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# Extreme Makeover

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### Extreme Makeover

1. 1. Extreme Makeover: The Dental/Plastic Surgery Team
2. 2. Beauty <ul><li>What is Beauty? </li></ul><ul><ul><li>Beauty is a result of 2 ideal components: </li></ul></ul><ul><ul><ul><li>Symmetry </li></ul></ul></ul><ul><ul><ul><li>Harmony </li></ul></ul></ul>
3. 3. <ul><li>SYMMETRY- the mirror image of parts or components about an axis </li></ul><ul><li>HARMONY- a recurring theme </li></ul>
4. 6. <ul><ul><li>“ Beauty is power, a smile is its sword” – Charles Read </li></ul></ul><ul><ul><li>“ Beauty is not caused, it is” </li></ul></ul><ul><ul><li>– Emily Dickenson </li></ul></ul>
5. 7. <ul><li>How is it measured? </li></ul><ul><ul><li>The Golden Ratio </li></ul></ul><ul><ul><li>is a mathematical ratio that seems to appear recurrently in beautiful things in nature as well as in other things that are seen as &quot;Beautiful&quot;. </li></ul></ul><ul><ul><li>The &quot;Golden Ratio&quot; is a mathematical ratio of 1.618:1 , and the number 1.618 is called &quot; Phi &quot;. </li></ul></ul>
6. 8. The four front teeth, from central incisor to premolar are the most significant part of the smile and they are in Golden Proportion to each other. This phenomenon has been combined in a grid which can be used to assist us in perfecting the aesthetics of the eight front teeth. The above picture shows a grid in the mouth with the front teeth clearly shown in the demarcations predicted.
7. 9. Smile Design: <ul><li>General Criteria: </li></ul><ul><ul><li>Smile Line </li></ul></ul><ul><ul><li>Midline </li></ul></ul><ul><ul><li>Axial Inclination </li></ul></ul><ul><ul><li>Buccal Corridor </li></ul></ul><ul><li>Specific Criteria: </li></ul><ul><ul><li>Incisal Embrasures </li></ul></ul><ul><ul><li>Golden Proportion </li></ul></ul><ul><ul><li>Symmetry </li></ul></ul><ul><ul><li>Incisal Edge Position </li></ul></ul><ul><ul><li>Emergence Profile </li></ul></ul><ul><ul><li>Labial Contour </li></ul></ul>
8. 10. Smile Design <ul><li>Periodontal Issues: </li></ul><ul><ul><li>Cervical Embrasures </li></ul></ul><ul><ul><li>Margin Placement and </li></ul></ul><ul><ul><li>Design </li></ul></ul><ul><ul><li>Periodontal Health </li></ul></ul><ul><ul><li>Gingival Contour and Shape </li></ul></ul><ul><li>Materials and Finish: </li></ul><ul><ul><li>Choice of Materials </li></ul></ul><ul><ul><li>Labial Anatomy </li></ul></ul><ul><ul><li>Surface finish </li></ul></ul><ul><ul><li>Shade Selection </li></ul></ul>
9. 11. General Concepts <ul><li>Smile Line </li></ul><ul><ul><li>Do the incisal edges follow the Curve of Spee and the Curve of Wilson? </li></ul></ul><ul><ul><li>Do the incisal edges follow the curve of the lower lip while smiling? </li></ul></ul>
10. 12. General Concepts: <ul><li>Buccal Corridor </li></ul><ul><ul><li>Is there dark spaces while smiling between the corners of the mouth and the buccal surfaces of the upper teeth? </li></ul></ul><ul><ul><li>What is the arch form? </li></ul></ul>
11. 13. Specific Criteria: <ul><li>Symmetry: </li></ul><ul><ul><li>Is the cervical/incisal tooth length symmetrical from right to left? </li></ul></ul><ul><ul><li>Is the interproximal contact proper in length and position? </li></ul></ul><ul><ul><li>Are contralateral teeth properly arranged for size and position? </li></ul></ul>
12. 14. Periodontal Related Issues: <ul><li>Cervical Embrasures </li></ul><ul><ul><li>Are there black triangles present? </li></ul></ul><ul><li>Margin placement and Design </li></ul><ul><ul><li>Is the treatment a crown or veneer or something in between? </li></ul></ul><ul><li>Gingival contour and shape </li></ul><ul><ul><li>This is the biggest killer of a beautiful cosmetic result. </li></ul></ul><ul><ul><li>Is the gingival architecture in harmony with the smile design? </li></ul></ul>
13. 16. Materials and Finish: <ul><li>Choice of materials </li></ul><ul><ul><li>When do I use a Veneer, all porcelain crown, or PFM with porcelain margin? </li></ul></ul><ul><li>Shade Selection </li></ul><ul><ul><li>What is the hue, chroma and value? </li></ul></ul><ul><ul><li>Is incisal translucency and halo effect appropriate? </li></ul></ul>
14. 17. Treatment Planning <ul><li>It is the responsibility of the general dentist to offer the best possible treatment to the patient and hence must have the knowledge of the procedures he/she will refer out in order to confidently offer treatment to the patient. </li></ul><ul><li>Let’s see some before pictures </li></ul>
15. 19. Canine 1 st Premolar
16. 26. Thank you