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Seven major violations in the design of a smile

Students and practitioners are increasingly turning to digital smile design techniques in order to directly demonstrate potential aesthetic changes to patients and members of the treatment team (including dental technicians). The principles of smile design include research on the aesthetics of the face, labiodental dynamics, the architecture of the gums and dentition, as well as the phonetic component. In order to better explain to patients and demonstrate to their colleagues the dynamics of aesthetic changes in a smile, many doctors do a fantastic job, illustrating the principles of designing a smile relative to the necessary ideal state of harmony, based on the individual anatomical features and physiological characteristics of each individual patient.

This approach is useful not only from the point of view of the demonstration, but also regarding the identification of possible violations that compromise the aesthetic appearance. Therefore, recommendations regarding the proper assessment and solution of specific errors that have arisen at the stage of designing a smile are a kind of guide in the practice of aesthetic dentistry.

This article discusses seven major violations in the design process, as well as methods for evaluating and solving them to restore the perfect harmonic shape.

A crooked smile is a violation that is extremely noticeable not only for the dentist, but also for the average person, like a crookedly nailed shelf on a flat wall. After restoration, few people additionally check the condition of the interdental line, and it is precisely this effect that affects the visual inclination of the smile line relative to the vertical axis (photo 1 and photo 2). Smile straightening requires the development of a preliminary treatment plan taking into account the basic aesthetic principles. Among the aspects that must be investigated: horizontal and vertical parameters of the face, including the line connecting the corners of the mouth, as well as the interpupillary horizontal. A vertical line drawn through the middle of the face should be estimated relative to the nose bridge, nose tip and mid-chin. It is also important to ensure that the interdental contact line is perpendicular to the absolute horizontal. To prevent a smile curve, it is important to understand that the analysis of facial aesthetics should begin with a study of the patient’s photograph, and in no case should be reduced to the analysis of models (which is an extremely popular violation, given that even most models are analyzed only on the subject of interest section of the jaw). When studying the plane of the face, one must take into account the patient’s horizontal position of the head, since it is largely a reference point for the further development of the smile design. As a rule, this criterion in most cases coincides with the absolute horizontal plane, relative to which some facial features may have disturbances (as a result of the asymmetry effect). It is also important to analyze the area of ​​the face as a whole, and not concentrate on the position of only the area of ​​interest relative to the horizontal plane. The restoration of the horizontal plane is also an important point of cooperation with the dental technician using the facial arch and wax reproduction.

A comprehensive analysis of the face before the intervention is the key to the success of treatment. Changes in the incisor angle, which may be invisible, can be detected by graphical analysis of photographs, which also facilitates collaboration with the laboratory in correcting the smile curve (restorations are made by IPS e.max and IPS Empress (Ivoclar Vivadent)

A comprehensive analysis of the face before the intervention is the key to the success of treatment. Changes in the incisor angle, which may be invisible, can be detected by graphical analysis of photographs, which also facilitates collaboration with the laboratory in correcting the smile curve (restorations are made by IPS e.max and IPS Empress (Ivoclar Vivadent)

The use of the facial arch and mock-up helps the doctor coordinate the dental technician with respect to the required position of the cutting edges and the interdental line, which makes the final treatment results more predictable.

The use of the facial arch and mock-up helps the doctor coordinate the dental technician with respect to the required position of the cutting edges and the interdental line, which makes the final treatment results more predictable.

The formation of a smile requires maintaining symmetry between the cutting edge of the front teeth of the upper jaw and the border of the lower lip following it (the principle of labiodental dynamics). A labiodental dynamics is formed from the incisal region, where a convex line is created, which extends into the region of the masticatory teeth.

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