Section 19 - Esthetics

Handout
Abstracts
001. Frush, J. P. and Fisher, R. D. Introduction to dentinogenic restorations. J Prosthet Dent
!"#-9, 19.
00$. Frush, J. P., Fisher, R. D. %he d&nesthetic inter'retation on the dentogenic conce't. J
Prosthet Dent "!"-"1, 19".
00(. Sears, ). H. An ana*&sis o+ art +actors in +u** denture construction. JADA $!(-1$, 19(".
00,. -*ancheri, R. .. /'tica* i**usions and cos0etic grinding. Re1 Assoc Dent 2e3 "!10(-111.
4Re'rinted in J5DA, 16!$,, 190.7
00. 2a1ros8o1+is, F. and Ritchie, 9. 2. %he +ace-+or0 as a guide +or the se*ection o+ 0a3i**ar&
centra* incisors. J Prosthet Dent ,(!01-0, 19"0.
00#. 5ade, R. E. %he ro*e o+ the 0andibu*ar anterior teeth in co0'*ete denture esthetics. J
Prosthet Dent ,$!(#"-(60, 1969,
006. )ig, R. 9. and -rundo, 9. 5. %he 8inetics o+ anterior tooth dis'*a&. J Prosthet Dent (9!0$-
0,, 196".
00". -ris0an, A. S. Esthetics! A co0'arison o+ dentist:s and 'atient:s conce'ts. JADA 100!(,,
19"0.
009. .e1in, E. I. Denta* esthetics and the go*den 'ro'ortion. J Prosthet Dent ,0!$,,-$$, 196".
010. .o0bardi, R. E. %he 'rinci'*es o+ 1isua* 'erce'tion and their c*inica* a''*ication to denture
esthetics. J Prosthet Dent $9!("-("$, 196(.
011. .orton, .. and ;hitbac8, P. Esthetic 'ara0eters o+ 0andibu*ar anterior teeth. J Prosthet
Dent ,#!$"0-$"(, 19"1.
01$. Scandrett, F. R., <erber, P. E. and =0rigar, >. R. A c*inica* e1a*uation o+ techni?ues to
deter0ine the co0bined @idth o+ the 0a3i**ar& anterior teeth and the 0a3i**ar& centra* incisor. J
Prosthet Dent ,"!1-$$, 19"$.
01(. %Aan, A. H. .., 2i**er, E. D. and %he, J. 9. P. So0e esthetic +actors in a s0i*e. J Prosthet
Dent 1!$,-$", 19",.
01,. Pound, E. 5ontro**ing ano0a*ies o+ 1ertica* di0ension and s'eech. J Prosthet Dent (#!1$,-
1(, 196#.
01. 2athe@s, %. 9. %he anato0& o+ a s0i*e. J Periodont Res (9!1$"-1(,, 196".
01#. 9uichet, B.F and D... Fro0 +unction to esthetics! Anterior or occ*usa* co0'ro0ises to
esthetics. 5urr /'in 5os0et Dent 199(!-#0.
016. Rosenberg, E.S., 5ut*er, S.A. Periodonta* considerations +or esthetics! Edentu*ous ridge
aug0entation. 5urr /'in 5os0et Dent 199(!#1-##.
01". %urb&+i**, ;.F. Dentures and 'artia*s or esthetic re0o1ab*e 'rosthetics. 5urr /'in 5os0et
Dent 199(!6-69.
Section 19 - Esthetics
(Handout)
Definitions:
Esthetic 1. Pertaining to the stud& o+ beaut& and the sense o+ beauti+u*. Descri'ti1e o+ a s'eci+ic
creation that resu*ts +ro0 such stud&C obAecti+ies beaut& and attracti1eness, and e*icits '*easure.
$. 'ertaining to sensation var of AES%HE%I5
Esthetics adj 4169"7 1. the branch o+ 'hi*oso'h& dea*ing @ith beaut&.
$. in dentistr&, the theor& and 'hi*oso'h& that dea* @ith beaut& and the beauti+u*, es'ecia**& @ith
res'ect to the a''earance o+ a denta* restoration, as achie1ed through its +or0 andDor co*or. %hose
subAecti1e and obAecti1e e*e0ents and 'rinci'*es under*&ing the beaut& and attracti1eness o+ an
obAect, design or 'rinci'*e. --Aesthetica**& adj
Denta* Esthetics the a''*ication o+ the 'rinci'*es o+ esthetics to the natura* or arti+icia* teeth and
restorations
Denture Esthetics the e++ect 'roduced b& a denta* 'rosthesis that a++ects the beaut& and
attracti1eness o+ the 'erson.
re+! 9P%-6, J PR/S%HE% DEB%, "1417! (9-110C1999
Historical Evolution of Esthetics in Dentistry!
1. Historica**&, esthetics s&non&0ous @ith denture esthetics.
$. 19(0:s - Sears -Art Factors in +u** denture construction
(. 190:s - Frush and Fisher -EdentogenicE denture -
,. 1960:s - .o0bardi- )isua* 'erce'tion in dentures
)ig - <inetics o+ Anterior %ooth Dis'*a&
Pound - )ertica* di0ension
.e1in - 9o*den 'ro'ortion
. 19"0:s - 2a1ros8o1+is and Ritchie - Face +or0 +or se*ection o+ 0a3i**ar& centra*s
.orton - 0andibu*ar anteriors
Scandrett- @idth o+ 0a3i**ar& anteriors
%Aan and 2i**er - Esthetic +actors in a s0i*e
Rieder - Pro1isiona*s and Esthetics in Fi3ed 'rosthodontics
#. 1990:s - 9uichet - Function to esthetics
Rosenberg and 5ut*er - Periodonta* considerations
%urb&+i** - Esthetic Re0o1ab*e 'rosthetics
%oda&, esthetics inc*udes not on*& co0'*ete dentures, a @ide 1ariet& o+ +i3ed 'rosthodontics,
1eneers, i0'*ants, as @e** as b*eaching. ,,,60 internet @eb sites Ecos0etic dentistr&E , (,##6
2ed*ine artic*es on cos0etic dentistr&, and #( dentists in the 2ar&*and Suburban 'hone boo8
ad1ertising Ecos0etic dentistr&E
Principles of Esthetics: Esthetics in dentistr& is *i8e dinner at a +ine restaurant. It is the che+,
and not the 'atron @ho 8no@s the reci'e and ingredients o+ the 0enu se*ection. It is the 'atron,
ho@e1er, and not the che+ @ho e1a*uates the ?ua*it& o+ the 0ea*. .i8e@ise, the dentist is
res'onsib*e +or 8no@ing the reci'e and ingredients to achie1e an esthetic resu*t, but it is the
'atient @ho in the end e1a*uates the success or +ai*ure o+ the esthetic resu*t.
Focus on the Face ! 9o*den 'ro'ortion-;hat is the 9o*den Pro'ortionF A 0athe0atica*
re*ationshi' bet@een 0.#1", 1 , and 1.#1" such that the ratio o+ the s0a**er to the *arger is
e?ui1a*ent to the ratio o+ the *arger to the @ho*e.
a. 0.#1" G 1 H 1.#1"
b. 1 H 1.#1" 40.#1" 7
c. II1II H 0.#1" 1.#1"7
It @as +or0u*ated as one o+ Euc*id:s e*e0ents, used e3tensi1e*& in 9ree8 architecture.
Ho@ does the 9o*den Pro'ortion a''*& to +acia* estheticsF
Pro'ortions bet@een the s0i*e and +ace
Pro'ortions bet@een the teeth and s0i*e- s'aces bet@een the corner o+ 0outh and the denta* arch
+or0 a Ebac8dro'E +or the anterior seg0ent, and is in go*den 'ro'ortion to the @idth o+ the s0i*e
- the @ho*e o+ the anterior esthetic seg0ent is in go*den 'ro'ortion to the @idth o+ the s0i*e.
Factors of a smile! 4%Aan, 2i**er J %he7
a. s0i*e t&'e! ;hat are the three categories o+ o'en s0i*esF ;hat 'ercentage o+ the
'o'u*ation has each t&'eF
high- re1ea*s tota* *ength o+ 0a3i**ar& anterior teeth and a contiguous band o+
gingi1a410.6K7. a1erage-re1ea*s 6-100K o+ the 0a3i**ar& anterior teeth and
inter'ro3i0a* gingi1a on*&4#".9,K7. *o@ - dis'*a&s *ess than 6K o+ 0a3i**ar& anterior
teeth.4$0.,"K7
b. 'ara**e*is0 o+ 0a3i**ar& incisa* cur1e @ith *o@er *i'. Does the 0a3i**ar& incisa* cur1e
'ara**e* the inner cur1ature o+ the *o@er *i' in 0ost 'eo'*eF Les- ",."K. 1(.9K ha1e a
straight, rather than a cur1ed *ine, and 1.(K ha1e a re1erse cur1ature.
c. 'osition o+ the incisa* cur1e re*ati1e to touching the *o@er *i'! touching4,#.#1K7, not
touching 4(,.#$7, incisa* 'ortions co1ered b& *o@er *i' 41.6#K7
d. nu0ber o+ teeth dis'*a&ed in a s0i*e! # anteriors on*& 46.01K7
# anteriors G 1st 're0o*ar 4,".#K7
# anteriors G 1st J $nd 're0o*ar 4,0.#K7
# anteriors G 're0o*ars G 1st 0o*ar 4(.6,7
Denture Esthetics!
Dentogenics - ter0 coined to be si0i*ar to E'hotogenicE, de+ined as e0inent*& suitab*e +or
'roduction or re'roductionC the art, 'ractice and techni?ues used to achie1e that esthetic goa* in
dentistr&.
%hree areas o+ +ocus! 4Sears7 Face, %eeth, 9u0s
1. Face! ;hat are so0e o+ the changes that @e see in the +ace @ith agingF Is there such a thing as
an Ea1erageE +aceF ;hat e++ect do 1ariations in the 1ertica* di0ension ha1e on +acia* estheticsF
$. %eeth! %ooth se*ection- 're e3traction records, casts, 'hotogra'hs, etc. siMe! a7 @idth- tooth
@idth as a +actor o+ +acia* @idth
a. 1#!1 biM&go0atic @idth to tooth ratio ;hat did Scandrett, et.a* +indF 2easuring
interco00isura* @idth, intera*ar @idth, biM&go0atic @idth, sagitta* crania* dia0eter,
interbucca* +renu0 distance, 'hi*tru0 @idth, and age,Signi+icant corre*ation @as +ound
@ith a** +actors e3ce't age, @ith interco00isura* @idth ha1ing the highest corre*ation to
@idth, and biM&go0atic @idth ha1ing the *o@est corre*ation. 5onc*usionF
b. @idthDheight 'ro'ortion- teeth o+ e?ua* @idths but di++erent *engths appear to ha1e
different @idths sha'e! 5an +ace +or0 be used as a guide to tooth sha'eF ;hat did
2a1ros8ou+is and Ritchie +indF
co*orDshade se*ection!
Hue,- 'osition on the s'ectru0
5hro0a- saturation o+ the 'ercei1ed co*or
)a*ue- *ightnessDdar8nessC @hite-gra&-b*ac8
Does o*der a*@a&s 0ean dar8erF
Ho@ do s8in tone, hair co*or, e&e co*or, +eatures e++ect tooth shade se*ectionF
E++ect o+ *i'stic8 and 0a8eu'F
arrange0ent! i0'ortance o+ .i' su''ort
2id*ine- 1ertica*C Ho@ do @e deter0ine itF 5an it be eccentricF s'ea8ing *ine - the incisa* *ength
or 1ertica* co0'osition o+ the anterior teeth! at rest 4Frush and Fisher7.
a. &oung @o0an (00 be*o@ *i' *ine
b. &oung 0an $00 be*o@ *i' *ine
c. 0idd*e age 1.00 be*o@ *i' *ine
d. o*d age, 0 00 be*o@ to $00 abo1e *i' *ine 4)ig and -rundo7
0a3 centra* 0and centra*
0a*e- 1.9100C 1.$(
+e0a*e- (.,0 0.,9
to age $9 (.(6 0.1
o1er age #0 - .0, $.9
s'ea8ing s'ace- the interocc*usa* s'ace @hich e3ists bet@een the 'osterior teeth @hen the 'atient
is enunciating the DSD sound.4Pound7
s0i*ing *ine 4see %Aan7
'osterior teeth- @hat ro*e do the& '*a& in estheticsF
occ*usa* '*ane- 'ara**e*is0 H har0on& 0ust rise as it 'rogresses 'osterior*& *ong a3is inc*ination
- Shou*d the *ong a3es o+ a** the teeth be 'ara**e*F
cur1ature-4see %Aan7
rotations- *atera* incisor 'osition
gradation4+ront to bac8 'rogression7- di0inution in siMe and detai* 0ust occur gradua**&, eg.,
a1oid e3cessi1e*& short or bucca**& '*aced +irst bicus'id.
ba*ance- *e+t and right ba*ance
For0a* ba*anceHe3act s&00etr&
In+or0a* ba*ance-e?ua* but di++erent E1isua*E @eights
bucca* corridor- ba*ance bet@een the b*ac8 ho*e and the
E0o*ar to 0o*ar s0i*eE ;hich tooth contro*s the siMe and sha'e o+ the bucca* corridorF 5us'id
2andibu*ar anterior teeth! Are esthetics o+ the 0andibu*ar anteriors a 0atter o+ concernF ;hen
are the 0andibu*ar anterior teeth dis'*a&edF S'ea8ingF restingF s0i*ingF 5hanges @ith ageF
diagnostic denture - =nder @hat conditions 0ight a diagnostic denture be considered to be o+
1a*ueF
SPA- Se3 Persona*it& Age ;hat are the in+*uences o+ each o+ these +actors on denture
+abricationF
SEN- 0ascu*ineHstrong, *arge, s?uareC +e0inineHde*icate, rounded, s0a**er
PERS/BA.I%L- s'ectru0 o+ 'ersona*it& t&'es ranging +ro0 1igorous to 0ediu0 to de*icate
A9E- trans*ucenc&, shade, @ear
(. 9u0sD Denture base- gu0 *ine 4see a*so %Aan7- the gu0 *ine at the cer1ica* ends o+ the teeth
shou*d 1ar&
'a'i**a- ;hat +our de+inite 'ur'oses do correct*& designed 'a'i**a ser1eF
1. h&gienic, se*+ c*eansing interdenta* area
$. a co0'*e0entar& +actor in age inter'retation4shorter and @ider @ith age7
(. deter0ines the out*ine +or0 o+ the tooth
,. co*or re+*ection to the interdenta* area
;hat are so0e genera* ru*es +or the +or0ation o+ the interdenta* 'a'i**aF
1. shou*d e3tend to the 'oint o+ tooth contact +or c*ean*iness
$. shou*d be o+ 1arious *engths
(. shou*d be con1e3 in a** directions
,. shou*d be sha'ed according to age o+ 'atient
. shou*d end near *abia* +ace o+ tooth
diaste0a- can be considered unsight*&, - shou*d be used as&00etrica**&, @hen used, - shou*d not
be so @ide as to a''ear as a b*ac8 ho*e, - i+ too narro@ 0a& tra' +ood, - 0a& be re?uested b&
'atient i+ their natura* dentition contained a diaste0a
co*or - 1aries bet@een indi1idua*s, and in the indi1idua*
;hat are so0e o+ the gingi1a* co*or 1ariationsF
Esthetics in Fied Prosthodontics!
Pro1isiona* restoration!
1. Ho@ does the 'ro1isiona* restoration he*' us to 0eet the increasing*& co0'*e3 esthetic
de0ands o+ the 'atientF
5ontributes to a s&ste0atic a''roach to e1a*uate, 0odi+&, 'ro1ide a 'rotot&'e o+ the e1entua*
+i3ed restoration
$.. Su00ariMe the se?uence o+ e1ents +ro0 diagnosis to de*i1er& o+ +ina* restorations.
a. Pre*i0inar& tooth 're'arations are 0ade and a +irst set o+ 'ro1isiona* restorations are
de*i1ered based u'on diagnostic data obtained at 're1ious a''oint0ent4s7 and a
diagnostic @a3 u'.
b. %he 'atient is gi1en a +e@ @ee8s to e1a*uate the initia* 'ro1isiona* restorations, con+ir0
character- 5haracteriMation and shade data. %he author suggests ha1ing both the
*aborator& technician @ho +abricates the 'ro1isiona*s and the cera0ist 'resent to 0eet
@ith the 'atient 4here in the Ba1&, that is ELouE and ELouE7.
c. A cast is 0ade +ro0 an i0'ression @ith the 'ro1isiona*s in '*ace to +aci*itate
co00unications @ith the *aborator& 4Lou7
d. +ina* tooth 're'arations are 0ade and a second set o+ 'ro1isiona*s are de*i1ered, based
u'on changes deter0ined +ro0 the +irst set o+ 'ro1isiona*s. %he 'atient is gi1en a +e@
@ee8s to e1a*uate this set o+ 'ro1isiona*s
e. A+ter a +e@ @ee8s, the 'atient is schedu*ed +or ree1a*uation, and i+ necessar&, changes
can be 0ade and a third set o+ 'ro1isiona*s +abricatedC an i0'ression is 0ade @ith the
'ro1isiona*s in '*ace.
+. the cast @ith the esthetica**& satis+actor& 'ro1isiona*s is sent to the *aborator&4Lou7 +or
use in 0a8ing the +ina* restoration4s7.
$. Shou*d the 'atient ha1e contro* o+ the estheticsF
Bo - the 'atient is a 'artici'ant in the 'rocess. ;h& notF %here 0a& be contraindications to
anato0ic or 0echanica* 'rinci'*es. .oss o+ contro* can *ead to unrea*istic e3'ectationsDde0ands
b& the 'atient.
2andibu*ar anterior teeth ! arrange0ent! cur1ed #9.K
straight 16.K
irregu*ar 1(.#K
horiMonta* o1er*a'! 0ean (.0600
)ertica* o1er*a'! (. 00
A1erage thic8ness! 1."00
tooth o1er*a'! bet@een centra* and *atera* (K
bet@een *atera* and canine 11K
diaste0a! 10K
contours- usua**& con+or0 to 0a3i**ar& anteriors
Fi3edDFi3ed-Re0o1ab*eDI0'*ants
1. ;hat are so0e o+ our o'tions in restoring the 'atient 0issing 0u*ti'*e anterior teeth 4e.g.,
<enned& 5*ass I) 'atient7F < I) RPD, barJc*i's 4e.g. Hader bar7, i0'*ants........
Soft tissue esthetics:
So+t tissue aug0entation ! ;hen shou*d @e consider so+t tissue aug0entationF 'ontic area +or
+i3ed 'rosthodontics
Hard tissue aug0entation ;hen shou*d @e consider hard tissue aug0entationF edentu*ous ridge
aug0entation
9uided tissue regeneration - +or *oca*iMed ridge aug0entation, +or correction o+ co**a'sed or
de+or0ed ridges
Summary: )isua* sti0u*i are trans0itted +ro0 the e&es to the brain. %he inter'retation o+
Ebeauti+u*E or Eug*&E is a co0bination o+ scienti+ic 'rinci'*es, te0'ered @ith the 1ie@er:s
'reconcei1ed, conditioned bac8ground and e3'erience. In so0e cu*tures, teeth @hich are sha1ed
to a 'oint, or teeth @hich are co*ored b*ac8 are dee0ed Ebeauti+u*E. %he state0ent that Ebeaut& is
in the e&e o+ the beho*derE is a co0'*e3 'uMM*e @hich @e are tas8ed to so*1e on a dai*& basis.
;hi*e there is no shortcut to success or secret +or0u*a, 'ractica* a''*ication o+ the abo1e
'rinci'*es can achie1e a success+u* 'rosthodontic resu*t, grati+&ing to both 'atient and
'ractitioner.
- !"stracts -
19-##1$ Frush% &$ P$ and Fisher% '$ D$ (ntroduction to dentino)enic restorations$ & Prosthet
Dent *:*+,-*9*% 19**$
Abstract not a1ai*ab*e at this ti0e ...............
19-##-$ Frush% &$ P$% Fisher% '$ D$ .he dynesthetic interpretation on the dento)enic concept$
& Prosthet Dent +:**+-*+1% 19*+$
Abstract not a1ai*ab*e at this ti0e ...............
19-##/$ Sears% 0$ H$ !n analysis of art factors in full denture construction$ &!D! -*:/-1-%
19/+$
Abstract not a1ai*ab*e at this ti0e ...............
19-##1$ 2lancheri% '$ 3$ 4ptical illusions and cosmetic )rindin)$ 'ev !ssoc Dent 5e
+:1#/-111$ ('eprinted in &6D!% 17:-1% 19*#$)
Abstract not a1ai*ab*e at this ti0e ...............
19-##*$ 5avros8ovfis% F$ and 'itchie% 9$ 5$ .he face-form as a )uide for the selection of
maillary central incisors$ & Prosthet Dent 1/:*#1-*#*% 19+#$
Abstract not a1ai*ab*e at this ti0e ...............
19-##,$ 6ade% '$ E$ .he role of the mandi"ular anterior teeth in complete denture esthetics$
& Prosthet Dent 1-:/,+-/7#% 1979$
Abstract not a1ai*ab*e at this ti0e ...............
19-##7$ 0i)% '$ 9$ and 2rundo% 9$ 6$ .he 8inetics of anterior tooth display$ & Prosthet Dent
/9:*#--*#1% 197+$
Abstract not a1ai*ab*e at this ti0e ...............
19-##+$ 2risman% !$ S$ Esthetics: ! comparison of dentist:s and patient:s concepts$ &!D!
1##:/1*% 19+#$
Abstract not a1ai*ab*e at this ti0e ...............
19-##9$ 3evin% E$ ($ Dental esthetics and the )olden proportion$ & Prosthet Dent 1#:-11--*-%
197+$
Abstract not a1ai*ab*e at this ti0e ...............
19-#1#$ 3om"ardi% '$ E$ .he principles of visual perception and their clinical application to
denture esthetics$ & Prosthet Dent -9:/*+-/+-% 197/$
Abstract not a1ai*ab*e at this ti0e ...............
19-#11$ 3orton% 3$ and ;hit"ac8% P$ Esthetic parameters of mandi"ular anterior teeth$ &
Prosthet Dent 1,:-+#--+/% 19+1$
Abstract not a1ai*ab*e at this ti0e ...............
19-#1-$ Scandrett% F$ '$% <er"er% P$ E$ and =mri)ar% >$ '$ ! clinical evaluation of
techni?ues to determine the com"ined @idth of the maillary anterior teeth and the
maillary central incisor$ & Prosthet Dent 1+:1*---% 19+-$
Abstract not a1ai*ab*e at this ti0e ...............
19-#1/$ .Aan% !$ H$ 3$% 5iller% E$ D$ and .he% &$ 9$ P$ Some esthetic factors in a smile$ &
Prosthet Dent *1:-1--+% 19+1$
Abstract not a1ai*ab*e at this ti0e ...............
19-#11$ Pound% E$ 6ontrollin) anomalies of vertical dimension and speech$ & Prosthet Dent
/,:1-1-1/*% 197,$
Abstract not a1ai*ab*e at this ti0e ...............
19-#1*$ 5athe@s% .$ 9$ .he anatomy of a smile$ & Periodont 'es /9:1-+-1/1% 197+$
Abstract not a1ai*ab*e at this ti0e ...............
19-#1,$ 9uichet% B$F and D$3$ From function to esthetics: !nterior or occlusal
compromises to esthetics$ 6urr 4pin 6osmet Dent 199/:**-,#$
Abstract not a1ai*ab*e at this ti0e ...............
19-#17$ 'osen"er)% E$S$% 6utler% S$!$ Periodontal considerations for esthetics: Edentulous
rid)e au)mentation$ 6urr 4pin 6osmet Dent 199/:,1-,,$
Abstract not a1ai*ab*e at this ti0e ...............
19-#1+$ .ur"yfill% ;$F$ Dentures and partials or esthetic remova"le prosthetics$ 6urr 4pin
6osmet Dent 199/:7*-79$
Abstract not a1ai*ab*e at this ti0e ...............