Please note this is a comparison between Version 2 by Fanny Huang and Version 1 by Francesca Cinelli.

Predictable results in the aesthetic treatment of anterior teeth can be obtained by resorting to the concept of dental aesthetics and, in particular, defining the ideal tooth dimensions and proportions to obtain a harmonious smile.

- teeth dimensions
- golden proportions
- golden percentage

Which are the harmonious tooth dimensions? Which are the teeth proportions to produce a pleasant smile? What are the means available to plan a cosmetic treatment? Clinicians have long sought to answer these questions to obtain predictable results during the treatment process and to limit the “subjectivity” in achieving aesthetic goals. To summarize, update, and integrate current knowledge, literature was reviewed to find evidence regarding teeth dimensions and anterior teeth proportions theories. Aesthetic facial parameters were also considered, such as interpupil and inter-canine distance, nasal inter-alar width, and mesiodistal distance of the maxillary anterior teeth. Gender and ethnicity were also taken into account.

Among the most famous proportions theories, the “Golden Proportions theory” involves ancient Greek art and architectural mathematical relationships. Since the pre-Christian era, it has been established that the golden proportions, which are based on the ratio between the diagonal and the side of a square, represent absolute perfection. It is universally recognized and defined with the ratio 1.618:1. Richard Lombardi proposed the application of the “Golden Proportions theory” in dentistry ^{[1]} (**Figure 1**a). In particular, the mesiodistal width of the central and lateral incisors can be repeated in constant proportion ^{[1]}. Since then, numerous other theories on dental proportions have been proposed. In 1978, Levin ^{[2]} reviewed the concept: The width of the central incisor (1.618) is in “golden proportion” with the width of the lateral (1), which is in “golden proportion” with the canine (0.618) (**Figure 1**b). He stated that there is no relationship between the real measured widths of the incisors; hence, he proposed the golden proportion based on the apparent size, from a frontal point of view. Levin ^{[2]} also proposed the use of a segmented grid, based on the Golden Proportion, which would help to visualize dental proportions. Preston ^{[3]} proposed his own theory: The width of the maxillary lateral incisor should be 66% of the width of the central one, and the canines should be 84% of the lateral ones (or 55% of the central ones) ^{[3]} (**Figure 1**c). A few years later, Snow proposed the “Golden Percentage” or “Golden Mean” ^{[4]}: Within the inter-canine distance, each tooth corresponds to a percentage of space occupied. The percentages are the following (canine to canine): 10%, 15%, 25%, 25%, 15%, and 10% ^{[4]} (**Figure 1**d). The author ^{[4]} declared this method more accurate for determining symmetry, dominance, and proportion for esthetically pleasing smiles, but also that those percentages should be validated by further studies. In 2000, RED (Recurring Esthetic Dental) proportions were introduced by Ward ^{[5]}, which are based on the constant reduction in the width of the next tooth as it progresses distally, in frontal view. The range of suggested RED proportions is between 62% and 80% ^{[5]} (**Figure 1**e). The Golden Proportion lead to a narrow lateral incisor and to a reduction in the display of the canine. So, he suggested those constant proportions moving distally. More recently, Marquardt proposed the concept of a Golden Rectangle in which the height of the central incisor is in golden proportion with the combined width of the maxillary central incisors (1:1.618) ^{[6]} (**Figure 1**f). He focused only on the central incisors.

Various theories developed over the years regarding dental proportions.

Various theories have been proposed, but individual differences make it difficult to find a universal rule, exact “magic numbers”. However, interest in the aesthetics of the smile has not waned, meaning that there is an increasing need for treatment to achieve aesthetic standards. Today, the clinician’s concern is not to find and apply a universal rule to all patients but to find harmony in the individual smile. Therefore, considering the importance of references in the esthetic treatment of anterior teeth and the gaps that exist to achieve the best results, this narrative review aims to analyze the following main theme: the size of the anterior teeth and the relationships that bind them. In particular, size, symmetry, and proportion between central incisors and all the anterior teeth were first considered, and then these data were related to gender, ethnicity, and facial parameters.

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