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The first 25 slides, exactly as they appear. The full deck has 140 content slides.
Maxillofacial Surgery
Smile Aesthetics
Built from Facial Aesthetics — Concepts and Clinical Diagnosis
What’s inside
13 sections · 140 slides
Overview
- What this deck covers
Why the smile matters
The mouth is one of the two places the eye keeps returning to
- Where the eye goes
- Where the 'rules' come from
Types of smile, and how one is made
Posed versus spontaneous, and the two-stage muscular sequence
- Two kinds of smile
- Posed and spontaneous smile
- The eye muscle is the giveaway
- How to spot a true smile
- How a smile is built
- The two stages in words
- A quirk worth knowing
Lip lines: the starting point
Where the lips sit against the teeth, at rest and in movement
- Start with the lips
- What 'lip lines' means
- The 'ideal' relationship at rest
- The resting upper lip line
- High and low resting lip lines
- Lower lip line, and the smiling line
- Men and women differ at rest
- Incisor exposure at rest relative to sex — adapted from Vig and Brundo
- Tooth display swaps over with age
- Incisor exposure at rest relative to age — adapted from Vig and Brundo
- How tooth display changes with age
- Lip lines follow the bite
- Tooth display in Class III and Class II bites
Upper lip and upper incisor
The key relationship, and the seven things that control it
- The parameter that matters most
- Posed and spontaneous lift differ
- Upper lip and upper incisor relationship
- What controls how much tooth shows
- Seven factors that set upper incisor display
- Factor 1 — upper lip height
- The upper lip keeps growing
- Increase in upper lip height with age — adapted from Bhatia and Leighton
- Factor 2 — the smile curtain
- Treating a hypermobile upper lip
- Surgery to limit upper lip elevation
- Factor 3 — vertical maxilla position
- Total vertical maxillary excess
- Gummy smile before and after lifting the maxilla
- When only the front is gummy
- Anterior vertical maxillary excess
- Factor 4 — sagittal maxilla position
- Factor 5 — incisor inclination
- Uprighting proclined incisors increases tooth display
- Factor 6 — crown height and wear
- Factor 7 — gingival margin level
- Testing for delayed apical migration
- Probing the gingival sulcus
- Deep overbite: diagnose before you treat
Listening to the smile
Four speech sounds that put the lips and jaw in reproducible positions
- Why speech sounds help
- The 'F' and 'V' sounds
- The 'E' sound
- The 'M' sound
- The 'S' sound
- The four sounds at a glance
- One warning about phonetics
- Speech shows the lower teeth
- Lower incisor display in speech with age
Three-quarter view and occlusal guidance
The speaking line, and the three checks before restoring incisor height
- The speaking line
- The speaking line in three-quarter view
- How to look, and what to expect
- Restoring incisor height: three checks
- Anterior occlusal guidance
Symmetry, lip curvature and occlusal planes
Telling a soft tissue asymmetry apart from a real tooth-plane cant
- Smile symmetry
- Asymmetrical smile
- The trap this creates
- Dynamic upper lip curvature
- Three lip curvatures, and how common
- Four dynamic upper lip curvatures
- A cant, or only the look of one?
- True versus apparent cant
- How to check for a cant
- Sagittal cant of the occlusal plane
- Posterior vertical maxillary excess on smiling
- Camper's plane, the reference line
- Checking the maxillary occlusal plane against the alar-tragal line
The smile arc
Two curves that should run parallel — and everything that flattens them
- What the smile arc is
- Where the idea came from
- The smiling line: accentuated and flat curves
- The ideal arc
- Ideal smile curvature
- When the arc goes wrong
- Flat and reverse smile curvature
- What changes the smile arc
- Occlusal plane inclination
- Occlusal plane pitch and incisal edge curvature
- Smile arc before and after maxillary surgery
- Burstone's point
- Prove it with your own head
- Head tilt changes the apparent smile curvature
- Lower lip and incisor inclination
- An arc you can flatten by accident
- Ideal arc and iatrogenic flattening
- Crown height and the arc
Dental midlines
Position matters, but angulation is what people actually notice
- Which midlines to check
- The mandibular dental midline
- Dental midlines before and after orthodontic correction
- < 2 mm
- Angulation beats position
- Incisor angulation to the patient's left
- Avoiding the slanted midline
- Midline shift with correct and excessive incisor angulation
Buccal corridors
The dark corners of a smile — and why they may matter less than we think
- What a buccal corridor is
- A smile without buccal corridors
- Cause 1 — a narrow upper arch
- Cause 2 — back teeth tipped inwards
- Cause 3 — a maxilla set too far back
- Maxillary advancement and the buccal corridors
- Cause 4 — how wide the mouth gets
- 55 ± 3 mm
- Cause 5 — lower face height
- The concealed premolar smile
- The concealed premolar smile
The smile in profile
Maxillary incisor position and inclination, and the labial face tangent
- Why the profile smiling view matters
- Sagittal position of the central incisors
- Incisor position and inclination before and after surgery
- The traditional way to measure inclination
- Four problems with the long-axis method
- Problems one and two
- Labial crown face versus long axis inclination
- Problems three and four
- Variation in the crown-root angle
- A better measurement
- The maxillary incisor labial face tangent
- What the tangent should look like
- Assessing incisor proclination in profile
- Proclination is not only cosmetic
- Attractiveness research: the question
- Attractiveness research: the answer
- 85°
- Class III correction and the labial face tangent
- Protrusion is not proclination
- Why that distinction matters
Pulling it together
What to carry into the next clinic
- Take-home points
- Take-home points
- Diagnostic traps to avoid
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Facial Aesthetics: Concepts and Clinical Diagnosis, 2nd Edition