The golden proportion in esthetic treatment planning

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  • 1. The golden proportion in estheticThe golden proportion in esthetic treatment planningtreatment planning INDIAN DENTAL ACADEMY Leader in continuing dental education
  • 2. introductionintroduction • Beauty is in the eye of the beholder • Perception of beauty in the brain • esthetics – the branch of philosophy dealing with beauty
  • 3. Fibonacci numbersFibonacci numbers • Presented 1202 by Filius Bonacci in text Liber Abaci • The series is 0,1,1,2,3,5,8,13,21,34,55,89,144….. • Likened to multiplication of rabbits • Each no. is 1.618 times the previous no.
  • 4. Golden sectionGolden section • Known since 550 B.C. to Egyptians and Greeks • Marvellous as it is perceived as beauty, harmony and balance • Static symmetry vs. Dynamic symmetry • 1.618/1 = 0.618 referred to as Ф after phidias • Kepler in 1600 callled it as divine proportion • Key to normal morphology • Natural law of growth of animals and plants
  • 5. Clinical application in dentistryClinical application in dentistry • width of 1┘: 1┐= 1.618 • Lower incisors width : upper intercanine width = 0.618 • Found in people with most attractive smiles, faces and most graceful figures • Fundamental component of major biologic plan
  • 6. Golden rectangleGolden rectangle • Base of 1.0 and perpendicular side 1.618 • E.g. playing cards, credit cards, picture frames, 3”* 5” postcards • Golden triangle, pentagon, spirals • Dynamic: seem to display some sort of life, animation • Golden divider by Robert M. Ricketts
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  • 8. Why it worksWhy it works • Face, jaws and teeth as geometric structures present more esthetics if they align more with GP • Referred to as golden to each other • Smile analysis by several investigators confirm presence of GP
  • 9. CompositionComposition • Study of objects made visible by contrasts in color , line and texture • Components • Unity : oneness, ordering of parts of a composition to give the individual a total, whole effect • Static dynamic • Regular geometry logarithmic spirals • Passive, inert dynamic, living
  • 10. • Cohesive elements : tend to unify a composition • Repetition of shape, line and color • Unfortunately appear static or dead • Arrangement of maxillary ant. Teeth to a circle • Segregating elements: introduce unity with variety • Hogarth’s line of beauty • introduced to teeth arrangement
  • 11. DominanceDominance • One shape, color should dominate • Others subservient • E.g the maxillary central incisor is the most dominant tooth by virtue of it’s visible size • Not maxillary cuspid as only mesial side is visible • Mouth is the dominant feature of the face
  • 12. ProportionProportion • Golden proportion is ideal guide • Disadvantages • Unfortunately applied unilaterally • Malaligned teeth, overlap, diastemas • Requires calliper and calculator
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  • 14. Golden percentagesGolden percentages • Calculated as total sum / individual ratio i.e. 0.618+1+1.618+1+0.618=6.472/ individual ratio • 10%-15%-25%-25%-15%-10% • Does not depend upon lateral incisors only but the individual tooth’s contribution to whole • Teeth with identical width generate identical % • Asymmetry clearly identifiable and quantifiable
  • 15. Smile analysisSmile analysis • Repeatable, measurable objective principles can be applied o improve esthetics • Consider the following factors in the dentofacial analysis • Upper lip position – high, average or low • Upper lip curvature • Parallelism of maxillary incisal curve with lower lip • Relation between maxillary anteriors and lower lip • Number of teeth displayed in a smile • Midline relation of the central to the philtrum
  • 16. • Interpupillary line to midline of face • Midline of teeth to midline of face • Lip symmetry • Profile ( influences dominance given to centrals) • The negative space • Buccal corridor
  • 17. Dental analysisDental analysis • Width and height of existing teeth • Proportion • Parallelism • Axial inclination, rotation, malposition • Gingival characteristics
  • 18. Smile designSmile design • Age, sex and personality • Oral health • Three factors effecting smile design • Symmetry across midline • Anterior or central dominance • Regressive proportion
  • 19. Treatment planningTreatment planning • Step 1 – establish facial symmetry and midline • Interpuppilary line // horizon • Placement of midline at exact center – artificial • Eccentric unexaggerated midline – natural illusion • Maxillary midline and facial /labial frenum midline – 70.4% • Do not use mandibular midline • Stable positioning without leanings to left or right
  • 20. • Step 2 – record the highest lip line • Height of upper lip at full smile • Length of centrals • Amount of visible gingiva • Photographs or manual • Ideal smile, gummy smile or long lip smile • Obvious gingival asymmetry noted • Postion of lateral incisor
  • 21. • Step 3 – take photographs • As viewed from the front • Lips retracted • Horizontal frame should // interpupillary line • Or vertical margin // the facial midline • 8” from centrals , 1: 2 magnification
  • 22. Grid analysis systemGrid analysis system • Given by CK Naylor • Incorporation of midline axis, incisal plane, highest lipline, proportionate contact areas forms a grid • Provides a method of demonstrate variations from esthetic arrangement of anterior teeth
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  • 24. • Step 4 – draw the lines on the photograph • aim to coincide with idealized positions of • Incisal plane- // upper or lower frame at the position of idealized incisal edge • Incisal edge- cornerstone and set to correct level determined for the pt’s smile • Visibility at rest and lip mobility • Incorporated to grid and verified in mock up • Highest lip line drawn • Midline axis drawn perpendicular to the incisal plane
  • 25. • Proportionate placement of contact areas • Cental incisor to lateral incisor establishes the former as dominant factor in the composition • Repeated proportion by Lombardi between CI, LI and canines • Most followed is golden proportion (1/1.618=0.618) • CI= 9mm → LI = 9*0.618= 5.56mm • Golden percentages can be used
  • 26. RED ProportionRED Proportion • Recurring esthetic dental proportion • Basically implies not to follow the 62% proportion • States that proportion of the successive widths of the teeth as viewed from the frontal should remain constant as one moves distally dentist can define his own RED proportion • Several studies have reported mean proportions of 66-78% for LI: CI
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  • 28. • Step- 5 treatment phase • Carried out in mouth based on the grid system • Final result visualized with mock up or provisionals • Conventional therapy constituted after patient’s consent.
  • 29. ConclusionConclusion • Golden proportion ids the starting point in smile design • Strict adherence to it is questionable but it serves as useful tool for initial evaluation of dominance and proportion
  • 30. Thank you For more details please visit