This document discusses conservative esthetic dental procedures for improving smiles. It outlines various artistic elements that are important to consider, such as shape, symmetry, color, position and alignment of teeth. Specific procedures described include tooth whitening, microabrasion, veneers and bonding to treat discolored, malformed or misaligned teeth in a minimally invasive manner. The goal is to give patients a natural looking smile through these conservative esthetic techniques.

1. Additional
Conservative
Esthetic Procedures

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Introduction
Significant improvements in tooth-colored
restorative materials and adhesive
techniques have resulted in numerous
conservative esthetic treatment possibilities
Children and teenagers are especially sensitive
about unattractive teeth. When teeth are
discolored, malformed, crooked, or missing,
often the person makes a conscious effort to
avoid smiling and tries to “cover up” his or her
teeth.
smile
One of the greatest assets a person
can have is a smile that shows
beautiful, natural teeth 2

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ARTISTIC ELEMENTS
○Shape or form
○Symmetry and proportionality
○Color
○Position and alignment
○Surface texture
○Translucency
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Shape and form
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Cosmetic contouring

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Shape and form
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Cosmetic contouring

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Shape and form
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Cosmetic contouring

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Shape and form
Illusions of shape
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Shape and form
Illusions of shape
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Creating illusionsof length. A, Normal length. B, A tooth can be madeto appear shorter by emphasizing
horizontal elements and by positioning the gingival height of contour further incisally. C, The illusion of
length is achieved by moving the gingival height of contour gingivally and by emphasizing vertical elements,
such as developmental depressions.

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SYMMETRY AND PROPORTIONALITY
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Based on this formulaasmile, whenviewed from the front, isconsidered to be esthetically pleasing
if each tooth in that smile (starting from the midline) is approximately 60% of the sizeof the tooth
immediately mesial to it.

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POSITION AND ALIGNMENT
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Positionand alignment. A, A minorrotation is first treated by reducing enamel in the area of prominence. B,
The deficient area is restored to proper contour with composite. C, Maxillary lateral incisor is in slight
linguoversion. D, Restorative augmentation of facial surface corrects malposition.

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SURFACE TEXTURE
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Teeth in young individuals characteristically exhibit significant surface characterization,
whereas teeth in older individuals tend to possess a smoother surface texture caused by
abrasional wear.

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COLOR
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COLOR
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Translucency
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Smile design
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Smile design
central incisor width to length ratio : it should be 75-85%
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Smile design
Mesial inclination of upper teeth slightly toward the midline
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Smile design
Midline placement
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Smile design
Smile at rest
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Smile design
Gum line symmetry and margin height
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Smile design
Gummy smile
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Smile design
Gingival zenith
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Smile design
Smile line
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Smile design
Flossing contact point
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Smile design
Incisal embrasure
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Smile design
Golden ratio
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Smile design
Buccal corridor and black triangle
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Section Divider 2
A new way to engage with customers
from across the globe.
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Conservative Treatments
for Discolored Teeth

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Conservative Treatments for Discolored Teeth
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non vital
bleaching

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VITAL BLEACHING PROCEDURES

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Vaselineon the patient's lips and gingiva rubberdam
35% hydrogen peroxide intense light system

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Dentist Prescribed-Home
Applied Technique

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Nightguard vital bleaching

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MICROABRASION AND
MACROABRASION
Microabrasionand macroabrasion representconservativealternatives for the reductionoreliminationof
superficial discolorations. As the terms imply, the stained areasordefectsareabraded away. These
techniques do result in the physical removal of tooth structure and, therefore, are indicated only for
stainsorenamel defects that do not extend beyond a few tenths of a millimeter in depth. If the defect or
discoloration remains after treatment with microabrasion or macroabrasion, a restorative alternative is
indicated
MICROABRASION
Involves the surfacedissolutionof theenamel by theacid along with the abrasivenessof the pumice to
removesuperficial stains ordefects.

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Young patient withunesthetic fluorosis stains oncentralincisors. , Premacompound
applied withspecialrubbercupwithfluted edges
Stain removed from left central incisor after microabrasion. Treated enamel surfaces
polished with prophylactic paste. Topical fluorideapplied to treated enamel surfaces

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 Macroabrasion simply uses a 12-fluted composite finishing burora fine
grit finishing diamond ina high-speed handpiece toremovethedefect
Macroabrasion. Outer surface of mandibular first molar is anesthetic because of
superficial enamel defects., Removal of discoloration by recontouring andpolishing
procedures. Completed treatment.

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VENEERS
A veneer is a layerof tooth-colored material that is applied toa tooth to restore localized or
generalized defectsand intrinsicdiscolorations
Common indications for veneersinclude
teethwith facial surfaces thatare malformed, discolored, abraded, eroded, or have
faultyrestorations .
Twotypes of esthetic veneersexist:
(1) partial veneers
(2) full veneers.
Partial veneers are indicated for the restoration of localized defectsor areas of intrinsic
discoloration.
Full veneers are indicated for the restoration of generalized defects or areas of intrinsic
staining involving the majority of the facial surface of the tooth.

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DIRECT VENEER TECHNIQUES
Direct PartialVeneers.
Small localized intrinsic discolorations or defects that
are surrounded by healthy enamel are ideally treated
with direct partialveneers
localized white spotsare
evident
Intraenamelpreparations completed partialveneers

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Indirect processed composite veneers. A, Patient with six defective direct-
composi te veneers. B, Finished window preparations forindirect-processed
composite veneers. C, Left
central incisor isolated, etched, and ready for veneer bonding. D, Veneer is
positioned and seated with blunt instrument or finger. E, Veneer-bonding
medium is light-cured. F,Completed
i ndirect-compositeveneers.

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○ Artistic elements are common to virtually
every conservative esthetic dental
procedure; a basic knowledge and
understanding of these artistic elements
is required to attain esthetic results
consistently.
Summary
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referances
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48. Thank
You