Dental perspective / cosmetic dentistry course

DENTAL PERSPECTIVEDENTAL PERSPECTIVE
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com

ContentsContents
 IntroductionIntroduction
 Classification of smileClassification of smile
 components of smilecomponents of smile
 various dental componentsvarious dental components
 SummarySummary
 ReferencesReferences

INTRODUCTIONINTRODUCTION
 The word ‘esthetics’ comes from the Greek wordThe word ‘esthetics’ comes from the Greek word
‘aistheticos’ meaning of ‘sense perception’ .‘aistheticos’ meaning of ‘sense perception’ .
 ““Esthetics is a branch of philosophy dealing withEsthetics is a branch of philosophy dealing with
beauty and beautiful, especially with judgment ofbeauty and beautiful, especially with judgment of
taste concerning them”.taste concerning them”.

 The art of esthetic dentistry can be defined as theThe art of esthetic dentistry can be defined as the
creation of beauty in form and function of thecreation of beauty in form and function of the
orofacial complex.orofacial complex.
 The role of prosthodontist in carving an aestheticallyThe role of prosthodontist in carving an aesthetically
pleasing smile is exceptionally important owing topleasing smile is exceptionally important owing to
the rehabilitative treatment procedures he is expertisethe rehabilitative treatment procedures he is expertise
in.in.

Classification of a smileClassification of a smile
 The Commissure smile (67%)The Commissure smile (67%)
 The Cuspid smile (31%)The Cuspid smile (31%)
 Complex smile (2%)Complex smile (2%)

Components of a smileComponents of a smile
 Facial componentsFacial components
 Dental componentsDental components
 Gingival componentsGingival components
 Physical componentsPhysical components

Dental componentsDental components
 MidlineMidline
 Incisal edgesIncisal edges
 Incisal embrasuresIncisal embrasures
 Contact points / connectorsContact points / connectors
 Axial inclinationAxial inclination
 Tooth ratioTooth ratio
 Tooth textureTooth texture
 Tooth formTooth form
 GradationGradation
 Shade progressionShade progression

MidlineMidline
 Facial midlineFacial midline
 Canted midlineCanted midline

Incisal edgesIncisal edges
 General contourGeneral contour
 Inter – incisal angleInter – incisal angle
 ThicknessThickness

General contourGeneral contour
 Incisal edges of mandibular teeth, which are often leftIncisal edges of mandibular teeth, which are often left
intact and can provide significant assistance inintact and can provide significant assistance in
configuring maxillary teeth.configuring maxillary teeth.

Inter incisal anglesInter incisal angles
 Mesioincisal andMesioincisal and
distoincisal angles have adistoincisal angles have a
great influence on thegreat influence on the
definition of the so-calleddefinition of the so-called
negative spacenegative space
 used to create illusiveused to create illusive
effects of dimensioneffects of dimension

ThicknessThickness
 Esthetically pleasingEsthetically pleasing
incisors display a thinincisors display a thin
and delicate edge.and delicate edge.
 Thick incisal edges canThick incisal edges can
make teeth look old,make teeth look old,
artificial, and bulky.artificial, and bulky.

Incisal embrasuresIncisal embrasures
 The pattern of silhouettingThe pattern of silhouetting
created by the edges andcreated by the edges and
separations between theseparations between the
maxillary anterior teethmaxillary anterior teeth
against the darker backgroundagainst the darker background
of the mouth helps define aof the mouth helps define a
good-looking smile .good-looking smile .
 The size and volume of theThe size and volume of the
incisal embrasures betweenincisal embrasures between
teeth increase as the dentitionteeth increase as the dentition
progresses away from theprogresses away from the
midlinemidline www.indiandentalacademy.comwww.indiandentalacademy.com

Contact points / connectorsContact points / connectors
 The contact points – 2x2mmThe contact points – 2x2mm
 Marked by passingMarked by passing
articulating ribbonarticulating ribbon
 The connector zoneThe connector zone
 50-40-30 rule50-40-30 rule

Axial inclinationAxial inclination
 follows a progression asfollows a progression as
the teeth move awaythe teeth move away
from the midline.from the midline.

Tooth ratioTooth ratio
 Due to individualDue to individual
variations and proximal/variations and proximal/
incisal tooth wear, it isincisal tooth wear, it is
difficult to providedifficult to provide
adequate tooth ratio.adequate tooth ratio.
 Golden proportion-Golden proportion-
lombardilombardi
 Preston’s studyPreston’s study

 Sterrett’s studySterrett’s study
 Crown width/length ratios of incisors and canines areCrown width/length ratios of incisors and canines are
identical (range 77% to 86%).identical (range 77% to 86%).
 Central incisors are wider than lateral incisors by about 2Central incisors are wider than lateral incisors by about 2
to 3 mm.to 3 mm.
 Central incisors are wider than canines by about 1 to 1.5Central incisors are wider than canines by about 1 to 1.5
mm.mm.
 Canines are wider than lateral incisors by about 1 to 1.5Canines are wider than lateral incisors by about 1 to 1.5
mm.mm.
 Central incisors and canines have similar crown heightsCentral incisors and canines have similar crown heights
(variation of only about 0 . 5 mm), an average of 1 to 1.5(variation of only about 0 . 5 mm), an average of 1 to 1.5
mm longer than lateral incisors.mm longer than lateral incisors.www.indiandentalacademy.comwww.indiandentalacademy.com

Tooth textureTooth texture
 Texture diminishes with age,Texture diminishes with age,
resulting in decreased lightresulting in decreased light
reflection and darker teeth.reflection and darker teeth.
 The horizontal component VsThe horizontal component Vs
vertical componentvertical component
 Reproduction of surface detailsReproduction of surface details
in restorative dentistry.in restorative dentistry.
 Surface texture andSurface texture and
morphology can also be used tomorphology can also be used to
generate illusive effects of sizegenerate illusive effects of size

Tooth formTooth form
 Central incisorsCentral incisors

Three main typal tooth forms.Three main typal tooth forms.
 Square: Straight outline withSquare: Straight outline with
marked and parallel transition linemarked and parallel transition line
angles and lobes.angles and lobes.
 Ovoid : Rounded outline withOvoid : Rounded outline with
smooth transition line angles (nosmooth transition line angles (no
lobes) showing incisal and cervicallobes) showing incisal and cervical
convergence ("barrel" shape).convergence ("barrel" shape).
 Triangular : Straight outline withTriangular : Straight outline with
marked transition line angles andmarked transition line angles and
lobes showing cervicallobes showing cervical
convergence (distinct inclination ofconvergence (distinct inclination of
the distal outline).the distal outline).

Lateral incisorsLateral incisors
 peg-shaped lateral incisors,peg-shaped lateral incisors,
anomalies such as a pointedanomalies such as a pointed
tubercle and a deeptubercle and a deep
develop-mental groovedevelop-mental groove
extending lingually downextending lingually down
the root.the root.

CaninesCanines

GradationGradation
 When similar structuresWhen similar structures
are aligned in an archare aligned in an arch
form one after the otherform one after the other
they appear tothey appear to
progressively abate inprogressively abate in
size from the nearest tosize from the nearest to
the farthest. This givesthe farthest. This gives
an illusion of depth.an illusion of depth.

Shade progressionShade progression

Dental CompositionDental Composition
 the size, shape, and intra and interarch relationshipsthe size, shape, and intra and interarch relationships
 Tooth size is determined by measuring the incisogingival length andTooth size is determined by measuring the incisogingival length and
dividing it by its mesiodistal width.dividing it by its mesiodistal width.
 Researchers have attempted to geometrically link the width of race,Researchers have attempted to geometrically link the width of race,
gender, bizygomatic width, and size of the face.gender, bizygomatic width, and size of the face.
 Rufenacht has proposed morphopsychological determination of theRufenacht has proposed morphopsychological determination of the
ideal proportion and has suggested that the width of the centralideal proportion and has suggested that the width of the central
incisor should be considered constant throughout life.incisor should be considered constant throughout life.

 The width/length ratio of the central incisor shouldThe width/length ratio of the central incisor should
range from 0.75 to 0.8range from 0.75 to 0.8
 lower values create a long narrow tooth, while valueslower values create a long narrow tooth, while values
greater than this range result in a short wide tooth.greater than this range result in a short wide tooth.
 Other factors to determine the tooth dimension .Other factors to determine the tooth dimension .
 If no records are available, age, sex, race, andIf no records are available, age, sex, race, and
personality should be considered.personality should be considered.

Golden proportionGolden proportion
 beauty as an exactbeauty as an exact
mathematical conceptmathematical concept
 This led Pythagoras toThis led Pythagoras to
conceive the Goldenconceive the Golden
Proportion (1/1.618 =Proportion (1/1.618 =
0.618), and Plato, the0.618), and Plato, the
Beautiful ProportionBeautiful Proportion
(1/1.733 = 0.577).(1/1.733 = 0.577).
 S/L = L/(S + L) = 2/(1 +S/L = L/(S + L) = 2/(1 +
5) = 0.6185) = 0.618

CONCLUSIONCONCLUSION
 Dentistry is an ever changing science. As newDentistry is an ever changing science. As new
research and clinical experience broaden ourresearch and clinical experience broaden our
knowledge, changes in treatment are required. Thisknowledge, changes in treatment are required. This
paradigm shift in the field of dentistry comes alongparadigm shift in the field of dentistry comes along
just in time to meet the final needs and wants ofjust in time to meet the final needs and wants of
patient who perceives an attractive smile no longer aspatient who perceives an attractive smile no longer as
a luxury but rather a necessary part of their life style.a luxury but rather a necessary part of their life style.

 While there is no shortcut to success or secretWhile there is no shortcut to success or secret
formula, practical application of the aestheticformula, practical application of the aesthetic
principles can achieve a successful prosthodonticprinciples can achieve a successful prosthodontic
result, gratifying to both patient and practitioner.result, gratifying to both patient and practitioner.

ReferencesReferences
 1) Goldstein, RE: Change your Smile, ed 3 Chicago,1) Goldstein, RE: Change your Smile, ed 3 Chicago,
Quintessence, 1997.Quintessence, 1997.
 2) David A. Garber : The edentulous ridge in fixed2) David A. Garber : The edentulous ridge in fixed
prosthodontics.prosthodontics.
 3) Robert Rifkin : Facial analysis: a comprehensive3) Robert Rifkin : Facial analysis: a comprehensive
approach in treatment planning in aesthetic dentistry :approach in treatment planning in aesthetic dentistry :
Pract Periodont Aesthet Dent 2000;12(9):865-871Pract Periodont Aesthet Dent 2000;12(9):865-871
 4) Irfan Ahmad : Geometric consideration in anterior4) Irfan Ahmad : Geometric consideration in anterior
dental aesthetics. Pract Periodont Aesthet Dentdental aesthetics. Pract Periodont Aesthet Dent
1998;10(7):813-8221998;10(7):813-822www.indiandentalacademy.comwww.indiandentalacademy.com

 Esthetic dentistry- an artist’s science;Esthetic dentistry- an artist’s science;
Ratnadeep patil.Ratnadeep patil.
 Anterior dental aestheics; dental perspective;Anterior dental aestheics; dental perspective;
Ahmed, BDJ;199;2;july 2005.Ahmed, BDJ;199;2;july 2005.

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