The principles that make up esthetics are subtle.1 Methodical analysis has revealed that principles can be applied to evaluate and alter dental esthetics with predictability.2 Each principle can be considered, recognized, assessed and developed individually in esthetic management.3 Among the esthetic principles, the proportion can be predicted with a formula that defines the ratio of the component from one constituent to the next. The golden proportion (1.618 : 1.0) is a mathematically constant ratio that defines the dimensions between larger and a smaller length. This specific relation is unique, perfect, ideal, and desirable. It has been used from studying beauty to design esthetic restorations.4,5 It is also a valuable tool for the evaluation of symmetry, dominance, and proportion in the diagnosis of tooth arrangement and in the application of esthetic dental treatment.6 On the contrary, the researchers found that usage of the golden proportion is theoretical and its application is challenging.7-10 The studies have shown both the presence and the disapproval of golden proportion. The uncertainty of golden proportion in esthetic analysis and in smile design intended this study to evaluate the existence or presence of golden proportion in Indian population.

The selected population was approved by a five member panel comprising of 2 restorative dentists, two patients and one resident for esthetics for standardization. The sample size for this study consisted of 576 volunteers, 305 females and 271 males, ranging in age from 21 to 30 years. A random population of acceptable esthetics was selected. The selection criteria required the subjects to have all of their natural anterior teeth with no history of orthodontic treatment, tooth size alteration, spacing and restorations. The volunteers were of Indian origin, their consent and ethical clearances were obtained from the institution ethical committee for the study. The teeth evaluated for maximum width on the incisal edge. Entire procedure was made simple as the patient restorations were evaluated in normal clinical situations rather than in complex environment. The flat end of digital caliper is used to measure the widths of the maxillary central, lateral and canine, mandibular central, lateral and canine. The width of maxillary and mandibular anterior teeth arch width was measured using a flexible ruler. The widths of the teeth were measured at the mesio-distal contact points of teeth (Fig. 1). Anterior teeth width was measured from distal contact point of 13 to distal contact point of 23 in maxilla and distal contact point of 33 to distal contact point of 43 in mandibular teeth using flexible ruler (Fig. 2). Each measurement was made thrice by the same operator and the repetitive value was used for accuracy and calibration of results.

The golden proportion for each subject was assessed by multiplying the width of the larger component by 62% and compared the width of the smaller component for proportion to be analyzed. The width of central incisor was multiplied by 62% and compared with the width of the adjacent lateral incisor. Similarly the width of the lateral incisor, canine and the maxillary and mandibular teeth were evaluated for golden proportion. The measurements were recorded and statistically analyzed.

Data obtained were entered into Microsoft Excel sheet and analyzed statistically using SPSS statistical package version No. 10. Descriptive statistics were calculated for the frequency of participants having various ratios of golden proportions based on sex. Chi square analysis was used to find if there exists any association between sex and various ratios of golden proportions. Alpha error was set at 5%, and P value less than 0.05 was considered statistically significant.

The data revealed no statistical significance in the ratio of golden proportions based on gender. The data obtained from this study is summarized in Table 1. The mean ratio existed between maxillary and mandibular teeth ranged from 73% to 84%. The ratio of 1.2 and 1.3 were more common than 1.618 which is observed in 1% of the samples.

The golden proportion (1.618 : 1.0) describes the ratio between the dimensions of a larger and a smaller length. Various researchers have opined for and against the use of this mathematic proportions in dentistry.1-9 Levin4 observed the golden proportion between the width of central incisor, lateral incisor and the canine. George and Bhat11 found that the golden proportion is reliable predictors for determining the width of the maxillary central incisors in the south Indian population. Preston12 found 17% of his study samples had golden proportion between the width of the maxillary central and lateral incisors. Lombardi1 recommended a repeated ratio concept in contrast to golden proportion. Mahshid et al.13 reported that the golden proportion did not exist between the widths of the maxillary anterior teeth and it was substantiated by Ward,14 Gillen et al.,15 Rosenstiel et al.16 The variation of thoughts among researchers17-25 and lack of similar study on Indian population aimed this study to evaluate the existence of golden proportion between anterior teeth in the Indian population.

The results of the study indicated that golden proportion did not exist in majority of the Indian population. The ratio of 1.2 and 1.3 were more commonly observed in 43% and 42% of individuals than 1.618. The ratio of 1.5 and 1.6 were found in 5% and 1% of the study group evaluated. The 1.2 ratio which was commonly observed is substantiated by Rosensteil et al.16 Javaheri and Shahnavaz,26 Jahanbin et al.,27 Decker,28 Sarver and Ackerman,29 Marguardt,30 Howells and Shaw,31 Amoric,32 Phillips et al.,33 Wolfart et al.34 consider golden proportion to be a superior aspect of esthetics but the proportion is more artistic, theoretical and impractical in nature. It is also inappropriate to anticipate for every patient to possess this precise relationship because human are individuals with unique facial and dental features. Being one of the microesthetics factors of esthetics it is not a major consideration whereas the other macroesthetic factors and principles play a significant role in determining esthetics.35

The adherence to a particular proportion for all patients universally is impractical.22 The results of this study showed varied existence of specific ratio of 1.2 in 43% of study samples and 1.3 and 42% of samples. No major differences in proportion existed between the sexes and in the symmetry of maxillary and mandibular teeth. Findings of this study were substantiated by other investigations of de Castro et al.,36 Ong et al.,37 Wolfart et al.,38 Shell and Woods39 done on non-Indian population. The results of this study have inferred that golden proportion is negligible and not seen in majority of Indian population.

Unlike other studies8,11 the sample size selected for the study is superior but larger group is required to obtain definitive conclusions on Indian population which varies with cultural diversity. Though the width measurements were made to clinical precision there might be a 0.5 mm variation exist in the proximal contact area measurement which can be a binding limitation in this study. From the results obtained and within the limitations of the study the following were appraised. Ethnic differences should be considered for esthetics and proportion studies especially with Indian population which varies with cultural diversity. The golden proportion was not found between maxillary and mandibular anterior teeth in majority of Indian population and the ratio of 1.2 and 1.3 is more commonly seen in Indian population. There were no major changes seen in the proportions between sexes and symmetry of teeth in Indian population.

This study inferred that golden proportion between the widths of maxillary and mandibular teeth was not observed in the majority of Indian population.