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Fixed Prostodontics 2 > Esthetics > Flashcards

Esthetics Flashcards

1
Q

Aethetics vs Esthetics – Same word, same term. Like color vs colour
Refers to:
(3)

A

-The philosophy study of beauty and taste
-The perception of the beautiful in nature and art
-Relating to the study of the principles of beauty

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2
Q

Aethetics vs Esthetics
3 Main Categories:
(3)

A

-Facial Esthetics
-DentoFacial Esthetics
-Dental Esthetics

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3
Q

Facial Esthetics:
(3)

A

-Occlusal Vertical Dimension
-Facial lower 1/3
-Lip Support

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4
Q

-Lip Support
(2)

A

-Rickett’s “E” plane
-Nasolabial Angle

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5
Q

Dental Esthetics:
(5)

A

-Width:Height proportion
-Tooth:Tooth Proportion
-Gingiva
-Embrasures
-Tooth Long axis

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6
Q

-Gingiva
(2)

A

-Papilla height
-Zeinth positions

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7
Q

DentoFacial Esthetics:
(4)

A

-Smile Analysis
-Anterior Tooth Display
-Dental Midline
-Occlusal Plane

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8
Q

Esthetics –
Proportions Inner Canthus / Ala of nose / Canine Position
Width corresponds to

A

canine
-Canine width

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9
Q

Esthetics – Lip Support –

A

Rickett’s E Plane
Fundamentally the “E” planeis simply a line drawn from the tip of
the nose to the tip of the chin. The key assessment was to look
at how the upper and lower lip related to that line.
Dr. Ricketts felt that to have a pleasing facial profile, in the average
Caucasian face, the lower lip would be 2 mm behind the line,
and the upper lip 4 mm behind the line, with variations being
normal for patients of different ethnic backgrounds, but with
some commonalities applying to all patients.
Those commonalities would be that the closer to the “E” plane the
lips are, in some cases even being anterior to the plane, the lips
and teeth will dominate the smile with the nose and chin
appearing weak. And the farther behind the plane the lips are,
the more likely the nose and chin will dominate the smile.
The key was to evaluate the “E” plane relationship prior to
performing orthodontic treatment.

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10
Q

An example of how the “E” planewould be used is a patient with significant crowding of both upper and lower arches.

A

The clinician must decide whether to consider extracting teeth, such as first premolars or expanding the arch. If the lips in profile
were on or in front of the “E” plane, the decision would be extraction and anterior retraction, improving the lip to “E” plane
relationship.
If on the other hand the lower lip is 6 mm behind the “E” plane, the decision would be to align the teeth and expand the arch,
moving the anterior teeth and lips.

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11
Q

Lip Support:
-Nasolabial Angle
-Greater than 90 degrees =
-Less than 90 degrees =

A

Convex
Concave

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12
Q

Esthetics – Dental Esthetics
-Smile Analysis
Proportions of Central Incisors
-Width to Height Ratio
-Ideal width —
-Ideal height —
-A “pleasing” relationship between width
and height (length) is between —
-Width divided by height (length).

A

8.5 - 9.0mm
10.5 – 11mm
75% - 85%.

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13
Q

So, when length has been lost, how
might you determine what an
esthetic length needs to be if you are
crowning these anterior teeth?
Knowing the —, you can
determine the most esthetic length.
What other factors are here that will
impact your length decision?
(4)

A

width

-wear, posterior occlusal support,
protrusive, canine guidance

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14
Q

Inclination

A

Ideally, there is a slight inclination of the
long axis of the teeth toward the midline.
The incisal and occlusal segments of the
facial surfaces have lingual inclincation
-This is why we have bi-planar facial
reduction for crown preparations.

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15
Q

Inclination – Buccal Corridor

A

-Lingual inclination of posterior teeth can create “negative space” creating a noticeable and
unesthetic space or lack of space when a person smiles.

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16
Q

Interproximal Contacts and
Embrasures
-Interproximal contacts are situated more
— from anterior to posterior
-Embrasures become — from anterior to
posterior

A

cervically
larger

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17
Q

-50:40:30 Rule –

A

Contact dimension between:
Central’s,
Centrals and Laterals,
Laterals and Canines

18
Q

Embrasures
-Most gingival papilla proportions are around —% of the tooth length.
-Shape of the teeth can impact embrasure and papilla height.

A

40

19
Q

Gingival Zenith
(4)

A

-Gingival zenith of central incisors and
canines are in a line parallel to
interpupillary line
Zenith of Centrals are distal to tooth
vertical midline
Zenith of Laterals are distal to tooth
vertical midline
Zenith of Canines are in line with vertical
midline.

20
Q

Golden Proportion

A

A comparative ratio used to determine
sizes of maxillary anterior teeth.
Central = 9mm
Lateral - 9 x 0.618 = 5.56mm
Canine – 5.56 x 0.618 = 3.44mm
Frame of reference used for many
years, but is not perfect….

21
Q

Esthetics – Dental Esthetics
-Smile Analysis
Alternative Tooth Proportion Ratio
Central = –%
Lateral = –% of Central
Canine = –% of Lateral
Central Incisor is –% Width to Length

A

100
65
85
79

Patients present with unique dentition.
Having a ratio to gauge sizes is very
helpful to determine how large ideal
crowns from 6-11 need to be. Or if
missing a lateral, how large would it
be ideally if replaced?

22
Q

Esthetics – Dental Esthetics
-Smile Analysis
3 Common mistakes made when replacing
maxillary anterior teeth:

A

-Flat facial aspect of the central incisors
-Lateral incisor is too wide OR Lateral incisor is too
narrow
-Flat incisal plane
**If centrals are widened, they will most likely need to
be elongated for proportion.

23
Q

In analyzing a person’s smile, there are some
characteristics we examine:
(4)

A

-”Smile Line”
-Can be High, Average, Low
-Parallelism of maxillary incisal curve with lower lip
-Position of the incisal curve relative to touching
the lower lip
-The number of teeth displayed in the smile.

24
Q

Smile Analysis:
-Overall — are displayed
- — shows
-Incisal curvature parallels the
-Incisal curvature totally or slightly
—- are displayed
-Maxillary — coincides with a harmonious balance of smile.
Research reveals these are keys to what the average person
(and dental professionals) deem as esthetic qualities of a smile.

A

length of maxillary teeth
Interproximal gingiva
lip curvature
touches lower lip (within 2mm)
6 Maxillary anterior and 2nd premolars
midline

25
Q

Incisal Curve (Smile line)
(3)

A

-Incisal edges of the maxillary anterior teeth
-Parallels the inner curvature of the lower lip and
interpupillary line
-Perpendicular to the facial/dental midline

26
Q

Incisal Curve: Incisal Edge Position
(4)

A

-Central incisors and canines lie on the same
curved line
-Incisal edges of laterals are 1.0mm short of this
line
-Follows curve of lower lip
-Incisal curve touches the lower lip
-or within 2mm

27
Q

Maxillary Anterior Display
-Full smile –
—% of young people show entire length of
central incisors
**Can you see why some older folks come to the
dentist to “look younger”?
-Low Lip Line–
- – have high smile line twice as often as —

A

lip moves to incisor tooth-gingiva
interface
80
Less than 75% incisors showing with no
gingival display
Women, men

28
Q

Maxillary Anterior Display
-Maxillary Excessive Gingival Display
-”Gummy Smile”
-Many reasons for this
(4)

A

-Hyperactive lip
-Vertical Maxillary Excess
-Altered Passive Eruption
-Dentoalveolar Extrusion

29
Q

Excessive Maxillary Display
-HyperActive Lip
(2)

A

-Normal movement ~ 6-8mm
-Hyperactive ~ up to 2 times that movement

30
Q

Excessive Maxillary Display
-Vertical Maxillary Excess
(2)

A

-Maxilla height is higher than normal
-This is a skeletal issue

31
Q

Dentoalveolar extrusion

A

-over eruption of gingiva and bone due
conditions like tooth wear

32
Q

Altered Passive Eruption

A

-a condition in which the free gingival
margin fails to recede during tooth
eruption to a level apical to the cervical
convexity of the clinical crown.

33
Q

Maxillary Anterior Display
-Length of Maxillary incisor exposed when at rest
-average of – exposed in females
-average of – exposed in males
-Younger person average –
-Older person average –

A

3.5mm
2.0mm
3.4mm
1.25mm

34
Q

F” and “V” –

A

Inner edge of vermillion border (wet-
dry line)
-Area used to determine position of incisal 1/3
of anterior maxillary incisors

35
Q

”S” –

A

Mandibular incisal edge is 1mm behind and
below maxillary incisal edge
-Used to determine vertical dimension of
speech

36
Q

Dental Midline
(2)

A

The maxillary midline coincides with the facial
midline and is perpendicular to the
interpupillary line.
Ideally, matching maxillary midline to mandibular
midline is preferred but not always possible.

37
Q

Dental Midline
-Orthodontists, General Dentists, and
even lay people could identify a –
discrepancy in crown –.

-A maxillary midline deviation of – mm was
necessary before orthodontists rated it
significantly less esthetic than the others.
-However, general dentists and lay people were
less likely to call a – mm deviation unesthetic.

A

2mm
angulation

4

38
Q

Occlusal Plane
-Camper’s line –

A

A plane extending from the inferior
border of the ala of the nose to the inferior point on
the border of the tragus
-The dental occlusal plane typically coincides with
Camper’s plane.

39
Q

Interpupillary line
– reference line for

A

incisal plane

40
Q

Interpupillary Line and Incisal Edge
-If only relying on facebow to gauge
incisal plane,

A

a cant can be created
due to the asymmetry of the external
auditory meati. Interpupillary line is a
better reference for incisal plane.

41
Q

Radiating Symmetry
-Teeth have unique shapes and differ
from person to person.
-From the midline, left and right sides
should mirror each other.
-If there are variations, the more — in
the arch, the less noticeable they
become.
-If there are spaces between the anterior
teeth, if you restore 6-11, leaving
spaces distal to — will be less
noticeable than spaces around —. How about some ortho first?

A

distal
6 and 11
8 and 9

42
Q

Radiating Symmetry – Diastema
-Leaving a diastema is personal preference.
Some want it gone, others consider it special
to their personality.
-To treat a diastema, consider orthodontic
movement as a conservative treatment first.
-If fixed restorations are your patients choice to
fill in proportions esthetically, extra space
can be left over when achieving correct
esthetic proportions. Any left over space
hidden behind the — is usually not
noticeable.
-A wax up will be very beneficial here to help
visualize the final crown shapes.

A

canines

Fixed Prostodontics 2 (13 decks)

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