esthetics Flashcards
what aspects of a patients smile might they want to improve
1) color, shape, spacing, crowding
golden proportions
1) ratio of the smaller piece to larger piece : larger piece to the original string
2) ratio is 1.618
3) width of canine: lateral
- lateral: central
4) width to height is also golden ratio
symmetry
1) central incisors
- discrepancies of 0.2 mm or less in 63% of population
- 14% are totally identical
2) lateral incisors differ significantly in size, shape, rotation, and length
why do we leave enamel
1) enamel bonding is the best
2) flexure of the tooth
- delamination
3) implant cycle
- when recurrent decay causes larger and larger restorations => eventually needs implant => eventually this fails
- the moment you touch the tooth with the bur, you have set it on the path for extraction
phonetics
1) maxillary incisor should touch the wet white dry line of lower lip
round
1) feminine
2) youthful
flat
1) masculine
2) mature
ideal isnt everything
1) some people do not want to meet your ideal standards
esthetic case workflow
1) SOAP
2) records
3) simulated smile design
what is the chief concern
1) crowding
2) spacing
3) color
facial midline
1) ideally bisects the face
2) passes through nose, philtrum, and chin
dental midline
1) parallel to facial midline and as close to it as possible
a dental midline shift of 4 mm
isnt noticeable to lay person
a dental midline angulation
1) easier to detect
commisure
1) the corners are pulled first
2) 67%
cuspid smile
1) exposes canine first
2) 31%
complex smile
1) 2%
2) simultaneously exposing both top and bottom rows
tissue display
1) 32%
- high smile line
2) 42%
- gingival zenith
3) 26%
- lips fall over the gums
thin gingival phenotype
1) tissue recedes easily when irritated
2) occurs in presence of PFMs and rough open crown margins
3) probe visible under gumline
thick phenotype
1) thick band of attached gingiva
2) tissue is more resilient
3) inflammation over recession
are veneers indicated
1) when teeth are resistant to bleaching
2) tooth size discrepancy
3) peg lateral
4) loss of extensive tooth structure
5) morphological change
bioclear
1) just composite
2) system of matrices
- clear plastic
- have to buy many
3) works great for filling in embrasures
4) more affordable, no lab fee
5) minimally invasive
6) ceramic tends to chip over time
7) staining on margins
how many veneers
1) what about 6
- proceed with caution
- canines can be overbulked
- cause dark buccal corridor
2) usually 4 or 8 is better
if there is diastema but nice shaped teeth
1) orthodontics / invisalign
2) free whitening
what if they only have front teeth?
1) no veneers! too much flexure and force
2) implants, partial denture first
business in the back party in the front
1) need to have strong occlusion in the back and aesthetics in the front
short teeth
1) not good for crowns or veneers
2) occlusion can be an issue
- lost interocclusal space
- compensatory supraeruption
3) need to intrude lower anteriors orthodontically and create some space
- then restore
record
1) full photographic series
2) high quality impressions
3) horizontal plane
