By Dr. Jason Olitsky
If it's crooked... they will notice. Every time.
When evaluating the aesthetic principles inherent to successful smile
design, there are 7 violations that are common and undermine the success
of the finished cosmetic case. Here’s one of my top clinical tips for
maximizing the outcome of your aesthetic cases by instituting a knowledge
of facial symmetry into your approach to cosmetic dentistry in the
practice.
Getting the Smile Straight
The first violation of smile design is simple yet can have dramatic
effects on the perceived success of a restoration: a crooked smile.
My primary advice is to recognize that when restoring a smile, dentists must
pay close attention to the inter-incisal line, unless they want to deal
with the resulting “tipped” appearance of the smile in relation to the
face.
The comprehensive approach to achieving a straight smile includes multiple
factors that utilize pre-treatment plan work-ups and facial aesthetic
principles, such as:
- Horizontal and vertical facial perimeters
- The commissural line and inter pupillary line
- A vertical line drawn through the middle of the face (including the glabellar area)
- The tip of the nose
- The middle of the chin
Keeping these different aesthetic principles in mind throughout
treatment planning a smile, rather than just at the beginning of the
evaluation, is necessary in order to guarantee consistent results.
Transfer these esthetic principles over during the process of narrowing
the analytic scope of the treatment to mounted models on the bench top.
There are two techniques that when mastered can contribute to the ideal straight smile:
First, start with a solid basis of pre-treatment
photography so that the patient’s unique facial esthetics can be
analyzed. This involves taking in the patient’s face as a whole. Many
dentists will become too influenced by common facial asymmetries and
lose sight of the true horizontal plane.
Second, relate the restorative horizontal plane to a
laboratory technician comfortable with utilizing a face bow or digital
smile design, as this process during mounting and waxing of the case can
lead to drastically improved results.
With one or both of these techniques in your cosmetic arsenal, you
can be sure that the patient will be satisfied with their smile.
Look for the next 6 “Violations of Smile Design” on the blog in
our upcoming series by CMS educator Dr. Jason Olitsky, where he’ll
discuss concepts such as negative space, overcontoured teeth, and gum
symmetry.
Original post on Clinical Mastery Series Blog.