Extreme Makeover

Extreme Makeover:Extreme Makeover:

The Dental/Plastic Surgery The Dental/Plastic Surgery TeamTeam

BeautyBeauty• What is Beauty?What is Beauty?

– Beauty is a result of 2 ideal Beauty is a result of 2 ideal components:components:

•SymmetrySymmetry

•Harmony Harmony

• SYMMETRY- the mirror image of parts SYMMETRY- the mirror image of parts or components about an axisor components about an axis

• HARMONY- a recurring themeHARMONY- a recurring theme

““Beauty is power, a smile is its Beauty is power, a smile is its sword” – Charles Readsword” – Charles Read

““Beauty is not caused, it is” Beauty is not caused, it is” – – Emily DickensonEmily Dickenson

• How is it measured?How is it measured?– The Golden RatioThe Golden Ratio– is a mathematical ratio that seems to is a mathematical ratio that seems to

appear recurrently in beautiful things in appear recurrently in beautiful things in nature as well as in other things that nature as well as in other things that are seen as "Beautiful".are seen as "Beautiful".

– The "Golden Ratio" is a mathematical The "Golden Ratio" is a mathematical ratio of ratio of 1.618:11.618:1, and the number , and the number 1.618 1.618 is called "is called "PhiPhi".".

The four front teeth, from central incisor to premolar are the most significant part of the smile and they are in Golden Proportion to each other. This phenomenon has been combined in a grid which can be used to assist us in perfecting the aesthetics of the eight front teeth. The above picture shows a grid in the mouth with the front teeth clearly shown in the demarcations predicted.

Smile Design:Smile Design:

• General Criteria:General Criteria:– Smile LineSmile Line– MidlineMidline– Axial InclinationAxial Inclination– Buccal CorridorBuccal Corridor

• Specific Criteria:Specific Criteria:– Incisal EmbrasuresIncisal Embrasures– Golden ProportionGolden Proportion– SymmetrySymmetry– Incisal Edge PositionIncisal Edge Position– Emergence ProfileEmergence Profile– Labial ContourLabial Contour

Smile DesignSmile Design

• Periodontal Issues:Periodontal Issues:– Cervical EmbrasuresCervical Embrasures– Margin Placement and Margin Placement and

Design Design – Periodontal HealthPeriodontal Health– Gingival Contour and ShapeGingival Contour and Shape

• Materials and Materials and Finish:Finish:– Choice of Choice of

MaterialsMaterials– Labial AnatomyLabial Anatomy– Surface finishSurface finish– Shade SelectionShade Selection

General ConceptsGeneral Concepts

• Smile LineSmile Line– Do the incisal edges follow the Curve of Do the incisal edges follow the Curve of

Spee and the Curve of Wilson?Spee and the Curve of Wilson?– Do the incisal edges follow the curve of Do the incisal edges follow the curve of

the lower lip while smiling? the lower lip while smiling?

General Concepts:General Concepts:

• Buccal CorridorBuccal Corridor– Is there dark spaces while smiling Is there dark spaces while smiling

between the corners of the mouth and between the corners of the mouth and the buccal surfaces of the upper teeth? the buccal surfaces of the upper teeth?

– What is the arch form?What is the arch form?

Specific Criteria:Specific Criteria:

• Symmetry:Symmetry:– Is the cervical/incisal tooth length Is the cervical/incisal tooth length

symmetrical from right to left?symmetrical from right to left?– Is the interproximal contact proper in Is the interproximal contact proper in

length and position?length and position?– Are contralateral teeth properly Are contralateral teeth properly

arranged for size and position?arranged for size and position?

Periodontal Related Issues:Periodontal Related Issues:

• Cervical EmbrasuresCervical Embrasures– Are there black triangles present?Are there black triangles present?

• Margin placement and DesignMargin placement and Design– Is the treatment a crown or veneer or something Is the treatment a crown or veneer or something

in between?in between?

• Gingival contour and shapeGingival contour and shape– This is the biggest killer of a beautiful cosmetic This is the biggest killer of a beautiful cosmetic

result.result.– Is the gingival architecture in harmony with the Is the gingival architecture in harmony with the

smile design?smile design?

Materials and Finish:Materials and Finish:

• Choice of materialsChoice of materials– When do I use a Veneer, all porcelain When do I use a Veneer, all porcelain

crown, or PFM with porcelain margin?crown, or PFM with porcelain margin?

• Shade SelectionShade Selection– What is the hue, chroma and value?What is the hue, chroma and value?– Is incisal translucency and halo effect Is incisal translucency and halo effect

appropriate?appropriate?

Treatment PlanningTreatment Planning

• It is the responsibility of the general It is the responsibility of the general dentist to offer the best possible dentist to offer the best possible treatment to the patient and hence treatment to the patient and hence must have the knowledge of the must have the knowledge of the procedures he/she will refer out in procedures he/she will refer out in order to confidently offer treatment to order to confidently offer treatment to the patient.the patient.

• Let’s see some before picturesLet’s see some before pictures

Canine

1st Premolar

Thank youThank you