Smile attractiveness of patients treated for congenitally missing maxillary lateral incisors as rated by dentists, laypersons, and the patients themselves Luciana Manzotti De-Marchi, DDS, MSc, a Núbia Inocencya Pavesi Pini, DDS, MSc, b Adilson Luis Ramos, DDS, PhD, c and Renata Corrêa Pascotto, DDS, PhD d School of Dentistry, State University of Maringá, Maringá, Paraná, Brazil; State University of Campinas, Piracicaba, São Paulo, Brazil Statement of problem. Esthetic judgments can help dental professionals better understand how attentive people are to their own smiles and those of others. Purpose. The purpose of this study was to evaluate the smile attractiveness of patients treated for maxillary lateral incisor agenesis compared with that of individuals with a complete dentition. Material and methods. Photographs were made of the smiles of patients with maxillary lateral incisor agenesis who were treated with space closure and teeth recontouring (n¼26) or space opening and implants (n¼20) and of a control group with a complete dentition (n¼22). Both laypersons and dentists assessed smile attractiveness by using a visual analog scale. Patients and controls also assessed the level of satisfaction with their own smile. Assessments were performed twice, and the reliability of the method was determined with Cronbach a and intraclass correlation. Multifactorial and 1-way ANOVA were used to analyze smile attractiveness and participant satisfaction, followed by the Bonferroni post hoc test (a¼.05). Results. Attractiveness ratings by dentists and laypersons did not differ significantly among the study groups (P¼.64). The ratings of male dentists and female laypersons differed significantly from those of other evaluators (P¼.01). Patients with space closure and teeth recontouring were significantly more satisfied than controls (P¼.002). No significant differences were found between the patients with implants and controls or between the patients with implants and those with space closure and teeth recontouring. Conclusions. The smiles of patients with maxillary lateral incisor agenesis were judged to be as attractive as those of the controls. Male dentists were the most critical raters, closely followed by female laypersons. All participants had high levels of satisfaction with their own smile; patients treated with space closure and teeth recontouring were the most satisfied. (J Prosthet Dent 2014;-:---) Clinical Implications Treatments of patients with congenital unilateral or bilateral maxillary lateral incisor agenesis can produce esthetics comparable with the esthetics of individuals with complete dentitions who have never undergone any type of orthodontic treatment; a slight advantage was observed for patients treated with space closure and teeth recontouring. Dental agenesis in the anterosuperior region can compromise the balance and the symmetry of the smile, negatively affecting self-esteem. 1-4 Maxillary lat- eral incisor agenesis (MLIA) can be treated either by space closure and teeth recontouring (SCR) or space opening/maintenance for the place- ment of implant-supported prostheses a Graduate student, School of Dentistry, State University of Maringá. b Auxiliary Professor, Department of Dentistry, University Center of Maringá. c Graduate student, School of Dentistry (Restorative Dentistry), Piracicaba Dental School, State University of Campinas. d Associate Clinical Professor, School of Dentistry, State University of Maringá. De-Marchi et al