ON FINAL: Esthetic Principles for Fixed Prosthodontics Flashcards
What does esthetics refer to?
-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
What do you consider for facial esthetics?
- Occlusal Vertical Dimension
- Facial lower 1/3
- Lip Support
— Rickett’s “E” plane
— Nasolabial Angle
What do you consider for Dentofacial esthetics?
- Smile Analysis
- Anterior Tooth Display
- Dental Midline
- Occlusal Plan
What do you consider for Dentofacial esthetics?
- Width:Height proportion
- Tooth:Tooth Proportion
- Gingiva
— Papilla height
— Zeinth positions - Embrasures
- Tooth Long axis
What is the width corresponding to the canines?
canine width
What “should” line up down the front of the face?
inner canthus, ala of nose, canine position
What is the rickett’s E plane?
Fundamentally the “E” plane is 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 ____ mm behind the line, and the upper lip ____ mm behind the line
2 mm
4mm
An example of how the “E” plane would be used is a patient with significant ________ of both upper and lower arches.
crowding
If 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.
If the lips in profile were on or in front of the “E” plane, the decision would be…
extraction and anterior retraction
What is the nasolabial angle?
- Greater than 90 degrees = Convex
- Less than 90 degrees = Concav
What are the width/height ratios of the central incisors?
-Ideal width 8.5 - 9.0mm
-Ideal height 10.5 – 11mm
A “pleasing” relationship between width and height (length) is between ________%
Width divided by height (length)
75% - 85%
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 width, you can determine the most esthetic length.
Ideally, there is a slight ____________ of the long axis of the teeth toward the midline
inclination
Lingual inclination of posterior teeth can create “negative space” creating a noticeable and unesthetic space or lack of space when a person smiles. This is called the…
buccal corridor
Interproximal contacts are situated more ___________ from anterior to posterior
cervically
Embrasures become _______ from anterior to posterior
larger
Contact dimension between:
Central’s
Centrals and Laterals
Laterals and Canines
50:40:30 Rule
Most gingival papilla proportions are around ___% of the tooth length.
40%
Gingival zenith of central incisors and canines are in a line parallel to the…
interpupillary line
Zenith of Centrals are _______ to tooth vertical midline
distal
Zenith of Laterals are _______ to tooth vertical midline
distal
Zenith of Canines are ________ with vertical midline.
in line
What is the golden proportion?
not as important to know… we don’t use it much anymore
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
3 Common mistakes made when replacing maxillary anterior teeth:
- Flat facial aspect of the central incisors
- Lateral incisor is too wide OR Lateral incisor is too narrow
- Flat incisal plane
How would you go about crowning these three teeth with ideal esthetics?
use ortho to bring the lateral into a more ideal position… then crown them
In analyzing a person’s smile, there are some characteristics we examine:
- ”Smile Line”
- 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.
What is all included in a smile analysis?
- Overall length of maxillary teeth are displayed
- Interproximal gingiva shows
- Incisal curvature parallels the lip curvature
- Incisal curvature totally or slightly touches lower lip (within 2mm)
- 6 Maxillary anterior and 2nd premolars are displayed
- Maxillary midline coincides with a harmonious balance of smile.
What is the incisal curve/smile line?
- Incisal edges of the maxillary anterior teeth should parallel the inner curvature of the lower lip and interpupillary line
Incisal curve touches the lower lip or within __ mm
2
____% of young people show entire length of central incisors
80
Low Lip Line– Less than ___% incisors showing with no gingival display
75
Women have high smile line ______ as often as men
twice
What is another name for maxillary excessive gingival display?
”Gummy Smile”
What are the reasons for maxillary excessive gingival display (gummy smile)?
- Hyperactive lip
- Vertical Maxillary Excess
- Altered Passive Eruption
- Dentoalveolar Extrusion
What is vertical maxillary excess?
- Maxilla height is higher than normal
- This is a skeletal issue
What is dentoalveolar extrusion?
-over eruption of gingiva and bone due conditions like tooth wear
What is altered passive eruption?
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
What should be the length of maxillary anterior display at rest in females and males?
- average of 3.5mm exposed in females
- average of 2.0mm exposed in male
What should be the length of maxillary anterior display at rest in younger versus older people?
- Younger person average 3.4mm
- Older person average 1.25mm
Where are the F and V sounds come from?
Inner edge of vermillion border (wet dry line)
- Area used to determine position of incisal 1/3 of anterior maxillary incisors
Where are the S sounds come from?
Mandibular incisal edge is 1mm behind and below maxillary incisal edge
-Used to determine vertical dimension of speech
What is the dental midline?
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
A maxillary midline deviation of __mm was necessary before orthodontists rated it significantly less esthetic than the others.
4mm
Orthodontists, General Dentists, and even lay people could identify a ____mm discrepancy in crown angulation.
2
What is campers line?
A plane extending from the inferior border of the ala of the nose to the inferior point on the border of the tragus
True/false
The dental occlusal plane typically coincides with Camper’s plane
True
If only relying on facebow to gauge incisal plane, a cant can be created due to the asymmetry of the external auditory meati. ___________________ is a better reference for incisal plane.
Interpupillary line
What are the characteristics of 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 distal in the arch, the less noticeable they become.
-To treat a diastema, consider ___________ as a conservative treatment first.
orthodontic movement
Leaving a diastema is a…
personal preference
- Some want it gone, others consider it special
to their personality
