2A- medical history

What should you document with digital smile design (DSD)?

Midline

Smile line

Tooth proportions

Gingival levels

Facial symmetry reference

Makes plan defendable and easy to explain

Regarding facial appearance what are the 3 main areas we study?

Macro aesthetics- facial proportions in 3 planes of space

Mini aesthetics- relationship between dentition and face

Micro aesthetics- relationship between teeth

What is studied in Macroaesthetics? (4)

Bilateral symmetry of fifths of face

Determine if jaws are located proportionally in sagital plane

Assess posture and prominence of lips

Assess angle of mandibular plane

What do you analyse in micro aesthetics?

Proportions of teeth-

Height, shape, gingival contours

Tooth tone and colour

What are the 10 most important points for digital records in aesthetic dentistry? (short answer)

High quality clinical photos (standardized)

Intraoral scans (or accurate impressions)

DSD

Shade records (and how you recorded them)

Bite and occlusion documentation

Before and after records

Patient consent + expectations in writing

Clear treatment plan and history

Lab communication records

Backup + security (non-negotiable)

How is the facial height divided?

Into equal thirds

From forehead to brow line

Brow line to base of nose

Base of nose to base of chin

What is useful in determining the lateral facial profile?

Cephalometric analysis

Can be straight, convex or concave

What is the lip line?

Lower border of lip as it related to teeth and gingival tissues

Average lip line exposes upper teeth and interdental papilla

High- gummy smile

Low- no gingival tissues

Within 2mm apical to height of gingival margin of max centrals

What is the average maxillary central incisal display for males vs females?

1.91mm

3.40mm

Important factor in youthful smile

What defect is seen in this image?

Embrasure spaces- poor hygiene and periodontal problems can alter it causing loss of papilla

What is the zenith point?

most apical point of the gingival tissues along the long axis of the tooth

What are the 2 clases of gingival height classification?

1- gingival margin of lateral incisors should be more coronal than that of central and canines

2- lateral incisors gingival margin apical

What is biological width?

JE and ct elements that occupy the space between the base of the gingival crevice and alveolar crest

3mm in normal gingiva

What is the smile line and what is it a reference for?

Imaginary line drawn along the incisal edges of maxillary anterior teeth

Ideal tooth arrangement, line should coincide or follow contour of lower lip when smiling

Midline refers to…

Vertical line formed by the contact of the max central incisors

Midline should be perpendicular to incisal plane and parallel to

What is considered to be one of the most accurate anatomical guide?

Philtrum

What is the axial inclination of anterior vs posterior teeth?

Inclines mesially towards midline

Same mesial inclination as cusp

Creates natural visual gradation, makes teeth appear to diminish in size as they progress posteriorly

What should the labial contour exhibit?

Reflects light in 3 planes- flat, convex, square/fan shaped from front view

What is an incisal embrasure?

Open space formed between proximal surfaces of incisal edges from contact points

Increase in depth from central to canine

What is the golden ration?

Mathematical model that tries to relate the MD distances of teeth.

Guide values are used- incisor and canine crowns have approximately the same width/height ratio (77-86%)

The anatomy of the central incisors

2-3mm wider than lateral ones

Canines are 1-1.5mm wider than the lateral incisors

Distal edge more convex than mesial-

Shape- square, ovoid, triangular

The elongation of incisal edge indicated in…(3)

Incisal wear

Inadequate tooth display

Displeasing tooth or crown proportion

The shortening of incisal edge indicated in…(3)

Correct excessive tooth display

To compensate for unaesthetic elongation created by periodontal recession

Displeasing tooth or crown proportion

What are the components of colour?

Hue

Value

Saturation (chroma)

Fluorescence

What does the Vita Classic shade guide?

Considers hue

Shade- A1, A2, A3, A3.5, A4

Think value 1st, chroma 2nd