Statement of problem
Computer-aided design (CAD) software can merge the intraoral digital scan with patient photographs or 3-dimensional (3D) facial reconstructions for treatment planning purposes. However, whether an individual perceives a 3D facial reconstruction as a better self-representation compared with a 2-dimensional (2D) photograph is unclear.
The purpose of this observational study was to compare self-perception ratings and self-representation preference of the 2D and 3D facial reconstructions among laypersons, dental students, and dentists.
Material and methods
Three populations participated in the study: laypersons, dental students, and dentists (n=20, N=60). Facial and intraoral features were digitized by using facial and intraoral scanners, and a complete-face smile photograph was obtained. Two simulations were performed for each participant: 2D (2D group) and 3D (3D group) reconstructions. In the 2D group, a maxillary digital veneer waxing from the left to the right second premolars was produced without altering the shape, position, or length of the involved teeth. A software program (Dental Systems; 3Shape A/S) was used to merge the maxillary digital waxing with the full-face smile photograph. One image was obtained for each participant. In the 3D group, a dental software program (Matera 2.4; exocad GmbH) was used to merge the intraoral and facial scans. Subsequently, 1 video of a 180-degree rotation of each 3D superimposition was obtained. Participants evaluated both superimpositions on a scale from 1 (least esthetically pleasing) to 6 (most esthetically pleasing). Finally, participants were asked which superimposition they preferred for a potential treatment outcome representation.
All the ratings were esthetically pleasing (median group rating 5 or 6). When analyzed solely for differences across occupation groups, ratings for the 2D representation varied significantly across populations (Kruskal-Wallis chi-squared=13.241, df=2, P=.001), but the ratings for the 3D representation did not exhibit statistically significant differences (Kruskal-Wallis chi-squared=4.3756, df=2, P=.112). Ordinal logistic regression revealed no significant main effects but a significant effect of the population×image-type interaction on the esthetic rating. All participants felt well-represented in both the 2D and 3D representations. Also, 40% of dentists, 55% of dental students, and 50% of laypersons preferred the 3D reconstructions. Sex and occupation in general had no effect on the ratings. However, students tended to give higher ratings to the 3D representations of themselves.
There is no evidence based on the current study that 2D and 3D representations were perceived differently, but representation preferences may depend on a person’s occupation. When individuals rated 3D visualization higher than 2D visualization, they strongly preferred the 3D visualization for representing the treatment outcome.
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- The diagnostic template: a key element to the comprehensive esthetic treatment concept.Int J Periodontics Restorative Dent. 1996; 16: 560-569
- Esthetic templates for complex restorative cases: rationale and management.J Esthet Restor Dent. 2008; 20: 239-250
- The glossary of prosthodontic terms. Ninth edition.J Prosthet Dent. 2017; 117: e1-e105
- Facially driven digital diagnostic waxing: new software features to simulate and define restorative outcomes.Curr Oral Health Rep. 2019; 6: 284-294
- Fundamentals of esthetics.Quintessence, Chicago1990: 205-241
- The science of communicating the art of esthetic dentistry: part I: patient-dentist-patient communication.J Esthet Dent. 2000; 12: 131-138
- Cognitive processes in the perception of art. Reversal theory cognitive synergy and the arts.Elsevier, North-Holland1984: 27-44
- Perception esthetics: factors that affect smile design.J Esthet Dent. 1996; 8: 189-192
- Occlusal cant in the frontal plane as a reflection of facial asymmetry.J Oral Maxillofac Surg. 1997; 55: 811-817
- Comparing the perception of dentists and laypeople to altered dental esthetic.J Esthet Dent. 1999; 11: 311-324
- Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations.Am J Orthod Dentofacial Orthop. 2006; 130: 141-151
- Lay preferences for dentogingival esthetic parameters: a systematic review.J Prosthet Dent. 2017; 118: 717-724
- Influence of symmetry and balance on visual perception of a white female smile.J Prosthet Dent. 2018; 120: 573-582
- Perception of occlusal plane that is nonparallel to interpupillary and commissural lines but with the maxillary dental midline ideally positioned.J Prosthet Dent. 2019; 122: 482-490
- Systematic literature review of digital three-dimensional superimposition techniques to create virtual dental patients.Int J Oral Maxillofac Implants. 2015; 30: 330-337
- A digital approach integrating facial scanning in a CAD-CAM workflow for complete-mouth implant-supported rehabilitation of patients with edentulism: a pilot clinical study.J Prosthet Dent. 2017; 117: 486-492
- Facially generated and additively manufactured baseplate and occlusion rim for treatment planning a complete-arch rehabilitation: a dental technique.J Prosthet Dent. 2019; 121: 741-745
- A report on a diagnostic digital workflow for esthetic dental rehabilitation using additive manufacturing technologies.Int J Esthet Dent. 2018; 13: 184-196
- Digital workflow for an esthetic rehabilitation using a facial and intraoral scanner and an additive manufactured silicone index: a dental technique.J Prosthet Dent. 2020; 123: 564-570
- Digital tools and 3D printing technologies integrated into the workflow of restorative treatment: a clinical report.J Prosthet Dent. 2019; 121: 3-8
- A new total digital smile planning technique (3D-DSP) to fabricate CAD-CAM mockups for esthetic crowns and veneers.Int J Dent. 2016; 2016: 6282587
- Esthetic dental perception comparisons between 2D- and 3D-simulated dental discrepancies.J Prosthet Dent. 2020; 124: 763-773
- Layperson and dental professional perception when evaluating their own virtually 2D or 3D simulated esthetic discrepancies.J Prosthodont. 2020; 29: 466-471
- Intraoral digital scans-part 1: influence of ambient scanning light conditions on the accuracy (trueness and precision) of different intraoral scanners.J Prosthet Dent. 2020; 124: 372-378
- Clinical study of the influence of ambient light scanning conditions on the accuracy (trueness and precision) of an intraoral scanner.J Prosthodont. 2020; 29: 107-113
- A language and environment for statistical computing.R Foundation for Statistical Computing, Vienna, Austria2020 (Available at:)https://www.R-project.org/Date accessed: June 1, 2018
- Ordinal regression models for ordinal data. R package version 2019.(Available at:)https://CRAN.R-project.org/package=ordinalDate accessed: June 1, 2018
- Vector generalized linear and additive models: with an implementation in R.Springer, New York2015: 33-90
Published online: February 02, 2021
© 2020 by the Editorial Council for the Journal of Prosthetic Dentistry.