Anterior aesthetics part 2: Tooth design
There are rules for tooth shapes that should be adhered to if you want to create beautiful, natural restorations. These pertain to the shape and dimension of teeth, tooth textures, line angles and negative space (which is defined by embrasures, contact points, gingival margins, incisal edges). There is some wriggle room for creativity within these rules but be sure to adhere to the basic outlines or your restorations will look unnatural.
Purposeful aesthetic design of tooth position:
-Left and right hand sides of the arch will not be perfectly symmetrical. The central incisors should be as symmetrical as possible but the importance of symmetry lessens the further from the midline you are and minor asymmetry in gingiva and tooth shapes can give a more natural appearance to a certain extent
-Upper central incisors are anatomically the widest anterior teeth and as they are perpendicular to the viewer they appear as the widest and most dominant tooth. Therefore imperfections in their design are the most noticeable.
-The upper incisal edges should lightly contact the wet-dry line during "f" and "v" sounds and must never be more labial to this line. Teeth that are too long will leave dents in the lower lip and will sound awkward saying "fifty five"
-Central incisor proportions generally can range from 70-85% (width divided by the height). Around 80% tends to be the most pleasing but this is under the control of the operator.
-The position of the central incisor is based on where you design your incisal edge and midline. The gingival extension is determined by how long you want the tooth which is determined by the smile position of the patient in the context of their age, gender and aesthetic requirements.
-Once you have determined the position and shape of the central incisors, the rest of the dentition can be planned back from this. Taking a one tooth at a time approach working off the form of the most aesthetically driven tooth you can take break down what seems like a difficult task into small manageable segments.
-The angle of the incisal third of the central incisors should be perpendicular to the occlusal plane
Purposeful aesthetic design of tooth position:
-Left and right hand sides of the arch will not be perfectly symmetrical. The central incisors should be as symmetrical as possible but the importance of symmetry lessens the further from the midline you are and minor asymmetry in gingiva and tooth shapes can give a more natural appearance to a certain extent
-Upper central incisors are anatomically the widest anterior teeth and as they are perpendicular to the viewer they appear as the widest and most dominant tooth. Therefore imperfections in their design are the most noticeable.
-The upper incisal edges should lightly contact the wet-dry line during "f" and "v" sounds and must never be more labial to this line. Teeth that are too long will leave dents in the lower lip and will sound awkward saying "fifty five"
-Central incisor proportions generally can range from 70-85% (width divided by the height). Around 80% tends to be the most pleasing but this is under the control of the operator.
-The position of the central incisor is based on where you design your incisal edge and midline. The gingival extension is determined by how long you want the tooth which is determined by the smile position of the patient in the context of their age, gender and aesthetic requirements.
-Once you have determined the position and shape of the central incisors, the rest of the dentition can be planned back from this. Taking a one tooth at a time approach working off the form of the most aesthetically driven tooth you can take break down what seems like a difficult task into small manageable segments.
-The angle of the incisal third of the central incisors should be perpendicular to the occlusal plane
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