Lay Person's Esthetic Perception of Black Triangles Using Q -Sort Assessment and Visual Analog Scale
Abstract
Objective: To evaluate the perception of laypersons regarding black triangles between the maxillary central incisors on the esthetics of smile. In addition, we also evaluated the difference between the two grading systems used i.e., Visual analog scale and Q sort assessment. Methods: A picture at smile was manipulated using Photoshop (CC 2019; Adobe Systems) computer program. Black triangles of different sizes were then created between the maxillary central incisors in the embrasure areas. Multiple photographs were generated, and they were evaluated via Visual analog scale and Q sort assessment method by 161 laypersons. Result: The results showed that the larger the black triangle the less attractive the images were rated, regardless of the assessment method used. The presence of no black triangle or a small black triangle (0.5 mm) resulted in the highest scores in both methods. Conclusions: The most attractive image with both assessment methods was the one without any black triangles. Q- sort assessment method is comparable to VAS method in assessing smile esthetics with Laypersons showing consistent agreement in identifying unattractive and attractive smiles. Both assessment methods (VAS scale and Q-sort) showed correlation value=0.9.References
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2. Kiyak HA. Does orthodontic treatment affect patients’ quality of life? J Dent Educ. 2008;72(8):886–94. https://pubmed.ncbi.nlm.nih.gov/18676797/
3. Al Taki A, Khalesi M, Shagmani M, Yahia I, Al Kaddah F. Perceptions of altered smile esthetics: a comparative evaluation in orthodontists, dentists, and laypersons. Int J Dent. 2016;2016: 7815274. Doi: 10.1155/2016/7815274.
4. Desai S, Upadhyay M, Nanda R. Dynamic smile analysis: changes with age. Am J Orthod Dentofac Orthop. 2009;136(3):310.e1-10; discussion 310-1. Doi: 10.1016/j.ajodo.2009.01.021.
5. Sharma N, Rosenstiel SF, Fields HW, Beck FM. Smile characterization by US white, US Asian Indian, and Indian populations. J Prosthet Dent. 2012;107(5):327–35. Doi: 10.1016/S0033-3913(12)60085
6. McLeod C, Fields HW, Hechter F, Wiltshire W, Rody Jr W, Christensen J. Esthetics and smile characteristics evaluated by laypersons: a comparison of Canadian and US data. Angle Orthod. 2011;81(2):198–205. Doi: 10.2319/060510-309.1.
7. Pithon MM, Bastos GW, Miranda NS, Sampaio T, Ribeiro TP, Euler L, et al. Esthetic perception of black spaces between maxillary central incisors by different age groups. Am J Orthod Dentofac Orthop. 2013;143(3):371–5. http://dx.doi.org/10.1016/j.ajodo.2012.10.020
8. Sriphadungporn C, Chamnannidiadha N. Perception of smile esthetics by laypeople of different ages. Prog Orthod. 2017; 18(1):8. Doi: 10.1186/s40510-017-0162-4
9. Havens DC, Mcnamara JA, Sigler LM, Baccetti T. The Role of the Posed Smile in Overall Facial Esthetics. Angle Orthod. 2010;80(2):322-28. Doi: 10.2319/040409-194.1.
10. Lima P, Oliveira E, Fonseca A, Guerra CJ, Mucha JN. Comparison of two scales for evaluation of smile and dental attractiveness. Dental Press J Orthod. 2015;20(2):42–8. Doi: 10.1590/2176-9451.20.2.042-048.oar.
11. Bernabe E, Kresevic VD, Cabrejos SC, Flores-mir F. Dental Esthetic Self-perception in Young Adults with and without Previous Orthodontic Treatment. Angle Orthod. 2006;76(3):412-6. Doi: 10.1043/0003-3219(2006)076[0412:DESIYA]2.0.CO;2.
12. Schabel BJ, McNamara Jr JA, Franchi L, Baccetti T. Q-sort assessment vs visual analog scale in the evaluation of smile esthetics. Am J Orthod Dentofac Orthop. 2009;135(4 Suppl):S61–71. Doi: 10.1016/j.ajodo.2007.08.019.
13. Hu X, Nahles S, Nelson CA, Lin Y, Nelson K. Analysis of Soft Tissue Display During Enjoyment Smiling: Part 1-Caucasians. Int J Periodontics Restorative Dent. 2013;33(1):e9-15. https://pubmed.ncbi.nlm.nih.gov/23342357/
14. Kurth JR, Kokich VG. Open gingival embrasures after orthodontic treatment in adults: prevalence and etiology. Am J Orthod Dentofac Orthop. 2001;120(2):116–23. Doi: 10.1067/mod.2001.114831
15. Sharma AA, Park JH. Esthetic considerations in interdental papilla: remediation and regeneration. J Esthet Restor Dent. 2010;22(1):18–28. Doi: 10.1111/j.1708-8240.2009.00307.x.
16. Cardaropoli D, Re S. Interdental papilla augmentation procedure following orthodontic treatment in a periodontal patient. J Periodontol. 2005;76(4):655–61. Doi: 10.1902/jop.2005.76.4.655.
17. Kokich Jr VO, Asuman Kiyak H, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Restor Dent. 1999;11(6):311–24. Doi: 10.1111/j.1708-8240.1999.tb00414.x.
18. Bolas-Colvee B, Tarazona B, Paredes-Gallardo V, Arias-De Luxan S. Relationship between perception of smile esthetics and orthodontic treatment in Spanish patients. PLoS One. 2018;13(8):e0201102. Doi: 10.1371/journal.pone.0201102. eCollection 2018.
19. Flores-Mir C, Silva E, Barriga MI, Lagravere MO, Major PW. Lay person’s perception of smile aesthetics in dental and facial views. J Orthod. 2004;31(3):204–9; discussion 201. Doi: 10.1179/14631204225022416.
Published
2025-10-31
How to Cite
IFTIKHAR, Ayesha et al.
Lay Person's Esthetic Perception of Black Triangles Using Q -Sort Assessment and Visual Analog Scale.
Journal of Indonesian Dental Association, [S.l.], v. 8, n. 2, p. 109-115, oct. 2025.
ISSN 2621-6175.
Available at: <http://jurnal.pdgi.or.id/index.php/jida/article/view/1360>. Date accessed: 05 nov. 2025.
doi: https://doi.org/10.32793/jida.v8i2.1360.
Section
Research Article
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
