Esthetic 1 Quiz

Smile Design Analysis

Smile design follows a detailed analysis that includes facial, labial, gingival, and dental analysis.

Facial Analysis

Face Shape: Square, tapering, square tapering, or ovoid.
Lateral Profile: Convex, concave, or straight.
Facial Midline: An imaginary line located in the center of the face, drawn between the nasion, base of the philtrum, and chin. This should ideally align with the midline between the maxillary central incisors.
Interpupillary Line: Passes through the center of the pupil of each eye. This line should be perpendicular to the midline of the face and parallel to the incisal plane.

Labial Analysis

Lip Morphology: Evaluates the lip shape and size, which can vary significantly between individuals.
Lip Line: Refers to the position of the lower border of the upper lip during smiling.
- High Lip Line: 3-4 mm of gingiva exposed on smiling.
- Medium Lip Line: 1-2 mm of gingiva exposed on smiling.
- Low Lip Line: Only the edges of upper front teeth are visible on smiling.
Teeth Alignment and Position: Teeth should be aligned harmoniously. Misaligned or rotated teeth disrupt the arch form and may negatively influence the esthetics of the smile.

Dental Analysis

Dental Midline: An imaginary vertical line between the central incisors that ideally coincides and is parallel with the facial midline. It should also be perpendicular to the incisal plane. Minor discrepancies (1-2mm) are acceptable.
Incisal Edge Length, Position, and Display:
- Incisal edge position determined by the vermillion border of the lower lip, parallel to the interpupillary line, phonetics, and lower anterior teeth.
- Mandibular incisors establish occlusal contact with the maxillary incisors, positioned 1 mm behind and 1 mm below the edges of the maxillary teeth.
- Phonetic analysis, especially the "F" sound, is critical for positioning the upper incisal plane as air is compressed between the lower lip and the upper incisal edges during this sound.
- The “S” sound helps evaluate the upper teeth slightly overlapping the lower teeth.
- In a relaxed, slightly open mouth, approximately 3.5 mm of the incisal third of the maxillary central teeth should be visible in young individuals.
Smile Line: An imaginary line along the incisal edges of the maxillary anterior teeth that mimics the curvature of the superior border of the lower lip when smiling. A pleasing smile has a smile line that follows the convex curvature of the lower lip.
- Convex Smile Line
- Flat Convex Smile Line
- Reverse Smile Line
Teeth Color: The most noticeable element in smile creation.
- Hue: Color tone or color name.
- Chroma: The intensity or saturation of hue.
- Value: Relative darkness and lightness of color.
Teeth Alignment and Position: There should be a natural, progressive increase in the mesial axial inclination towards the mesial of each following anterior tooth (from the central to the canine). This inclination is least noticeable with the centrals and more pronounced with the laterals and canines.
Interproximal Contact Point: As a general rule, the interproximal contact point moves more apically as it goes posteriorly from the midline.
Incisal Embrasures: V-shaped spaces present interproximally around the proximal contact between adjacent teeth. Incisal embrasures should have a natural, progressive increase in size or depth from the central to the canine.

Esthetic Formula

This refers to the natural harmony between teeth, supporting bones of the jaws, and soft tissue of the face.
Components of esthetic formula:
- Basal Bones: Mandible and maxilla - provide the form and contour of the lower face, and foundation for lips, cheeks, and associated musculature.
- Musculature: Size and attachment of lips, especially the upper lip, are critical for the overall esthetic appearance.
- Teeth: The arrangement and appearance of teeth play a significant role in smile aesthetics.

Perception of Dental Esthetics

Patient perception of dental esthetics can be influenced by various factors including age, gender, socioeconomic status, and lifestyle.
Smile concepts are subjective and opinions can vary based on personal experience and professional expertise.

Digital Smile Design

This is a versatile conceptual tool that strengthens diagnostic vision, improves communication, and enhances predictability throughout treatment.
Digital Smile Design sketches are typically performed in presentation software like Keynote or Microsoft PowerPoint.

Key Points for Study

The key to a successful smile design is a comprehensive analysis of facial features, lip positioning, and teeth characteristics.
Understanding the relationship between the basal bones, musculature, and teeth is crucial for achieving an esthetically pleasing smile.
Individual preferences and unique anatomy should be considered during smile design planning.
Digital tools can significantly enhance the communication and visualization process for both patients and dentists.