Determining the relationship between gingival zenith points and smile line in maxillary anterior and premolar teeth and the individual's self-confidence

This study was conducted to investigate the relationship between dentofacial esthetic parameters—primarily smile symmetry—and the psychosocial impact associated with individuals' perceptions of dental esthetics. The research was carried out at Biruni University Faculty of Dentistry between February 1, 2023, and September 30, 2024, and included 64 periodontally healthy voluntary participants. The data in the study were collected using a demographic data form, photogrammetric morphological analysis, conventional gingival zenith (GZ) measurement, photograph-based periodontal phenotype analysis, gingival color analysis performed with the CIELAB color system, and the Turkish Version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The positions of the GZ points were compared bilaterally on the lateral teeth, and participants were grouped based on GZ symmetry. The effects of individual variables such as smile line height, gingival color, periodontal phenotype, and smoking status on PIDAQ scores were analyzed statistically. The results showed agreement between traditional and photographic GZ measurement methods. Individuals with a gummy smile exhibited lower levels of dental self-confidence, whereas GZ symmetry did not have a direct impact on psychosocial outcomes. Marginal gingival pigmentation was significantly darker in smokers; however, smoking had no significant effect on PIDAQ scores. Although variables such as age, gender, brushing frequency, and phenotype did not significantly influence total PIDAQ scores, gender was found to significantly affect the "psychological impact" subdomain, with male participants demonstrating greater sensitivity in this domain as age increased. Furthermore, no statistically significant changes in gingival margin color were observed based on brushing frequency, age, or gender. Keywords: Gingival zenith, PIDAQ, esthetic dentistry, CIELAB