsof extraction, nonextraction, and untreated control sub-jects.

The findings showed that 6 panels of judges did notdifferentiate between the smile esthetics of subjectswith ideal occlusion and those with Class I occlusiontreated with or without extractions. In fact, transversecharacteristics of the smile appeared to be of littleimportance to an attractive smile. The final position ofthe anterior teeth had a definite effect on esthetics, butthe actual treatment modality alone had no predictableinfluence.

Facial profile preferences of blackwomen before and after orthodontictreatmentJavonne McKoy, Carla A. Evans, Grace Viana,Nina K. Anderson, and Donald B. Giddon

When planning treatment for black female patients,do white and black orthodontists differ in their prefer-ences for the expected changes in facial profile? Andwhether or not the orthodontists differ, what do blackwomen think about their facial profiles? After treat-ment, can they recognize their own pretreatment andposttreatment facial profiles?

Am J Orthod Dentofacial Orthop 2006;129:10A0889-5406/$32.00Copyright © 2006 by the American Association of Orthodontists.

doi:10.1016/j.ajodo.2005.11.014

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To answer these questions, these authors assembled15 black orthodontists, 15 white orthodontists, and 15black female patients and asked them to select theimages they considered most pleasing and determine azone of acceptability for 3 facial profiles. The resultsshowed that white orthodontists preferred flatter pro-files than black orthodontists and black women. Fur-thermore, the patients preferred fuller profiles than bothgroups of orthodontists. Clinicians varied in their eval-uations of relationships of the lip to the nose and thechin. After reading this article, you will have a betterunderstanding of how difficult it can be to understanddiffering expectations.

Correction of a mandibular lateralincisor-canine transposition—a casereportCenk Doruk, Hasan Babacan, and Altug Bicakci

There are many reasons to encourage parents totake their children to an orthodontist in the early mixeddentition stage of tooth development. This case reportadds another with the description of an 8-year-old girland the eruption of a “crooked tooth.” When radio-graphs showed the transposition of the mandibular rightlateral incisor and the canine, treatment options in-cluded alignment of those teeth in their transposedpositions, extraction of 1 transposed tooth, or treatmentto move the teeth into their normal anatomic positions.

This treatment decision can be difficult because it israrely seen in an average practice. How early must thedecision be made? Is the patient condemned to alifetime of functional problems if the transposed man-dibular incisor is extracted? Will the parents haveenough patience for the potentially lengthy treatment tomove all permanent teeth into their normal relation-ships?

These and other treatment dilemmas are discussed.The key to success in treating transpositions is todiagnose them early, when the problem can be cor-rected with less chance of injuring the surrounding hardand soft tissues. Read on and let me know what you

think.

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