Thanks for showing interest in our research. We wish to address your concerns and to state the following points. Regarding the control smile used as a starting point for the manipulation and creation of the discrepancies that the study objectives targeted, we referred to the article cited as your reference 1: Garber DA, Salama MA. The aesthetic smile: diagnosis and treatment. Periodontol 2000 1996;11:18-28. That article states: “Classically, the prosthodontist would like to set up a denture so that the level of the gingival margins of the maxillary teeth parallel the form of the upper lip. The incisal edges of these maxillary teeth tend to follow the form of the lower lip.” So the above quoted manuscript highlights that the prosthodontist should set up dentures according to the above mentioned principles. However, another important aspect mentioned in the referred manuscript is the holistic approach to creation of a beautiful smile by establishing harmony between the teeth, lip framework and the gingival scaffold. Since the objective of our study was to determine the impact of altered gingival characteristics, a smile with adequate gingival display was selected so as to be appreciated by the laypersons. I would also like to state that the reference mentioned is also of an article which focuses mainly on gingival scaffold and its alterations.
The reason that black buccal corridors were present in the images is not poor resolution but inadequate illumination, which could have been resolved with appropriate lighting, such as a ring flash. We have a limited armamentarium because of our government setup; however, use of a ring flash could have prevented this error. The camera used for this image was a digital single-lens reflex camera (D3100; Nikon, Tokyo, Japan) that captures an image size of 4608 × 3072 (large), 3456 × 2304 (medium), 2304 × 1536 (small) pixels and has a lens focal length of approximately 1.5 times. We used Photoshop (version CS2; Adobe Systems, San Jose, Calif) to manipulate the images. Coming over to the query about the software used, we would state that Other authors (eg, your references 4 and 5) used the same software, or maybe a different version, to manipulate the images. Our main objective was the gingival characteristics; hence, a smile in which these features could be morphed and appreciated was selected. The main essence of the study was the importance of the gingival characteristics rather than the smile arc or perfect photography. Even if it was not perfect, it did not create any bias in this study, since the smile was constant in all images with the only variable being the gingival characteristics. Thus, it could not have influenced the results.
We appreciate the input by readers and will consider these points for our future research.
∗ The viewpoints expressed are solely those of the author(s) and do not reflect those of the editor(s), publisher(s), or Association.