INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.comwww.ind...
contentscontents
►IntroductionIntroduction
►Facial assessmentFacial assessment
►PhysiognomyPhysiognomy
►MorphopsychologyMo...
INTRODUCTIONINTRODUCTION
www.indiandentalacademy.com
► The face is the first view requiring assessment by aThe face is the first view requiring assessment by a
dental practiti...
► Facial muscle contractions convey feelings of fear,Facial muscle contractions convey feelings of fear,
joy, happiness, a...
►Consequently, analysis of facial featuresConsequently, analysis of facial features
influences dental restorations, partic...
FACIAL ASSESSMENTFACIAL ASSESSMENT
www.indiandentalacademy.com
► The facial composition is one ofThe facial composition is one of
the most important issues for thethe most important iss...
► The optical illusion of a white band ofThe optical illusion of a white band of
teeth bordered by red lips isteeth border...
► The reason for the apparent illusion of the smile is dueThe reason for the apparent illusion of the smile is due
to:to:
...
► There are several ways of creating facial assessmentThere are several ways of creating facial assessment
includinginclud...
PHYSIOGNOMY:PHYSIOGNOMY:
► The facial perspective is the deciding factor for whether aThe facial perspective is the decidi...
► Although the relevance and meaning of facialAlthough the relevance and meaning of facial
features vary, physiognomic ass...
► In Asian and Chinese societies, the number, size, colourIn Asian and Chinese societies, the number, size, colour
and typ...
► Another example is that Africans regard having anteriorAnother example is that Africans regard having anterior
yellowgol...
► The relevance of this discussion on dentofacialThe relevance of this discussion on dentofacial
physiognomy is to raise c...
MORPHOPSYCHOLOGYMORPHOPSYCHOLOGY
► The study of morphopsychology involves establishing a linkThe study of morphopsychology...
► Facial analysis is assessed by the following factors:Facial analysis is assessed by the following factors:
•• Facial typ...
► From a typological perspective, faces are assigned to oneFrom a typological perspective, faces are assigned to one
of fo...
► SanguineSanguine (prominent thick well-(prominent thick well-
defined features associated withdefined features associate...
► Bilious (rectangular andBilious (rectangular and
muscular features coupled withmuscular features coupled with
a dominant...
► In both the frontal and sagittal views, the face is dividedIn both the frontal and sagittal views, the face is divided
i...
► This morphological differentiation signifies specificThis morphological differentiation signifies specific
psychological...
► To achieve equilibrium and harmonious integration, theTo achieve equilibrium and harmonious integration, the
facial zone...
► Each of the facial zones is assigned a sense organ (orEach of the facial zones is assigned a sense organ (or
receptor), ...
► A wide, curved, round angled tooth form is appropriate forA wide, curved, round angled tooth form is appropriate for
pat...
► Masculine facial features display prominent osseousMasculine facial features display prominent osseous
structures, angul...
► However, in contemporary society and aberrant life styles,However, in contemporary society and aberrant life styles,
the...
► Inheritance plays a major role for dental element form,Inheritance plays a major role for dental element form,
alignment...
► Accidents and disease may cause severe disfigurementAccidents and disease may cause severe disfigurement
beyond what is ...
► A sentimental social disaster may result in saggingA sentimental social disaster may result in sagging
(reduced muscle a...
GEOMETRICGEOMETRIC
► The final, and most objective, method of facialThe final, and most objective, method of facial
assess...
► Therefore, facial characteristics have noTherefore, facial characteristics have no
correlation to tooth shape, size, col...
► Ideal facial features may be related to the GoldenIdeal facial features may be related to the Golden
proportion, they ha...
► Commencing from the upper to the lowerCommencing from the upper to the lower
parts of the face, the horizontal lines are...
► These parallel lines create horizontal symmetry and act asThese parallel lines create horizontal symmetry and act as
coh...
► The cohesive forces are paramount in achieving pleasingThe cohesive forces are paramount in achieving pleasing
aesthetic...
► The incisal edges of the anterior teeth should be parallelThe incisal edges of the anterior teeth should be parallel
to ...
► If the incisal plane is tilted this could be attributed to dentalIf the incisal plane is tilted this could be attributed...
► The frontal view also enables assessment of whether theThe frontal view also enables assessment of whether the
patient h...
► Caution is advised when using a facebow, since the rightCaution is advised when using a facebow, since the right
and lef...
► Other auxiliary methods, complementing aOther auxiliary methods, complementing a
facebow, are using either a spirit leve...
► The case study shows a clinical example forThe case study shows a clinical example for
rectifying disparate interpupilla...
► From the sagittal aspect, the horizontal lines alsoFrom the sagittal aspect, the horizontal lines also
reinforce the coh...
► In addition, the Frankfurt horizontal plane, Rickett’s E-In addition, the Frankfurt horizontal plane, Rickett’s E-
plane...
► The nasolabial angle is the intersection of twoThe nasolabial angle is the intersection of two
lines using the nose and ...
► For males, this angle rages from 90° to 95° and for femalesFor males, this angle rages from 90° to 95° and for females
f...
► The Rickett’s E-plane is a line drawn from the nose tip toThe Rickett’s E-plane is a line drawn from the nose tip to
the...
► For example, in edentulous cases, the maxillary lipFor example, in edentulous cases, the maxillary lip
is unsupported an...
►Consequently, when artificial prostheses areConsequently, when artificial prostheses are
fabricated, the latter should re...
CONCLUSIONCONCLUSION
► Facial assessment is both subjective andFacial assessment is both subjective and
objective. Physiog...
ReferencesReferences
► Esthetics in DentistryEsthetics in Dentistry by RONALD.E.GOLDSTEIN.by RONALD.E.GOLDSTEIN.
► Ahmed,A...
Thank you
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.com
Upcoming SlideShare
Loading in …5
×

Facial perspectives / orthodontic therapist courses

594 views

Published on


Indian Dental Academy: will be one of the most relevant and exciting

training center with best faculty and flexible training programs

for dental professionals who wish to advance in their dental

practice,Offers certified courses in Dental

implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic

Dentistry, Periodontics and General Dentistry.

Published in: Education
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
594
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
1
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Facial perspectives / orthodontic therapist courses

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. contentscontents ►IntroductionIntroduction ►Facial assessmentFacial assessment ►PhysiognomyPhysiognomy ►MorphopsychologyMorphopsychology ►Geometric methodGeometric method ►ConclusionConclusion ►ReferencesReferences www.indiandentalacademy.com
  3. 3. INTRODUCTIONINTRODUCTION www.indiandentalacademy.com
  4. 4. ► The face is the first view requiring assessment by aThe face is the first view requiring assessment by a dental practitioner. This view not only reveals thedental practitioner. This view not only reveals the physical landmarks of a person’s identity, butphysical landmarks of a person’s identity, but also gives clues to their psychological make-up.also gives clues to their psychological make-up. ► In addition, from an evolutionary standpoint, theIn addition, from an evolutionary standpoint, the face is the most recognizable feature of the body, anface is the most recognizable feature of the body, an innate and learned response commencing in earlyinnate and learned response commencing in early childhood.childhood. ► Facial expressions mirror our emotional states andFacial expressions mirror our emotional states and serve as crucial non-verbal communication tools.serve as crucial non-verbal communication tools. www.indiandentalacademy.com
  5. 5. ► Facial muscle contractions convey feelings of fear,Facial muscle contractions convey feelings of fear, joy, happiness, anger, etc without uttering a singlejoy, happiness, anger, etc without uttering a single word.word. ► Depending on the surrounding soft tissueDepending on the surrounding soft tissue envelope of the lips and cheeks, showing anteriorenvelope of the lips and cheeks, showing anterior teeth can signify pleasure (by a smile), or disdainteeth can signify pleasure (by a smile), or disdain (by a sneer).(by a sneer). ► These examples illustrate the importance of teeth toThese examples illustrate the importance of teeth to the facial composition, serving the functions ofthe facial composition, serving the functions of mastication, communication and social interaction.mastication, communication and social interaction. www.indiandentalacademy.com
  6. 6. ►Consequently, analysis of facial featuresConsequently, analysis of facial features influences dental restorations, particularly ininfluences dental restorations, particularly in the anterior region, by integrating withthe anterior region, by integrating with existing skeletal and soft tissue features toexisting skeletal and soft tissue features to either enhance desirable qualities or distracteither enhance desirable qualities or distract attention from undesirable abnormalities.attention from undesirable abnormalities. www.indiandentalacademy.com
  7. 7. FACIAL ASSESSMENTFACIAL ASSESSMENT www.indiandentalacademy.com
  8. 8. ► The facial composition is one ofThe facial composition is one of the most important issues for thethe most important issues for the patient. This perspective influencespatient. This perspective influences most patients’ notions of a perfectmost patients’ notions of a perfect smile.smile. ► The reason for this is that mostThe reason for this is that most media images of beauty focus onmedia images of beauty focus on the face. The public is rarely usedthe face. The public is rarely used to scrutinizing a smile at closeto scrutinizing a smile at close distance, in the way routinely donedistance, in the way routinely done by dental professionals.by dental professionals. www.indiandentalacademy.com
  9. 9. ► The optical illusion of a white band ofThe optical illusion of a white band of teeth bordered by red lips isteeth bordered by red lips is constantly put forward in society,constantly put forward in society, where a perfect smile is depicted as awhere a perfect smile is depicted as a monolithic band of ivory.monolithic band of ivory. ► In reality, the upper anterior teeth areIn reality, the upper anterior teeth are not a white monolithic band borderednot a white monolithic band bordered by lips, but distinct entities withby lips, but distinct entities with specific proportions and embrasures.specific proportions and embrasures. ► These facts should be clearlyThese facts should be clearly conveyed to the patient at the onset ofconveyed to the patient at the onset of treatment to avoid latertreatment to avoid later disagreements.disagreements. www.indiandentalacademy.com
  10. 10. ► The reason for the apparent illusion of the smile is dueThe reason for the apparent illusion of the smile is due to:to: •• Angle and distance of viewAngle and distance of view •• LightingLighting •• Profound color contrast between teeth and the lipsProfound color contrast between teeth and the lips •• Poor image quality orPoor image quality or •• Image manipulation.Image manipulation. www.indiandentalacademy.com
  11. 11. ► There are several ways of creating facial assessmentThere are several ways of creating facial assessment includingincluding physiognomicphysiognomic,, morphopsychologicalmorphopsychological andand geometricgeometric.. ► The first two categories are subjective evaluations basedThe first two categories are subjective evaluations based on ideology, theology, sociology, culture and individuality,on ideology, theology, sociology, culture and individuality, while conversely, geometric appraisal is an objectivewhile conversely, geometric appraisal is an objective evaluation dictated by mathematics, devoid ofevaluation dictated by mathematics, devoid of idiosyncrasies inherent in the first two categories.idiosyncrasies inherent in the first two categories. www.indiandentalacademy.com
  12. 12. PHYSIOGNOMY:PHYSIOGNOMY: ► The facial perspective is the deciding factor for whether aThe facial perspective is the deciding factor for whether a treatment is a success or failure. The reason is that from thistreatment is a success or failure. The reason is that from this view, the patient, his/her family and friends make aview, the patient, his/her family and friends make a physiognomic judgement regarding an individual’s character.physiognomic judgement regarding an individual’s character. ► Physiognomy is the art of judging an individual’s character orPhysiognomy is the art of judging an individual’s character or personality by the appearance of their face.personality by the appearance of their face. ► This skill shares similar features with palmistry andThis skill shares similar features with palmistry and astrology, dating back to antiquity, forming part of ourastrology, dating back to antiquity, forming part of our collective consciousness.collective consciousness. www.indiandentalacademy.com
  13. 13. ► Although the relevance and meaning of facialAlthough the relevance and meaning of facial features vary, physiognomic assessment isfeatures vary, physiognomic assessment is prevalent in Eastern and Western cultures.prevalent in Eastern and Western cultures. ► physiognomic judgement, which is a subjectivephysiognomic judgement, which is a subjective assessment, profoundly affects social interaction.assessment, profoundly affects social interaction. It follows that if physiognomy plays a part inIt follows that if physiognomy plays a part in assessing people, the teeth, which are importantassessing people, the teeth, which are important facial landmarks, must also sway our judgement.facial landmarks, must also sway our judgement. This is termed asThis is termed as dentofacial physiognomydentofacial physiognomy.. www.indiandentalacademy.com
  14. 14. ► In Asian and Chinese societies, the number, size, colourIn Asian and Chinese societies, the number, size, colour and type of dental restorations are deciding factors of anand type of dental restorations are deciding factors of an individual’s status and even destiny.individual’s status and even destiny. ► In the developing world, missing incisors are synonymousIn the developing world, missing incisors are synonymous with poverty and despair, while discoloured teeth portendwith poverty and despair, while discoloured teeth portend disaster and misfortune.disaster and misfortune. www.indiandentalacademy.com
  15. 15. ► Another example is that Africans regard having anteriorAnother example is that Africans regard having anterior yellowgold prostheses as a sign of prosperity.yellowgold prostheses as a sign of prosperity. ► Finally, fashion trends and adulation inspire emulation, e.g.Finally, fashion trends and adulation inspire emulation, e.g. precious stones embedded into anterior teethprecious stones embedded into anterior teeth www.indiandentalacademy.com
  16. 16. ► The relevance of this discussion on dentofacialThe relevance of this discussion on dentofacial physiognomy is to raise cultural awareness of ethnicphysiognomy is to raise cultural awareness of ethnic minorities among dental health providers.minorities among dental health providers. ► Offering ethnic minority patients dental restorationsOffering ethnic minority patients dental restorations based on Western mores will alienate them frombased on Western mores will alienate them from their culture and standing in community.their culture and standing in community. ► And this will ultimately deter these patients fromAnd this will ultimately deter these patients from seeking further dental care for themselves and theirseeking further dental care for themselves and their families.families. www.indiandentalacademy.com
  17. 17. MORPHOPSYCHOLOGYMORPHOPSYCHOLOGY ► The study of morphopsychology involves establishing a linkThe study of morphopsychology involves establishing a link between the morphology of the human body withbetween the morphology of the human body with psychological make-up.psychological make-up. ► In dentistry, the face is the focus of attention, and theIn dentistry, the face is the focus of attention, and the ensuing discussion on morphopsychology is thereforeensuing discussion on morphopsychology is therefore limited to facial features.limited to facial features. ► The face is a reflection of our inner soul, influenced byThe face is a reflection of our inner soul, influenced by both heredity and environmental factors. The former isboth heredity and environmental factors. The former is beyond our control, while the latter is controllable by ourbeyond our control, while the latter is controllable by our will and certitude.will and certitude. www.indiandentalacademy.com
  18. 18. ► Facial analysis is assessed by the following factors:Facial analysis is assessed by the following factors: •• Facial typologyFacial typology •• Facial zones and segmental expansionFacial zones and segmental expansion •• Sensitive receptorsSensitive receptors •• Tegumental texture and reliefTegumental texture and relief •• Sexual typeSexual type •• Hemifaces.Hemifaces. www.indiandentalacademy.com
  19. 19. ► From a typological perspective, faces are assigned to oneFrom a typological perspective, faces are assigned to one of four categories :of four categories : •• LymphaticLymphatic (rounded full features with a timid personality)(rounded full features with a timid personality) www.indiandentalacademy.com
  20. 20. ► SanguineSanguine (prominent thick well-(prominent thick well- defined features associated withdefined features associated with intransigence and spontaneity).intransigence and spontaneity). ► NervousNervous (large forehead, thin(large forehead, thin delicate features with an anxiousdelicate features with an anxious disposition).disposition). www.indiandentalacademy.com
  21. 21. ► Bilious (rectangular andBilious (rectangular and muscular features coupled withmuscular features coupled with a dominant persona).a dominant persona). ► The form of teeth shouldThe form of teeth should conform to these four types, soconform to these four types, so that for example, providingthat for example, providing delicate or fragile looking teethdelicate or fragile looking teeth for a bilious face is clearlyfor a bilious face is clearly incongruous.incongruous. www.indiandentalacademy.com
  22. 22. ► In both the frontal and sagittal views, the face is dividedIn both the frontal and sagittal views, the face is divided into three zones: upper, middle and lower.into three zones: upper, middle and lower. ► The upper segment is from the hairline to the glabella (rootThe upper segment is from the hairline to the glabella (root of the nose), the middle from the root of the nose to theof the nose), the middle from the root of the nose to the subnasale, and the lower from the subnasale to the softsubnasale, and the lower from the subnasale to the soft tissue menton (chin prominence).tissue menton (chin prominence). www.indiandentalacademy.com
  23. 23. ► This morphological differentiation signifies specificThis morphological differentiation signifies specific psychological traits:psychological traits: - The upper third is associated with creativity- The upper third is associated with creativity -The middle with emotions and-The middle with emotions and -The lower with instinctive and sensual activities.-The lower with instinctive and sensual activities. www.indiandentalacademy.com
  24. 24. ► To achieve equilibrium and harmonious integration, theTo achieve equilibrium and harmonious integration, the facial zones should be equal quantitativelyfacial zones should be equal quantitatively (morphologically) and qualitatively (psychologically).(morphologically) and qualitatively (psychologically). ► If one of the zones is physically larger, say the middle thirdIf one of the zones is physically larger, say the middle third (emotional), another can compensate for this qualitatively,(emotional), another can compensate for this qualitatively, without creating imbalance.without creating imbalance. ► In the latter example, placing larger teeth in the lower thirdIn the latter example, placing larger teeth in the lower third of the face would counterbalance the physically largerof the face would counterbalance the physically larger middle third segment.middle third segment. www.indiandentalacademy.com
  25. 25. ► Each of the facial zones is assigned a sense organ (orEach of the facial zones is assigned a sense organ (or receptor), the upper third: the eyes, the middle: the nosereceptor), the upper third: the eyes, the middle: the nose and the lower: the lips.and the lower: the lips. ► The vestibular frame of the facial map of the face enclosesThe vestibular frame of the facial map of the face encloses these receptors, which can be either open or closed.these receptors, which can be either open or closed. ► Wide eyes, dilated nostrils and voluptuous lips haveWide eyes, dilated nostrils and voluptuous lips have obvious psychological significance of welcome, arousalobvious psychological significance of welcome, arousal and sensuality, respectively.and sensuality, respectively. ► Conversely, closed receptors convey the oppositeConversely, closed receptors convey the opposite connotations of alienation, passivity and frigidity.connotations of alienation, passivity and frigidity. www.indiandentalacademy.com
  26. 26. ► A wide, curved, round angled tooth form is appropriate forA wide, curved, round angled tooth form is appropriate for patients with open receptors andpatients with open receptors and vice versavice versa for those withfor those with closed receptors.closed receptors. ► Rough, pitted and textured skin requires teeth with similarRough, pitted and textured skin requires teeth with similar characteristics, while smooth silky soft tissue yearns for acharacteristics, while smooth silky soft tissue yearns for a glossy, smooth dentition.glossy, smooth dentition. ► In addition, younger patients with increased skin toneIn addition, younger patients with increased skin tone should have restorations that correspond to their vitality,should have restorations that correspond to their vitality, while older generations should have prostheses thatwhile older generations should have prostheses that convey wear and maturity, conforming to reduced toneconvey wear and maturity, conforming to reduced tone and more wrinkles.and more wrinkles. www.indiandentalacademy.com
  27. 27. ► Masculine facial features display prominent osseousMasculine facial features display prominent osseous structures, angular jaw lines, closed facial angle, andstructures, angular jaw lines, closed facial angle, and rectangular soft tissue angles, etc.rectangular soft tissue angles, etc. ► Feminine components encompass delicate osseous make-Feminine components encompass delicate osseous make- up, oval jaws, open facial angle and rounded soft tissuesup, oval jaws, open facial angle and rounded soft tissues angles, etc.angles, etc. www.indiandentalacademy.com
  28. 28. ► However, in contemporary society and aberrant life styles,However, in contemporary society and aberrant life styles, the conventional sexual types may be ambivalent.the conventional sexual types may be ambivalent. ► Therefore, the clinician should ascertain the biological, asTherefore, the clinician should ascertain the biological, as well as preferred sexual type, before prescribing anteriorwell as preferred sexual type, before prescribing anterior restorations, which may conflict with the patient’s overtrestorations, which may conflict with the patient’s overt sexuality.sexuality. ► Finally, hemi faces describe asymmetry of the right and leftFinally, hemi faces describe asymmetry of the right and left sides of a face. This may be inherited, sequalae of trauma,sides of a face. This may be inherited, sequalae of trauma, or determined by disease or psychologically.or determined by disease or psychologically. www.indiandentalacademy.com
  29. 29. ► Inheritance plays a major role for dental element form,Inheritance plays a major role for dental element form, alignment, colour, etc; the maxillary right and left anterioralignment, colour, etc; the maxillary right and left anterior sextant is rarely identical which does not often cause visualsextant is rarely identical which does not often cause visual tension, but adds diversity and interest to a dentaltension, but adds diversity and interest to a dental composition.composition. www.indiandentalacademy.com
  30. 30. ► Accidents and disease may cause severe disfigurementAccidents and disease may cause severe disfigurement beyond what is aesthetically acceptable, necessitatingbeyond what is aesthetically acceptable, necessitating clinical intervention to resolve the anomalies.clinical intervention to resolve the anomalies. ► Lastly, from a psychological aspect, the right and left brainLastly, from a psychological aspect, the right and left brain hemispheres are responsible for different cerebralhemispheres are responsible for different cerebral activities.activities. ► For a right-handed person, the left side of the brain,For a right-handed person, the left side of the brain, controlling the right part of the face, is responsible forcontrolling the right part of the face, is responsible for cognitive, computational and practical activities, while thecognitive, computational and practical activities, while the right side (controlling the left part of the face) for creativeright side (controlling the left part of the face) for creative and conceptual ideas.and conceptual ideas. www.indiandentalacademy.com
  31. 31. ► A sentimental social disaster may result in saggingA sentimental social disaster may result in sagging (reduced muscle and skin tonicity) to the left facial middle(reduced muscle and skin tonicity) to the left facial middle third (ascribed to emotions and feelings), which could bethird (ascribed to emotions and feelings), which could be compensated by providing appropriate anterior teeth in thecompensated by providing appropriate anterior teeth in the maxillary anterior right sextant.maxillary anterior right sextant. www.indiandentalacademy.com
  32. 32. GEOMETRICGEOMETRIC ► The final, and most objective, method of facialThe final, and most objective, method of facial assessment is based on mathematical principlesassessment is based on mathematical principles of evaluating beauty. Methods for quantifyingof evaluating beauty. Methods for quantifying ► beauty preoccupied ancient Greeks, and havebeauty preoccupied ancient Greeks, and have mystified philosophers and scientists throughoutmystified philosophers and scientists throughout the centuries.the centuries. ► The facial characteristics of a sibling may beThe facial characteristics of a sibling may be inherited from one parent, while tooth morphologyinherited from one parent, while tooth morphology from the other parent.from the other parent. www.indiandentalacademy.com
  33. 33. ► Therefore, facial characteristics have noTherefore, facial characteristics have no correlation to tooth shape, size, colour, alignment,correlation to tooth shape, size, colour, alignment, etc.etc. ► However, there is consensus that certainHowever, there is consensus that certain proportions (both facial and dental) areproportions (both facial and dental) are psychologically perceived as visually pleasing.psychologically perceived as visually pleasing. ► This dictum is the basis of mathematical analysisThis dictum is the basis of mathematical analysis of facial attractiveness.of facial attractiveness. www.indiandentalacademy.com
  34. 34. ► Ideal facial features may be related to the GoldenIdeal facial features may be related to the Golden proportion, they have little significance in dentistry.proportion, they have little significance in dentistry. ► However, in plastic or reconstructive surgery,However, in plastic or reconstructive surgery, facial landmarks according to the Goldenfacial landmarks according to the Golden proportion are valuable guidelines for the surgicalproportion are valuable guidelines for the surgical team.team. ► A geometric evaluation of the face is visualizingA geometric evaluation of the face is visualizing imaginary lines in the frontal and sagittal views.imaginary lines in the frontal and sagittal views. www.indiandentalacademy.com
  35. 35. ► Commencing from the upper to the lowerCommencing from the upper to the lower parts of the face, the horizontal lines are:parts of the face, the horizontal lines are: •• HairHair •• OphriacOphriac •• InterpupillaryInterpupillary •• InteralarInteralar •• Commissural.Commissural. www.indiandentalacademy.com
  36. 36. ► These parallel lines create horizontal symmetry and act asThese parallel lines create horizontal symmetry and act as cohesive forces unifying the facial composition.cohesive forces unifying the facial composition. ► The facial midline is perpendicular to the horizontal linesThe facial midline is perpendicular to the horizontal lines and opposes their cohesiveness.and opposes their cohesiveness. ► The latter are termed segregative forces and are essentialThe latter are termed segregative forces and are essential in a composition to give it interest and harmony.in a composition to give it interest and harmony. www.indiandentalacademy.com
  37. 37. ► The cohesive forces are paramount in achieving pleasingThe cohesive forces are paramount in achieving pleasing aesthetics; the deviation of the facial midline is secondaryaesthetics; the deviation of the facial midline is secondary and varies in many individuals without a deleterious effect.and varies in many individuals without a deleterious effect. ► It is the general parallelism of the horizontal lines, which isIt is the general parallelism of the horizontal lines, which is important, as opposed to the orientation of one single line.important, as opposed to the orientation of one single line. ► The interpupillary line is used as a reference for theThe interpupillary line is used as a reference for the occlusal and incisal plane orientations.occlusal and incisal plane orientations. ► The other horizontal lines can be eschewed and thereforeThe other horizontal lines can be eschewed and therefore do not act as definite references; they are however, usefuldo not act as definite references; they are however, useful accessory markers.accessory markers. www.indiandentalacademy.com
  38. 38. ► The incisal edges of the anterior teeth should be parallelThe incisal edges of the anterior teeth should be parallel to the interpupillary line and perpendicular to the midline.to the interpupillary line and perpendicular to the midline. www.indiandentalacademy.com
  39. 39. ► If the incisal plane is tilted this could be attributed to dentalIf the incisal plane is tilted this could be attributed to dental or skeletal factors. The dental factors that influence theor skeletal factors. The dental factors that influence the incisal table are attrition,erosion (e.g. gastric regurgitationincisal table are attrition,erosion (e.g. gastric regurgitation as in bulimia), abrasion, altered patterns of eruption andas in bulimia), abrasion, altered patterns of eruption and periodontal disease.periodontal disease. ► If the latter are eliminated, then the tilting could be due toIf the latter are eliminated, then the tilting could be due to a slanted maxilla.a slanted maxilla. ► It is vital to determine which factor is responsible for theIt is vital to determine which factor is responsible for the misalignment of the incisal plane, as this will have amisalignment of the incisal plane, as this will have a profound impact on the proposed treatment plan.profound impact on the proposed treatment plan. www.indiandentalacademy.com
  40. 40. ► The frontal view also enables assessment of whether theThe frontal view also enables assessment of whether the patient has an open or closed bite, following posterior toothpatient has an open or closed bite, following posterior tooth loss,resulting in a diminished linear dimension of the lowerloss,resulting in a diminished linear dimension of the lower third of the face.third of the face. ► As mentioned above, the interpupillary and incisal lines areAs mentioned above, the interpupillary and incisal lines are essential reference markers in prosthodontics.essential reference markers in prosthodontics. ► The latter are conveyed to the ceramist for articulation byThe latter are conveyed to the ceramist for articulation by means of a facebow transfer.means of a facebow transfer. www.indiandentalacademy.com
  41. 41. ► Caution is advised when using a facebow, since the rightCaution is advised when using a facebow, since the right and left soft tissue auditory meatus may be at differentand left soft tissue auditory meatus may be at different levels. A discrepancy in the intercondylar axis results inlevels. A discrepancy in the intercondylar axis results in ► differences between the functional and aesthetic planes ofdifferences between the functional and aesthetic planes of occlusion.occlusion. ► The best method to avoid this inaccuracy is by aligning theThe best method to avoid this inaccuracy is by aligning the facebow so that it coincides with the interpupillary line.facebow so that it coincides with the interpupillary line. www.indiandentalacademy.com
  42. 42. ► Other auxiliary methods, complementing aOther auxiliary methods, complementing a facebow, are using either a spirit level or anfacebow, are using either a spirit level or an applicator stick bite.applicator stick bite. www.indiandentalacademy.com
  43. 43. ► The case study shows a clinical example forThe case study shows a clinical example for rectifying disparate interpupillary and incisal planerectifying disparate interpupillary and incisal plane lines.lines. www.indiandentalacademy.com
  44. 44. ► From the sagittal aspect, the horizontal lines alsoFrom the sagittal aspect, the horizontal lines also reinforce the cohesiveness of the profile.reinforce the cohesiveness of the profile. www.indiandentalacademy.com
  45. 45. ► In addition, the Frankfurt horizontal plane, Rickett’s E-In addition, the Frankfurt horizontal plane, Rickett’s E- plane,11 the Steiner12 or Burstone13 lines and theplane,11 the Steiner12 or Burstone13 lines and the nasolabial angle also contribute to profile assessment.nasolabial angle also contribute to profile assessment. ► Two are considered in detail, the Rickett’s E-plane and theTwo are considered in detail, the Rickett’s E-plane and the nasolabial angle, which ascertain the protrusion or retrusionnasolabial angle, which ascertain the protrusion or retrusion of the maxilla as well as lip competence.of the maxilla as well as lip competence. ► In addition to soft tissue analysis,cephalometric referenceIn addition to soft tissue analysis,cephalometric reference points are invaluable for assessing the profile.points are invaluable for assessing the profile. ► The latter will distinguish between soft tissue and skeletalThe latter will distinguish between soft tissue and skeletal abnormalities and reveal Angle, Class I, II or III jawabnormalities and reveal Angle, Class I, II or III jaw relationships.relationships. www.indiandentalacademy.com
  46. 46. ► The nasolabial angle is the intersection of twoThe nasolabial angle is the intersection of two lines using the nose and lips as reference points.lines using the nose and lips as reference points. The two lines are tangents of the subnasale andThe two lines are tangents of the subnasale and the maxillary lip profile.the maxillary lip profile. www.indiandentalacademy.com
  47. 47. ► For males, this angle rages from 90° to 95° and for femalesFor males, this angle rages from 90° to 95° and for females from 100° to 105°. Assuming 90° as the normal, if thefrom 100° to 105°. Assuming 90° as the normal, if the nasolabial angle is <90°, the maxilla is prominent and anasolabial angle is <90°, the maxilla is prominent and a convex facial profile is manifested.convex facial profile is manifested. ► In this case, recessed maxillary anterior restorations areIn this case, recessed maxillary anterior restorations are considered. If the reverse is present, manifesting aconsidered. If the reverse is present, manifesting a concave profile, i.e. nasolabial angle is >90°, a prominentconcave profile, i.e. nasolabial angle is >90°, a prominent maxillary anterior dental segment is indicated.maxillary anterior dental segment is indicated. ► Spear15 has termed this concept of facial profile toSpear15 has termed this concept of facial profile to determine the position, and degree of dominance, of thedetermine the position, and degree of dominance, of the maxillary anterior teeth as ‘facially generated treatmentmaxillary anterior teeth as ‘facially generated treatment planning’.planning’. www.indiandentalacademy.com
  48. 48. ► The Rickett’s E-plane is a line drawn from the nose tip toThe Rickett’s E-plane is a line drawn from the nose tip to the chin prominence.the chin prominence. ► Accepted norms for the distance from the maxillary lip toAccepted norms for the distance from the maxillary lip to this imaginary line are 4 mm, while that for mandibular lip isthis imaginary line are 4 mm, while that for mandibular lip is 2 mm.2 mm. ► With edentulous cases, it is imperative to restore theWith edentulous cases, it is imperative to restore the Rickett’s E-plane to establish a correct facial profile.Rickett’s E-plane to establish a correct facial profile. www.indiandentalacademy.com
  49. 49. ► For example, in edentulous cases, the maxillary lipFor example, in edentulous cases, the maxillary lip is unsupported and the measurement to the E-is unsupported and the measurement to the E- plane is greater than 4 mm, indicative of aplane is greater than 4 mm, indicative of a deficient facial profile.deficient facial profile. www.indiandentalacademy.com
  50. 50. ►Consequently, when artificial prostheses areConsequently, when artificial prostheses are fabricated, the latter should re-establish lipfabricated, the latter should re-establish lip support and restore the facial profile.support and restore the facial profile. www.indiandentalacademy.com
  51. 51. CONCLUSIONCONCLUSION ► Facial assessment is both subjective andFacial assessment is both subjective and objective. Physiognomy and morphopsychologyobjective. Physiognomy and morphopsychology are subjective methods of appraisal, whileare subjective methods of appraisal, while geometric is an objective analysis.geometric is an objective analysis. ► It is the combination of the two that achievesIt is the combination of the two that achieves dental restorations which integrate with facialdental restorations which integrate with facial features and are perceived with aestheticfeatures and are perceived with aesthetic approval.approval. ► However, the ultimate result is heavily dependantHowever, the ultimate result is heavily dependant on the clinician’s and the ceramist’s creativity andon the clinician’s and the ceramist’s creativity and artistic input.artistic input. www.indiandentalacademy.com
  52. 52. ReferencesReferences ► Esthetics in DentistryEsthetics in Dentistry by RONALD.E.GOLDSTEIN.by RONALD.E.GOLDSTEIN. ► Ahmed,Ahmed, Anterior dental esthetics ,Facial perspectiveAnterior dental esthetics ,Facial perspective .. BRITISHBRITISH DENTAL JOURNAL VOLUME 199 NO. 1 JULY 9 2005 .DENTAL JOURNAL VOLUME 199 NO. 1 JULY 9 2005 . ► CRAIG KIRKHAM NAYLOR, DDSCRAIG KIRKHAM NAYLOR, DDS "" Esthetic Treatment Planning:TheEsthetic Treatment Planning:The Grid Analysis System.Grid Analysis System. (j(j Esthet Restor DentEsthet Restor Dent 14:76-84,14:76-84, 2002).2002). ► Snow SR.Esthetic smile analysis of maxillary anterior toothSnow SR.Esthetic smile analysis of maxillary anterior tooth width: the Golden Percentage. J Esthet Dent 1999; 11:177-width: the Golden Percentage. J Esthet Dent 1999; 11:177- 184.184. ► C. G. MURRAY.C. G. MURRAY. Treatment planning for the management ofTreatment planning for the management of selected dento-facial abnormalities.selected dento-facial abnormalities. Journal of OralJournal of Oral Rehabilitation, 1979, Volume 6, pages 89-99.Rehabilitation, 1979, Volume 6, pages 89-99. ► GIUSEPPE ROMEO, MARIO BRESCIANO, DDS,GIUSEPPE ROMEO, MARIO BRESCIANO, DDS, DiagnosticDiagnostic and Technical Approach to Esthetic Rehabilitations.and Technical Approach to Esthetic Rehabilitations. (J Esthet(J Esthet Restor Dent 15:204-216, 2003)Restor Dent 15:204-216, 2003) www.indiandentalacademy.com
  53. 53. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

×