{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:50:46Z","timestamp":1788277846215,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T00:00:00Z","timestamp":1511481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Asymmetric facial features such as a deviated nose and chin are common and known to affect smile esthetics. When presented with these asymmetries, the clinician must consider the impact they will have on the smile design parameters\u2014especially the placement and angulation of the dental midline, which is a common starting point for a case involving smile design. The purpose of this article is to determine if the nose and chin deviations affect the perception of dental midline angulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>An asymmetric facial model (AFM) was created from a digital symmetric facial model, used in a previous study by digitally deviating the nose and chin to the same side. Eight different pictures of this AFM were created, each with different degrees of maxillary midline angulation (both in and against the direction of the deviated nose and chin). Using a visual Likert scaled delivered via Websurvey in the private practice setting, one hundred and ninety\u2010six randomly selected laypersons were asked to evaluate each image according to their own notions of beauty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A minor axial dental midline angulation of 3.5\u00b0 can be perceived independently of the direction of the cant. All pictures where the midline was canted pointing in the opposite direction of nose and chin deviations presented lower rating mean values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Off\u2010center noses and chins can influence the perceived attractiveness of a smile with a canted dental midline. The degree and direction of a canted midline can influence the harmony between the smile and overall face, with canting in the same direction of the asymmetric features being rated as more attractive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Significance<\/jats:title><jats:p>The dental midline should be as vertically straight as possible. If a midline cant is present, however, it is more favorable to have a dental midline angulation which points in the same direction as nose and chin deviations, rather than in the opposite direction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jerd.12347","type":"journal-article","created":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T06:55:01Z","timestamp":1511506501000},"page":"119-125","source":"Crossref","is-referenced-by-count":36,"title":["Layperson's perception of axial midline angulation in asymmetric faces"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2701-1485","authenticated-orcid":false,"given":"Bruno Pereira","family":"Silva","sequence":"first","affiliation":[{"name":"Clinical Professor Department of Periodontology School of Dentistry University of Seville Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Jim\u00e9nez\u2010Castellanos","sequence":"additional","affiliation":[{"name":"Professor of Prosthodontics, School of Dentistry University of Seville Sevilla Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Stanley","sequence":"additional","affiliation":[{"name":"Division of Restorative Sciences, Adjunct Faculty Hermann Ostrow School of Dentistry of USC Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Mahn","sequence":"additional","affiliation":[{"name":"Research Department, Faculty of Dentistry Universidad de los Andes Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Coachman","sequence":"additional","affiliation":[{"name":"Private Practice Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivan","family":"Finkel","sequence":"additional","affiliation":[{"name":"Adjunct Clinical Instructor, Department of Cariology and Comprehensive Care New York University College of Dentistry New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3913(73)80013-7"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3913(84)80097-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3913(79)90065-9"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2005.09.027"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708-8240.1999.tb00414.x"},{"key":"e_1_2_7_7_1","first-page":"13","volume-title":"Esthetics of Anterior Fixed Prosthodontics","author":"Chiche GJ","year":"1994"},{"key":"e_1_2_7_8_1","volume-title":"Swissdent Technique and Procedure Manual","author":"Frush J.","year":"1971"},{"key":"e_1_2_7_9_1","unstructured":"SaavedraC Garcia\u2010Ad\u00e1mezR Garcia\u2010BaezaD.La angulaci\u00f3n de la l\u00ednea media interincisiva. Concepto de as\u00edmetria facial arm\u00f3nica Parte 1. Quintessence;2015;3:183\u201318."},{"key":"e_1_2_7_10_1","first-page":"11","volume-title":"Fundamental of Esthetics","author":"Rufenacht C.","year":"1990"},{"key":"e_1_2_7_11_1","first-page":"359","article-title":"The effect of axial midline angulation on dental esthetics","volume":"73","author":"Thomas JL","year":"2003","journal-title":"Angle Orthod."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2015.08.031"},{"key":"e_1_2_7_13_1","first-page":"132","article-title":"Changes in smile parameters as perceived by orthodontists, dentists, artists, and laypeople","volume":"9","year":"2008","journal-title":"World J Orthod."},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.1618"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1073-8746(98)80016-9"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2016.07.027"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjq146"},{"issue":"4","key":"e_1_2_7_18_1","first-page":"588","article-title":"Perception of maxillary dental midline shift in asymmetric faces","volume":"10","author":"Silva BP","year":"2015","journal-title":"Int J Esthet Dent."},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2011.0299"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9416(80)90004-4"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9416(83)90270-1"}],"container-title":["Journal of Esthetic and Restorative Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjerd.12347","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jerd.12347","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T19:44:07Z","timestamp":1694720647000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jerd.12347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,24]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1111\/jerd.12347"],"URL":"https:\/\/doi.org\/10.1111\/jerd.12347","archive":["Portico"],"relation":{},"ISSN":["1496-4155","1708-8240"],"issn-type":[{"value":"1496-4155","type":"print"},{"value":"1708-8240","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,24]]}}}