(These views are taken using the American Academy of Cosmetic Dentistry general guidelines. This system requires 11 photographic views: 1:10 full-face smiling front view 1:10 side view 3 nonretracted 1:2 front, right, and left smiling views 3 retracted 1:2 front, right, and left views and maxillary and mandibular 1:2 occlusal views. A full set of photographic views is indispensable good quality photographs can be acquired using a simple point-and-shoot digital camera (Canon G5). The first step in the evaluation and design is gathering the appropriate records, which include a full set of periapical x-rays, panoramic x-ray, 6-point periodontal charting, and articulated casts mounted using a face-bow and a semiadjustable articulator with specific features for aesthetic evaluation and design (Panadent). Subsequently, the engineer designs the structural stability and longevity of the building. The architects first goal is a beautiful and functional building. This concept is similar to the approach used when constructing a new building or doing extensive remodeling it should always start with the architectural design. The primary goal of this is to achieve an aesthetic and harmonious dento-facial treatment outcome this will be followed by the engineering of the occlusal scheme to ensure stability and longevity. This article will discuss dento-facial aesthetics only.Īny time we may be considering an aesthetic oral rehabilitation that includes more than 4 teeth, we should consider starting with a dento-facial smile evaluation and design. It is also an excellent way to communicate amongst the members of the aesthetic team (restorative dentist, specialist, dental technician) and the patient.Ī comprehensive dento-facial evaluation and smile design can be divided into 4 areas: (1) dento-facial aesthetics the evaluation of teeth as they relate to other facial structures, and the overall facial symmetry that is influenced by teeth (2) group aesthetics the evaluation of teeth as a group, independent of other facial structures (3) gingival aesthetics the evaluation of the soft tissue surrounding and framing the teeth and (4) tooth aesthetics the evaluation of the individual characteristics of the teeth. This gives us the opportunity to review crucial information even in the absence of the patient. 1-4 A popular approach to record and evaluate the dento-facial structures has been the use of photographic views to assess tooth position in relation to lips and face. In recent years more attention has been placed on the facial evaluation. They are more concerned about their smile and the way it enhances their face they look at the big picture. On the other hand, our patients are less concerned about how teeth and gums look. We may even take retracted pictures and show them to our colleagues for diagnostic consultation or to present our great results. ![]() When our patients come to us searching for aesthetic improvements, as dental professionals we immediately start to look at teeth and gums, as we have the techniques to repair and beautify them. A new photographic view, “conversational tooth reveal,” will also be introduced. This article will describe a systematic approach to dento-facial aesthetic evaluation using 11 photographic views, an articulated cast, and a form to help organize the available data (Dento-Facial Esthetic Diagnosis form) and enable a step-by-step, systematic evaluation of the dento-facial parameters. ![]() This will ensure consistent results and avoid the realization, after finishing a case, that facial parameters were overlooked, resulting in teeth that look great in the retracted view but don’t enhance the patients facial features. Although many experts have described the individual aspects and parameters for a dento-facial evaluation, a systematic approach to managing this information needs to be implemented.
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