@article{2989771, title = "Influence of lightness difference of single anterior tooth to smile attractiveness", author = "Ntovas, P. and Diamantopoulou, S. and Gogolas, N. and Sarri, V. and Papandreou, A. and Sakellaridi, E. and Petrakos, G. and Papazoglou, E.", journal = "Journal of Esthetic and Restorative Dentistry", year = "2021", volume = "33", number = "6", pages = "856-864", publisher = "John Wiley and Sons Inc", issn = "1496-4155, 1708-8240", doi = "10.1111/jerd.12678", keywords = "adult; art; article; canine tooth; Caucasian; central incisor; controlled study; dentist; facial expression; female; gender; human; human experiment; image recording; lateral incisor; layperson; major clinical study; male; maxilla; perception; questionnaire; visual analog scale; attitude to health; dental procedure; health personnel attitude; incisor, Attitude of Health Personnel; Attitude to Health; Dentists; Esthetics, Dental; Female; Humans; Incisor; Male; Maxilla; Smiling", abstract = "Objectives: To evaluate the influence of lightness difference of a single anterior maxillary tooth on difference smile attractiveness. Methods: A frontal view full-portrait image of a smiling male Caucasian, was digitally modified altering a single tooth, creating a series of images with varying lightness (ΔL) for the maxillary central, lateral and canine. A total of 160 participants (80 dentists, 80 laypersons) were asked to fill out a Visual Analog Scale questionnaire for every image recording smile attractiveness. Results: For central incisors ΔL≥1 negatively affected attractiveness. There was a higher tolerance for lightness mismatch when one lateral incisor is lighter and the same applies when the canine was darker. Difference in lightness affected smile attractiveness both for dentists and laypersons. No difference between males and females was observed for the dentists. For laypersons, females perceived smiles with lightness difference as significantly less attractive compared to males. Dentist's age did not affect smile attractiveness perception. Younger laypersons perceived darker color, as less attractive. Conclusions: Changes in lightness of a single anterior tooth significantly affected smile attractiveness in a different way for the central vs lateral vs canine. For the dentists, age and gender did not significantly affect smile perception, in contrast to laypeople. Clinical significance: Lightness differences of a single anterior tooth affects smile attractiveness. © 2020 Wiley Periodicals LLC." }