Evaluation of golden percentage in natural maxillary anterior teeth width: A systematic review

Statement of problem The color and form of teeth are 2 of the 3 main determinants of success in an esthetic restoration; the third is dental proportion. A recent systematic review of the literature devoted to the evaluation of dental proportion is lacking. Purpose The purpose of this systematic review was to investigate the quality and outcome of studies into maxillary anterior tooth proportion and to determine whether dental proportion ratios based on different geographic regions are appropriate. Material and methods An electronic search was conducted using PubMed, MEDLINE, Google Scholar, Embase, Scopus, Cochrane Library, Web of Science, and Science Direct databases. English-language articles reporting with the specific combination of medical subject heading (MeSH) key words were analyzed by 2 investigators. The titles, full text, and abstracts were scanned by investigators independently to identify articles that fulfilled the inclusion criteria. The general characteristics, outcomes, and quality of each study were reviewed and analyzed systematically. Results The search plan resulted in a total of 73 articles until September 2020; of which, 16 articles fulfilling the inclusion criteria were selected. The geographic distribution of the selected article revealed 12 articles from Asia, 2 from Continental Europe, and 2 from the United Kingdom. Golden percentage values of 25%, 15%, and 10% for central, lateral incisor, and canine teeth were not found. The mean predicted dental percentage was either larger or smaller than the successive widths of maxillary natural anterior teeth. Conclusions The golden percentage could not be used to formulate a smile design. Rather, the dental ratios should be set on a racial and ethnic basis for a population.