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Sunday, 22 November 2009 22:24 UAE time

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Steps in creating a beautiful smile

by Dr Larry W. Rosenthal and Dr Ken M. Hamlett on Thursday, 27 March 2008
The axial inclination should be more mesial and the gingival height .5 to 1mm below a line drawn from the central to the cuspid.

We divide the tooth shade into thirds: Cervical colour, body colour, and incisal colour (e.g., A1, OM3, B1).

Today, patients desire whiter teeth. However, the trend with practitioners is toward a more natural smile.

The eyes and the teeth are major components of the face.

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Therefore, we ask the patient to bring photographs of smiles they like; usually, they all have a brighter and wider smile in common.

The colour should be polychromatic (with the value being the most important aspect), with the highest value in the body or centre of the tooth.

Developing a definitive surface texture with lobing and incisal translucency approximating the age, gender, and personality of the patient all are important in achieving success.

The contours of the teeth may be the most important feature for a beautiful aesthetic result.

Contours

The contours of the teeth may be the most important feature for a beautiful aesthetic result. It is extremely important to develop an eye and feel for the final outcome.

The use of Golden Proportion is helpful in determining the size of the anterior teeth, with the length-to-width ratio of the maxillary central incisor being 75 to 80%. The length of the central is usually between 10.5 and 11 mm. There can be only a .2 to .3 variance between central sizes.

Before contouring, the teeth shown in Figure 1 were unattractive, flat, and square. You and/or the lab should be able to develop a reflective and deflective surface, with lobbing to create shadowing and light reflection for a natural-looking central tooth restoration.

Also, proximal line angles are developed; this is an important concept in tooth design. The mesial portion of the central should be straighter with a squarer incisal edge, whereas the distal portion is slightly round with a more round incisal edge.

The incisal contours are not mirror images, which add to the vitality.

Size and length

In developing the lateral incisor, proximal line angles again play an important role in creating a feminine look, with narrow necks and rounded incisal edges, and centrals more dominant and longer.

A masculine look, on the other hand, is created by widening the necks, flattening the incisal edges, and making centrals less dominant and almost the same length.

The axial inclination should be more mesial and the gingival height should be .5 to 1mm below a line drawn from the central to the cuspid.

The development of the cuspid is sometimes the hardest, but most important aspect of the smile-it is the cornerstone of the mouth. There should be two facial planes.


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