Esthetics and Smile Design Flashcards
how symmetrical are central’/ lateral incisors in reality
central; discrepancies of .2mm or less in 63% of the population (14% totally identical)
lateral incisors: differ significantly in size, shape, rotation and length!!!!!!!!!
esthetic ideal for profile of face: what are class i, ii, iii
class i: angle from chin to tip of nose is up and away= normal
class ii: convex
class III; concave face (chin sticks out)
phonetics; what do M, E, F, V, S sounds result in for teeth positioning
M = teeth at rest
E = maxillary incisal edge should be 1/2 way between upper and lower lip during this sound
F and V= maxillary incisors should touch wet-dry line of lower lip
S sound = lower incisors should be 1 mm below and 1mm behind maxillary incisal edge
round vs flat teeth what they do aesthetically
round: feminine, youthfull
flat : masculine, mature
what are the facial landmarks to consider for smiel design
facial midline, horizontal restorative plane
how much shift in positoning of midline is required to notice? what do we notice?
a dental midline shift of 4 mm IS NOT noitcable to the lay person!!!!
-its easier to detect deviations in dental midline angulation!
what is a commissure smile, how common is it?
67% of the population!!
-corners of the mouth are pulled up and outwards followed by the upper lip contracting to show the upper teeth.
what is a cuspid smile, what % of population
31% of population!
-levator labii superioris is dominant, exposing the canines first , followed by the corners of the mouth (kinda heart shaped..)
what is a complex smile? what % of pop
2% of population!
simultaneously exposing ALL of the upper and lower teeth!!!!
restorative challenge..
tissue display percentages : 1. gingiva showing (large amount) on maxilla teeth to molars, 2. just embrasures showing 3. NO gingiva showing on maxillary
- 32% of population
- 42% of population
- 26% of population
whats thin biotype? whats an issue with it regarding restorations
probe VISIBLE under gumline
tissue recedes more easily when irritated
-occurs in presence of PGMs or rough/open crown margins!!!
whats thick biotype?
thick band of attached gingiva. tissue is more resilient. tendency toward inflammation rather than recession
when would veneers be appropraite?
- teeth are RESISTANT to bleaching (whens that?!?!)
- require significant morphologic change (peg lateral)
- have lost extensive tooth structure
why should you be cautious about canine veneers
can appear overbulked, causing a dark buccal corridor behind them when smiling
what are alternative treatments to veneers?
- composite
- enameloplasty
- orthodontics
what records are needed for smile changes
- full photographic series; range of emotions
- high quality impressions
- current shade and patients desired shade
- kois dento facial analyzer for midline & horizontal restorative plane!
(photos, take alginates, mount models, wax up, duplicate cast)
wax up for smile design; rules, what should u never do
never take stone away. its additive only. if you must for misaligned teeth, use duplicate models !
what should you do after placing the smile design in a patients mouth
- clean excess from gingiva and embrasures with a tree top bur
- polish in the mouth
- show patient in mirror, adjust contour as needed until the patients happy
- if you make adjustments, capture changes with alginate impression (this will become new duplicate cast)
important time to establish what is and what is not possible
record photos with a range of movement/emotion (should be done with AND without try on)
