Cilj ovog istraživanja bio je utvrditi razliku u percepciji anatomskih varijacija prednjih zuba i okolnih struktura s obzirom na stupanj edukacije procjenjivača, a u tu su skupinu uključeni opća populacija, opći doktori dentalne medicine, specijalisti ortodoncije, specijalisti protetike i specijalisti parodontologije. U prvom dijelu istraživanja nastojali smo utvrditi postoji li statistički značajna razlika u procjeni anatomskih varijacija zuba s obzirom na stupanj edukacije, dob i spol procjenjivača. Isto tako nastojali smo utvrditi koliko vrsta specijalizacije, dob i spol pojedinačno i zajedno utječu na procjenu prilikom ispunjavanja OES upitnika
(Orofacijalna estetska skala). Drugi dio istraživanja sastoji se od analize i procjene kompjuterski manipuliranih fotografija osmijeha i donje trećine lica te koliki raspon varijacija svjetline zuba sve navedene skupine procjenjivača prihvaćaju i kada su zapazili da je promjena uočljiva te do koje granice smatraju da je ta promjena prihvatljiva. Na ostalim manipuliranim
fotografijama se osim boje zuba procjenjivala varijacija svjetline zubnog mesa oko zuba i do koje granice procjenjivači smatraju fotografiju prihvatljivom. Dalje se također procjenjivao raspon varijacije položaja rotacije zuba i kada su procjenjivači zapazili da je promjena uočljiva i do koje granice smatraju da je fotografija prihvatljiva. Rezultati ovog istraživanja su pokazali da su sva veća odstupanja od idealne estetike bila ocjenjena lošijim ocjenama od strane procjenjivača. Specijalisti parodontologije su dali najniže ocjene te su najkritičnija skupina među doktorima dentalne medicine i kritičniji su od opće populacije. Specijalisti protetike su
generalno manje kritični i više tolerantni na promjene estetike donje trećine lica što se može objasniti njihovim velikim znanjem i iskustvom o kompleksnosti postizanja idealne estetike. Opća populacija je najlošije zapažala promjene u boji zuba i zubnog mesa te rotaciji zuba, što pokazuje koliko je edukacija doktora dentalne medicine važna za njihov klinički rad i sposobnost zapažanja. Specijalisti protetike i specijalisti parodontologije su prvi zapazili promjene boje zuba i promjene zubnog mesa. Specijalisti ortodoncije su kao i opći doktori dentalne medicine i opća populacija srednje kritični naspram estetike osmijeha. Specijalisti ortodoncije su tek nakon specijalista protetike i parodontologije što se tiče zapažanja promjene u položaju zuba i bili su najkritičniji po tom pitanju narušavanja estetike donje trećine lica.
|Abstract (english)|| |
Introduction: The traditional focus of stomatology was, in the past, based mainly on biology and the aspects of its functions, but the modern approach is increasingly being directed towards patients and aesthetics, which nowadays is considered an important and integral part of a patient's oral hygiene. Therefore, nowadays when we discuss the improvement of quality of an individual's life we refer to removing oral pain and problems linked to chewing and speaking as well as improving their aesthetics. Thus, dental practitioners should not only pay attention to oral problems, but also consider the patient in general and evaluate how the entirety of the therapy in oral cavity will affect their overall health and quality of life.
Aim: The aim of this research is to determine the difference in perception of anatomical variations of front teeth and surrounding structures considering the evaluator's degree of education, and the group includes: general population, general dental practitioners, orthodontic specialists, prosthetics specialists and periodontology specialists.
Participants and Methods: The research consists of two parts: the first part of the research consisted of evaluating the photographs of multiple examinees (60 examinee photographs were chosen), and the second part consisted of evaluating manipulated photographs of a sole examinee, that is the photograph that frequently stands out as a typical example, was chosen for the second part of the research. During the first part of the research we attempted to determine whether there was a statistically significant difference in the evaluation of anatomical variations of teeth based on the examinee's
age and gender. We also attempted to determine how many types of specialisations, age and gender individually and collectively affected the evaluation during the process of filling out the OES questionnaire. At the end of the first part of the research we compared its results with similar studies that were also conducted by using the standardized OES questionnaire. The second part of the research comprises the analysis and the evaluation of technologically manipulated photographs of smiles and the lower third of the face, and the range of variations of teeth brightness that all groups of evaluators accept as well as the point when they noticed that the change was apparent and to which extent do they consider it to be acceptable. Other manipulated photographs were used to evaluate, apart from the colour of the teeth, the variation of brightness of gums around the teeth and to which extent the evaluators considered the photograph to be acceptable. Later the evaluation included variations of positions of the teeth rotation and the point when evaluators noticed that the change was noticeable and to which extent they considered the photograph to be acceptable. Research results have shown that all major deviations from the ideal aesthetics were given lower marks from the evaluators.
Results: Specialists od periodontology gave the lowest marks, and were the most critical group among dental practitioners and were proven to be more critical than the general population. Specialists of prosthetics were generally less critical and more tolerant to aesthetic changes to the lower third of the face which can be explained thanks to their great knowledge and experience of the complexities of achieving ideal aesthetics. The general population was the least successful at noticing changes to the color of the teeth and gums as well as the rotation of the teeth, which demonstrates the importance of education for dental practitioners, their clinical work and their perceptive abilities. Specialists of prosthodontics and periodontology were the first ones to notice the change in teeth and gum colour. Orthodontists, much like general dental
practitioners and the general population are moderately critical of smile aesthetics. Orthodontists place second after prosthodontists and periodontologists in noticing changes to the position of teeth and were the most critical regarding the disruption of aesthetics to the lower third of the face. The evaluators' age did not significantly affect their mark for aesthetic
teeth shape and colour, the appearance of dental arches and lips, and the evaluation of gingiva and the overall appearance of the lower third of the face. However, the research has proven that women were more critical than men when evaluating the appearance of the mouth and gums, and that they focused on these two characteristics of the smile.
Conclusion: Based on the results of this research we can conclude the following: all evaluating groups gave worse marks to each deviation from the ideal aesthetics and were increasingly more critical as the deviation strayed further from the ideal. Specialists of periodontology gave the lowest marks, which means that they were the most critical group of dental practitioners and are more critical in comparison to the general population. Despite the fact that specialists of prosthodontics are better at noticing changes than the general population and most dental practitioners, they are generally less critical and more tolerant of aesthetic changes to the lower third of the face, which can be explained thanks to their great knowledge of the complexity of achieving the ideal aesthetics. General population was the worst at noticing teeth and gingiva colour and teeth rotation, which demonstrates the importance of education for dental practitioners, their clinical work and their perceptive abilities. It was expected that specialists of prosthodontics to be the first ones to notice changes to the
teeth colour, and specialists of periodontology to be the first ones to notice changes to the colour of gingiva, which was partially proved to be correct because both groups of specialists evaluated both of these changes almost equally.
Orthodontic specialists were similar to general dental practitioners and the general population based on their evaluations, which proved them to be moderately critical of smile aesthetics. It was expected of them to be the first ones to notice changes in the rotation of teeth, while prosthodontists and periodontologists were unexpectedly the first ones to notice changes in the position of the teeth and were the most critical in regards to it disrupting the aesthetics of the lower third of the face. The biggest differences between dental practitioners in regards to aesthetics of the lower third of the face were between specialists of prosthodontics and periodontology, whilst orthodontists and general dental practitioners fell in the middle in regards to the criticism of the appearance of the mouth, dental arches, tooth shape and gums, meanwhile all dental practitioners were equally critical of teeth colour. Prosthodontists and periodontologists displayed minor differences in their observational capabilities and were equally critical of the changes in teeth and gingiva colour and teeth rotation. The evaluators' age had no effect during the evaluation of aesthetics of the shape and color of the teeth, appearance of dental arches and lips, nor the evaluation of gingiva and the overall appearance of the lower third of the face. It was proved that women were more critical than men only in regards to evaluating the appearance of the mouth and gums, i.e. in comparison to men they tend to focus more on these two characteristics of the smile. The stated results may help dental practitioners in planning therapies and additional education for specific specialists. It is necessary to additionally increase the number of evaluators in order to define the effect of their age on the evaluation process, as well as other aesthetic factors that are important to dental practitioners and their assessment of aesthetics of the lower third of the face.