Impact of Lightness Differences in Digitally Simulated Composite Resin Restorations on Perceived Smile Attractiveness

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Ntovas P., Korkut B., Unal T., Ferraris F., Fehmer V., Sailer I.

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, cilt.1, sa.1, ss.1-12, 2025 (SCI-Expanded)

Özet

Objectives: To investigate the effect of lightness differences between digitally simulated composite restorations and anterior

maxillary teeth, in combination with restoration type, and clinical experience on perceived smile attractiveness.

Materials and Methods: An imaging software program (Adobe Photoshop CC 2023) was used to digitally manipulate a frontal

full-face

portrait of a smiling female model, to create five types of moderate-sized

composite resin restorations of moderate size.

For each restoration 14 lightness differences were simulated. The image was digitally modified to simulate five different types of

composite resin restorations (Class III, Class IV, Class V, diastema closure (bilateral and unilateral approach)). Each restoration

was adjusted through 7 incremental increases and 7 incremental decreases of 1 unit in lightness (L* value), yielding a total of 70

images. The smile attractiveness of each picture was rated by 80 dentists and 80 laypersons, ranged from 21 to 77 years using a

visual analog scale. The Wilcoxon signed-rank

test was employed to assess whether the mean of a sample significantly differed

from the control (p < 0.05).

Results: Among the different restoration types, crown fracture repairs (Class IV) had the greatest negative impact, followed by

proximal restorations (Class III), diastema closures (Bilateral approach), diastema closures (Unilateral approach), and, lastly,

cervical restorations (Class V), which had the least impact on perceived smile attractiveness (p ≤ 0.05). The influence of lightness

differences, whether toward a darker or lighter restoration, was dependent on both the type of restoration and the observer's

experience.

Conclusions: The effect of lightness difference on perceived smile attractiveness was significantly influenced by both the type

of composite resin restoration and the observer's experience. Dental professionals perceived lightness discrepancies as less attractive

compared to laypersons, suggesting that experience plays a key role in the perception of esthetic outcomes