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The first 25 slides, exactly as they appear. The full deck has 144 content slides.
Maxillofacial Surgery
Dentogingival Aesthetics
Built from Facial Aesthetics — Concepts and Clinical Diagnosis
What’s inside
10 sections · 144 slides
Overview
- What this topic is about
- The dentogingival aesthetic unit
Anatomy of the teeth and their supporting tissues
What a tooth is made of, and what holds it in the jaw
- Why the teeth matter
- How a tooth is built
- Three kinds of lining in the mouth
- What holds a tooth in place
- The four supporting tissues, outside in
- The free gingiva
- Where the gum meets the tooth
- Free gingiva, attached gingiva and alveolar mucosa
- The attached gingiva
- Ligament, cementum and bone
- Bone follows the teeth
- When bone leaves the root exposed
- Why braces can move teeth at all
- Cutting across the gum-tooth junction
- The three parts and their depths
- The dentogingival unit and biological width
- What 'biological width' means
- Why the zone must be respected
- What happens if a crown margin invades it
Tooth shape
Where clinical evaluation starts, and a century of theories
- Where the examination begins
- Every crown is a mix of three shapes
- Ovoid, rectangular and triangular incisor crowns
- Why human teeth are not all alike
- When tooth shape goes wrong
- A century of theories about ideal tooth shape
- Tooth shape and face shape
- Tooth width against face width
- Incisor crown width against bizygomatic face width
- Testing the 1:16 ratio
- Sex, age and personality
- Sex, age and personality in tooth selection
- The 'sex' part of the theory
- The 'age' part: tooth wear
- Mammelons on unworn incisal edges
- Age is not a reliable guide
- Gum recession exposing abraded root surfaces
- Personality, and the verdict on all these theories
Tooth size and proportion
Millimetres, ratios, the Bolton analysis and the golden proportion
- What decides tooth size
- 8-9 mm
- Width-to-height ratio of the central incisor
- Crown width-to-height ratio of the central incisor
- The eye can be fooled
- Shorter incisors appear wider
- Brighter teeth appear larger
- Which ratio do people find attractive
- Tooth size as the seventh key to occlusion
- When upper and lower teeth do not match
- The Bolton analysis
- How to read the standard table
- Tooth size analysis (Bolton analysis) standard table of values
- Tooth size analysis (Bolton analysis) standard table of values (continued)
- Two quick checks at the first examination
- A diminutive upper lateral incisor
- Three proportions worth measuring
- Why the teeth look narrower going back
- Apparent versus actual widths across the curved arch
- The golden proportion
- The golden percentage
- The golden proportion and the golden percentage
- A looser version of the same idea
- Two problems with the golden proportion
- Arch form changes the observed tooth proportions
- Does the golden proportion survive testing
Symmetry, missing lateral incisors and arch form
What must match, and how far the arch can be changed
- Why symmetry matters most at the front
- How much asymmetry gets noticed
- A megadont upper central incisor
- Canines substituted for missing lateral incisors
- The peg-shaped or missing lateral incisor
- When both lateral incisors are affected
- Making the space fit
- Planning with a diagnostic set-up
- How far the arch can be changed
- Equilibrium theory
- Square, ovoid or tapered
- Ovoid, square and tapered arch forms
Tooth angulation and the gradation effect
How teeth tilt, and why they shrink towards the back of the smile
- What axial angulation means
- Axial angulation of the tooth long axes
- Front teeth lean mesially, more so towards the canine
- Measuring incisor crown angulation
- Mesial crown angulation increases towards the canine
- Why distant things look smaller
- Front-to-back progression across the smile
- What the gradation effect depends on
- Buccal contour of canine and premolars
- Parallel buccal contours of canine and premolars
- An abnormal premolar interrupting the progression
- Crown inclination and the occlusal plane
- Camper's plane in denture work
- Arch form and the key tooth
Gingival aesthetics
Colour, texture, biotype, gum margin level and contour
- When the gums become part of the smile
- Gingival colour
- Texture and periodontal biotype
- Where the gum margins should sit
- Ideal gingival margin levels and common asymmetries
- Overeruption of the front teeth
- Overeruption creating gingival height discrepancies
- Ankylosis and non-eruption
- Three more causes of uneven gum margins
- A canine extruded to correct its gingival margin
- What sets, and what can move, the gum margin
- How far the gum follows the tooth
- Gingival embrasures and the papillae
- Interdental papillae filling the gingival embrasures
- Papilla loss from periodontal disease
- Dark triangles after aligning triangular incisors
- The gingival zenith
- Gingival zenith points
Contacts, connectors and embrasures
The small spaces between teeth that decide how a smile reads
- Incisal embrasures
- Incisal embrasures widening towards the back
- Connectors versus contacts
- Contact areas and connector areas
- Will the papilla fill the gap
- The 50:50 rule between the central incisors
- The 50:50 rule between the central incisors
- Why aligning crowded incisors can create dark triangles
- Closing a dark triangle, step by step
- Managing dark triangles by enamel reduction and approximation
Tooth colour
Describing colour, how it changes with age, and choosing a shade
- Why colour carries so much weight
- Four ways to describe a tooth's colour
- Reading the four attributes
- Shade changes as you go back in the arch
- Tooth shade against skin colour
- Skin colour and tooth shade value
- A word before whitening
- Why teeth darken with age
- What the colour data show
- Why shade matching is partly subjective
- A systematic route to the right shade
- Shade selection in practice
- Rest the eyes between shades
Summary
What to carry away from dentogingival aesthetics
- Key points: the tooth and its support
- Key points: shape, size and proportion
- Key points: the smile and the gums
- Key points: colour and the big caveat
- References
- References (continued)
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- References (continued)
- Facial Aesthetics: Concepts and Clinical Diagnosis, 2nd Edition