Smile Design

What is Smile Design?

Smile Design is a multipurpose conceptual protocol which provides remarkable advantages:

  • The diagnostic abilities are facilitated through an extra-and-intra oral aesthetic and structural evaluation.
  • Improved communication between the team members providing a better visual perception, education and motivation for patients.
  • Increased effectiveness of case presentation and accordingly case acceptance.
 

The goal of an esthetic makeover is to develop a peaceful and stable masticatory system, where the teeth, tissues, muscles, skeletal structures and joints all function in harmony (Peter Dawson). It is very important that when planning treatment for esthetics cases, smile design cannot be isolated from a comprehensive approach to patient care. Achieving a successful, healthy and functional result requires an understanding of the interrelationship among all the supporting oral structures, including the muscles, bones, joints, gingival tissues and occlusion.

Smile Design
 

Facial Composition

Facial beauty is based on standard esthetic principles that involve proper alignment, symmetry and proportion of face.

In classical terms, the horizontal and vertical dimensions for an ideal face are as follows:

Horizontal

  • The width of the face should be the width of five “eyes”.
  • The distance between the eyebrow and chin should be equal to the width of the face.

Vertical

  • The facial height is divided into three equal parts from the fore head to the eyebrow line, from the eyebrow line to the base of the nose and from the base of the nose to the base of the chin.
  • The full face is divided into two parts, eyes being the midline.
  • The lower part of the face from the base of the nose to the chin is divided into two parts, the upper lip forms one-third of it and the lower lip and the chin two-thirds of it.

The basic shape of the face when viewed from the frontal aspect can be one of the following:

  1. Square
  2. Tapering
  3. Square tapering
  4. Ovoid

The lateral profile of an individual can be any one of the following:

  1. Straight
  2. Convex
  3. Concave

These factors play a role in determining the tooth size, shape and the lateral profile; in short, the tooth morphology is dependent on the facial morphology.

 

Tooth dimensions

Various guidelines for establishing correct proportions in an esthetically pleasing smile are:

  • 1. Golden proportion (Lombardi).
  • 2. Recurring esthetic dental proportions (Ward).
  • 3. M proportions (Methot).
  • 4. Chu’s esthetic gauges.

Golden proportion (Lombardi):

When viewed from the facial, the width of each anterior tooth is 60% of the width of the adjacent tooth (mathematical ratio being 1.6:1:0.6). It is difficult to apply as patients have different arch form, lip anatomy and facial proportions. Strict adherence to golden proportion calculations limits creativity and this may lead to cosmetic failure.

Recurring esthetic dental proportion (Ward):

The successive width proportion when viewed from the facial aspect should remain constant as we move posteriorly form midline. This offers great flexibility to match tooth properties with facial proportions.

M proportions (Methot):

This method compares the tooth width with the facial width using a software. The whole analysis is done in the computer and hence involves more of mathematics rather than artistic analysis.

Chu’s esthetic gauges:

Dr. Chu’s research supports Levin’s RED concept and refutes the golden proportion. A series of gauges are available to make intraoral analysis easier. The gauges allow for:

  • Fast, simple analysis and diagnosis of tooth width problems, tooth length problems and gingival length discrepancies.
  • Color coding predefines desired tooth proportions, quicker and easier to read than any other instrument.
  • Used as a reference guide between clinician and lab technician, hence reduces the incidences of miscommunications errors.
 

Smile Design - Before and after gallery

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