Measuring Patient’s Orofacial Estheticsin in Prosthodontics: A Scoping Review of a Current Instrument

Saraventi Mursid1, Diah Ayu Maharani2, Lindawati Kusdhany1, *
1 Department of Prosthodontics, Faculty of Dentistry, University of Indonesia, Jakarta 10430, Indonesia
2 Department of Preventive and Public Health Dentistry, Faculty of Dentistry, University of Indonesia, Jakarta10430, Indonesia

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© 2020 Mursid et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Prosthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia; Tel: +628161107587; E-mail:



Although prosthodontic treatment is aimed at improving oral function, esthetics has become the most common motivation for treatment. To ensure successful outcomes, valid and reliable instruments for comprehensively evaluating the esthetic aspects of prosthodontic treatment from both clinician perspective and patient self-assessment are needed. The literature on measurement tools used in prosthodontics to evaluate orofacial esthetic aspects was also studied.


A scoping review was conducted to map existing instruments such as a questionnaire, index, or scale designed to evaluate orofacial esthetics by clinician and patient for prosthodontic treatment.


Of the 27 studies evaluated, the Orofacial Esthetic Scale (OES) was used mostly for evaluating a patient’s esthetic perception. The ‘Dental Esthetic Screening Index’ (DESI) was found as the most currently developed instrument with objective quantification for the clinical situation having good reliability and validity. The Prosthetic Esthetic Index (PEI) also has sufficient psychometric properties as an objective assessment tool for clinicians. But the PEI and the DESI are still rarely used in research and practice. Teeth color and position were determined to be the most important factors in recognizing esthetic impairment. Following tooth analysis (appearance, color, alignment, space, proportion, and wear), gingival appearance, smile analysis, facial analysis, and unaesthetic restoration or prosthesis were the most important esthetic factors identified.


Esthetics is subjective and is influenced by many factors. Instruments for subjective and objective evaluation are needed to determine the esthetic perceptions of clinicians and patients. OES, PEI and DESI were found to be relevant instruments for this.

Keywords: Prosthodontics, Orofacial, Esthetics, Measurement, Prostheses, Dentofacial .