Evaluating Golden and Recurring Esthetic Dental (RED) Proportions Using Two Methods in an Urban Tirupati Population

Abstract

Background: The Golden Proportion and Recurring Esthetic Dental (RED) Proportion have been historically proposed as mathematical guidelines for achieving optimal smile esthetics. However, their applicability in natural dentition remains controversial because anterior tooth proportions vary among different populations. This study aimed to evaluate the presence of the Golden Proportion and RED Proportion in the Tirupati urban population and compared measurements obtained using photographic and cast-based methods. Methods: This analytical cross-sectional study included 200 participants aged 18-30 years with natural maxillary anterior dentition. Mesiodistal widths of the maxillary central incisors, lateral incisors, and canines were measured using standardized digital photographic analysis and direct measurements on dental casts with a digital Vernier caliper. Golden Proportion and RED Proportion ratios were calculated and compared between the two methods. Continuous variables were expressed as mean ± standard deviation, and paired t-tests were used for comparisons. Statistical significance was set at p < 0.05. Results: Central incisor measurements did not differ significantly between the photographic and cast-based measurement methods (p > 0.05), whereas significantly greater widths were recorded for the lateral incisors and canines using Vernier calipers (p < 0.001). Central and lateral incisors exhibited bilateral symmetry, while the canines showed minor asymmetry. The photographic method yielded a lateral incisor-to-central incisor ratio closer to the theoretical Golden Proportion; however, neither the Golden Proportion nor the RED Proportion was consistently identified in the study population. Conclusions: Neither the Golden Proportion nor the RED Proportion was consistently observed in the maxillary anterior dentition of the Tirupati urban population, indicating that these concepts should not be considered universal standards for smile esthetics. Photographic and direct measurements provide complementary information by representing perceived and actual tooth dimensions, respectively. Individualized smile design based on patient-specific anatomical characteristics and clinical judgment may be more appropriate than strict adherence to mathematical proportional theories.