The relationship between posttreatment smile esthetics and the ABO Objective Grading System

Objective: To evaluate the correlations between the components of the Objective Grading System developed by the American Board of Orthodontics (ABO) and smile esthetics. Materials and Methods: The clinical photographs of 48 orthodontically treated patients were rated by a panel of 25 experienced orthodontists (15 men and 10 women) and 20 parents of orthodontic patients (eight men and 12 women). One of the investigators, a director of the ABO, scored the posttreatment dental casts and panoramic radiographs of all patients according to the guidelines of the Objective Grading System. The relationship between the occlusal outcome and perceived smile attractiveness of the subjects were evaluated by a Pearson product-moment correlation. Logistic regression was used to determine whether the individual component or total combined scores of the ABO Grading System could predict whether a smile would be considered "attractive" or "unattractive" by the panel of raters. Results: Extremely weak relationships were found among all factors of the ABO Objective Grading System and perceived smile attractiveness (r values ranging from -0.11 to 0.14; P > .05). As derived from logistic regression equations, neither total scores nor individual components of the ABO Grading system could predict attractive or unattractive smiles. Conclusions: This study suggests that additional criteria might be incorporated into the assessment of overall orthodontic treatment outcomes, including variables evaluating the smile.