Elements of smile design

Question 1

Data Collection
(5)

Answer 1

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

Question 2

Esthetic Analysis
(4)

Answer 2

• Facial symmetry
• Smile symmetry
• Occlusion
• Tooth shape and color

Question 3

Facial Symmetry
(4)

Answer 3

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

Question 4

Midline axis:

Answer 4

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

Question 5

Dental Midline:
 Refers to the …
 Ideally, it should be coincident with —
 Not noticeable by most people up to – as long
as it is parallel to MA (Kokich et al, 1999).
 Max. and Mand. Dental midlines DO NOT coincide
in about –% of the cases (Bhuvaneswaran, 2010).
 — dental midline is more esthetically
unpleasant and more noticeable than shifted
midline (Kokich et al, 1999).

Answer 5

vertical contact interface between two maxillary centrals
facial MA
4 mm
75
Canted

Question 6

Use of (2) for anterior
restorations to show lab IPL

Answer 6

Bite stick and Regisil

Question 7

Esthetic Analysis
(4)

Answer 7

*Facial symmetry
*Smile symmetry
*Occlusion
*Tooth shape and color

Question 8

Smile symmetry
(4)

Answer 8

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

Question 9

Smile line:
Smile line influences the final configuration of:
(3)

Answer 9

1. The incisal edge position
2. Crown form
3. Length of the maxillary anterior teeth

Question 10

Smile line:
Acceptable results occur when:
(3)

Answer 10

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

Question 11

Buccal Corridor:

Answer 11

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.

Question 12

Buccal Corridor:
The following factors are assessed:
(5)

Answer 12

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

Question 13

Tooth reveal:
evaluation of (3) and its effect on tooth
exposure

Answer 13

upper lip line,
lip movement (hyper- vs. hypo-mobile) and
position (high vs. low)

Question 14

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 — will ideally follow
upper lip contour
* Exposed tooth at rest can impact perceived
age…youthful shows – mm of centrals;
mature – mm or less. — show more
tooth at rest than —.

Answer 14

papillae
2-4
2
Females, males

Question 15

Lip Line:

Answer 15

• 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 (Sabri R, 2005).

Question 16

Lip line can be:
1. Normal
2. Low
3. High

Answer 16

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

Question 17

Upper Lip Form
 Refers to
 Assessed by the position of the

Answer 17

the curvature of the upper lip during smiling.
philtrum in relation to the
commissural line

Question 18

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

Answer 18

Gingiva

Question 19

Gingival height and position:
(3)

Answer 19

 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.

Question 20

Occlusion
 Guidance:

Answer 20

Anterior or group function;
shallow vs. deep.

Question 21

 Parafunctional habits:

Answer 21

Consider soft or hard
appliances.

Question 22

 Location of occlusal contacts:

Answer 22

Class III, deep
bite, open bite, or cross bite (ant. and post.).

Question 23

 Size and proportions-

Answer 23

large vs. small and tall
vs. short teeth; width to length proportions
within the same tooth or among adjacent
teeth.

Question 24

 Tooth form-

Answer 24

square, ovoid, tapered, or
combinations.

Question 25

 Texture and surface characteristics-

Answer 25

smooth
vs. textured (e.g, prominent MR and
perikaymata).

Question 26

• Width-to-length proportion of max. CI

Answer 26

(77% - 86%)

Question 27

• CI is – mm wider than LI

Answer 27

2-3

Question 28

• CI is – mm wider than canines

Answer 28

1-1.5

Question 29

• CI and canine touch OP while LI is 0.5-1 mm shorter giving
  the characteristic

Answer 29

“Gull” shape of the incisal edges of
anterior teeth

Question 30

Color:
Value-

Answer 30

grey scale or brightness

Question 31

Chroma-

Answer 31

saturation or intensity

Question 32

Hue-

Answer 32

gradation or variety of a color

Question 33

Color:
Value-grey scale or brightness:
Example: Vita Classic
Example: Vitapan 3D

Answer 33

• Light to dark = B1 to C4
• Light to dark = 0M1 to 4M4

Question 34

Chroma-saturation or intensity:
Note difference in age:
* Mature patient- — saturation
* Young patient- — saturation

Answer 34

high
low

Question 35

Hue-gradation or variety of a color:
(2)

Answer 35

• 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

Question 36

– often have the highest value

Answer 36

Centrals

Question 37

— lower value and greater chroma

Answer 37

Cuspids