smile esthetics Flashcards by Caleb Houghton

Data Collection for smile analysis

Preclinical interview
Intra-oral photography
Diagnostic casts with facebow transfer
Comprehensive dental exam
*Esthetic analysis

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Esthetic Analysis components

Facial symmetry
Smile symmetry
Occlusion
Tooth shape and color

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Facial Symmetry components

Inter-pupillary line
Midline axis
Commissural line
Occlusal plane line

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interpupillary line

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Midline axis:

Cupid’s Bow and philtrum are used as the anatomic midline for MA in esthetic dentistry

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IPL and midline axis

ideally perpendicular, may not be in some cases

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Dental Midline:
 Refers to?
 Ideally, it should be coincident with?
 Not noticeable by most people up to?
 Max. and Mand. Dental midlines DO NOT coincide in about what % cases?
 Canted dental midline?

 Refers to the vertical contact interface between two maxillary centrals
 Ideally, it should be coincident with facial MA.
 Not noticeable by most people up to 4 mm as long as it is parallel to MA
 Max. and Mand. Dental midlines DO NOT coincide in about 75% of the cases
 Canted dental midline is more esthetically unpleasant and more noticeable than shifted midline

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Commissural line

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occlusal plane

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occlusal plane and commissural line

ideally parallel

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asymmetric commisural plane

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how can we show lab the IPL

Use of Bite stick and Regisil for anterior
restorations to show lab IPL

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Smile symmetry components

 Smile line
 Buccal corridor
 Tooth reveal
 Gingival height and position

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smile line

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Smile line influences the final configuration of:

The incisal edge position
Crown form
Length of the maxillary anterior teeth

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Acceptable results occur with smile line when :

The maxillary incisal edges are parallel to the line of the lower lip,
The lateral incisors 0.5 mm to 1.5 mm above the lower lip line,
The centrals and cuspids will approximate the lower lip near or at the vermillion border (wet-dry junction)

smile line shape?

straight

unesthtic smile line shape?

reversed/concave

Buccal Corridor:

The buccal corridor is the area distal to the canines between the buccal surfaces of the posterior teeth
and the buccal mucosa. It enhances or detracts from symmetry

The following factors are assessed for buccal corridor:

Negative space (max arch form vs smile width)
Canine prominence
Value/color of premolars
Position of premolars
Tone of facial muscles

Tooth reveal:

evaluation of upper lip line, lip movement (hyper- vs. hypo-mobile) and position (high vs. low) and its effect on tooth exposure
* Line connecting papillae will ideally follow upper lip contour
* Exposed tooth at rest can impact perceived age…youthful shows 2-4 mm of central; mature 2 mm or less. Females show more tooth at rest than males.

Lip Line:

Lip line is defined as the amount of vertical tooth exposure in smiling—in other words, the height of the upper lip relative to the maxillary central
incisors

Lip line amounts

Normal (≥75% of central incisors – 2 mm of gingival display)
Low (<75% of central incisor display during smiling)
High (≥3 mm of gingival display during smiling)

low lip line

lip line and smile line?

not the same

Upper Lip Form

 Refers to the curvature of the upper lip during smiling.  Assessed by the position of the philtrum in relation to the commissural line.

Gingiva role?

Gingiva frames the teeth to create a smile like a piece of art is surrounded by a beautiful frame

Gingival height and position:  The gingival zenith of the centrals should be? and equal to?  The gingival zenith of the laterals should be equal to or slightly incisal to?  Zenith points are usually slightly ?

 The gingival zenith of the centrals should be symmetrical to one another and relatively equal in height to the canines.  The gingival zenith of the laterals should be equal to or slightly incisal to the central incisor gingival level.  Zenith points are usually slightly lateral to midline axis of the tooth.

CI zeniths

Occlusion  Guidance:  Parafunctional habits:  Location of occlusal contacts:

 Guidance: Anterior or group function; shallow vs. deep.  Parafunctional habits: Consider soft or hard appliances.  Location of occlusal contacts: Class III, deep bite, open bite, or cross bite (ant. and post.

Tooth shape:  Size and proportions  Tooth form  Texture and surface

 Size and proportions-large vs. small and tall vs. short teeth; width to length proportions within the same tooth or among adjacent teeth.  Tooth form-square, ovoid, tapered, or combinations.  Texture and surface characteristics-smooth vs. textured

tooth forms based on age, sex, and personality

Width-to-length proportion of max CI.

- CI is 2-3 mm wider than LI - CI is 1-1.5 mm wider than canines - CI and canine touch OP while LI is 0.5-1 mm shorter giving the characteristic “Gull” shape of the incisal edges of anterior teeth

Color components

Value Chroma Hue

Value

grey scale or brightness: Example: Vita Classic * Light to dark = B1 to C4 Example: Vitapan 3D

Chroma

saturation or intensity Note difference in age: * Mature patient-high saturation * Young patient-low saturation

Hue

gradation or variety of a color * not a big factor in dentistry although can be affected by colors from lipstick etc. * Generally three hues: A, B, D (Vitapan 3D: L, M, R) in USA with more C category in Europe