The document discusses various esthetic considerations in dentistry. It defines key terms like esthetics, smile design, and composition. It describes factors that affect dental esthetics like soft tissue management, tooth reduction, shade selection, color variation, and principles of color. It discusses how to evaluate and match dental shades using systems like Vita and how natural tooth color can vary in different areas. The goal of esthetic dentistry is to create natural-looking restorations that harmonize with the face and surrounding teeth.

2. ESTHETIC CONSIDERATIONS

3. Smiling in the face of your
brother
Are “ charity ”
((Prophet Mohamed))

4. Does beauty really come from the inside out or does your
physical appearance play the greater role?
Do we really think beauty is only
skin deep or are our brains hard
wired to think otherwise?
What is beauty?

5. The secret of beauty and
attractiveness has been a
quest of humans for as long
as we have been civilized
Many women – even some men
- spend up to one-third of
their income on improving
their looks
5

6. Is that portion of the discipline that deals with achieving the
ultimate in appearance, escape from artificiality.
Esthetic
Branch of philosophy dealing with beauty.
The branch of philosophy dealing with beauty. In dentistry, the
theory and philosophy that deal with beauty and beautiful, with
respect to the appearance of a dental restorations, as achieved
through its form and or color. Those subjective and objective
elements and principles underlying the beauty and attractiveness
of an object, design or principle.

7. Esthetic dentistry:
Art and science of dentistry applied to create or enhance the beauty
of an individual within functional and physiological limits. The
application of the principles of esthetics to the natural or artificial
teeth and restorations.
Esthetic dentistry is characterized primarily by the smile. The goal in
the creation of esthetic dental restorations is to stimulate, or
improve upon, the appearance of the natural dentition. The
successful esthetic restorations must integrate harmoniously with
the whole of the face., not just with the surrounding teeth.

8. Smile:
is the ability of person to express a range of emotions with the
structure and movement of the teeth and lips can often determine
how well a person can function in society. the perceiveness of one’s
personality is said to be a God’s gift. Certain issues might create
discrepancies in this appearance, the role of a cosmetic dentist is
crucial in analyzing and crafting the desired smile.
Appearance Zone :
This is the anterior oral area where esthetics is of prime concern
and which is visible on smiling, from maxillary premolar to
premolar (usually 1st molars also).
Depends on the person’s self-image, mouth size, teeth size, smile
width, lip size and tightness.

9. Esthetic reshaping:
Modification of the surfaces of teeth to improve appearance.
Cosmetic dentistry:
Is application of the principles of esthetics and certain illusionary
principles, performed to signify or enhance beauty of an individual
to suit the role he has to play in his day-to-day life or otherwise.
Smile designing:
Is a process whereby the complete oral hard and soft tissues are
studied and evaluated and certain changes are brought about
which will have a positive influence on the overall esthetics of the
face. These changes are governed by the principles of esthetic
dentistry.

10. Composition:
means the act of combining elements or parts to form a whole.
There are various physical attributes of the elements of a
composition that impart the esthetic value.
Contrast: It is that factor which makes the various elements of a
composition visible. The eye can differentiate the parts of an
object due to contrast of colors, lines, patterns, textures, etc.
The relationship between the different parts of the face (facial),
the teeth and the gums (dental) made visible by contrast
constitutes the dento-facial composition.

11. Unity between different parts of the face, and teeth is essential
to give the effect of oneness or wholeness to the dento-facial
composition
Unity:
Prime requisite for a composition is unity that will give different
part of the composition the effect of a whole.

12. Factors Affecting Esthetics
1- SOFT TISSUE MANAGEMENT
A-FINISH LINE FORMATION.
B-IMP RESSION PROCEDUR.
C - THE TEMPORARY RESTORATION.
2- TOOTH REDUCTION
3- SHADE SELECTION
4 - COLOR VARIATION

13. 9- OPTICAL ILLUSON
8-TOOTH FORM,SIZE AND ARCH POSITION
7- DEGREE OF GLOSS
6- SURFACE CHARACTERIZATION
5-TRANSLUCENCY

15. 1- SOFT TISSUE MANAGEMENT
Optimal soft tissue health should be established before any
restorative procedures.
Many aspects of prosthetic treatment may cause esthetically
detrimental changes in the
form of changes in gingival form ,color or position following
cementation.

16. A- Finish line formation
With subgingival margins ….. every effort must be made to produce
minimal soft tissue
injury .
Retraction Cord Technique
-The preparation is completely established - with a suprra-gingival
finish line.
-Then a retraction cord is placed in the sulcus and temporarily
displace the gingiva laterally and apically
-Excessive instrument pressure exerted in placing the excessively
large cords----gingival damage.

17. -Single medium-sized ------------- posterior teeth.
-Too large or too many cords --------- excessive trauma.
-Finally, the finish line can be lowered without soft tissue injury.
-Healthy gingival tissue, one thin cord -------- anterior teeth
-Blanching (evidence of reduced blood supply) is often observed immediately after
placement of cord rapidly disappears.

18. An impression must provide detailed information about :
The prepared teeth, Surrounding intact teeth, Associated soft
tissues
B-Impression Procedure:
-Remove all cord from the sulcus as the impression material is
syringed around the prepared teeth.
-Removal of the impression from the mouth, then check the gingival
sulcus with an explorer and remove any remnants of retained
impression material.
-Severe tissue reactions when the impression material is left in the
sulcus.

19. Inadequate soft-tissue management
Causes of finish line not visible in the impression:
Bleeding from inflamed gingiva displacing the impression material
Tendency of the gingival cuff to recoil and displace
partially set impression material
because of inadequate bulk Sulcus impression tearing
Retraction cord
Two-cord technique
Rotary curettage
Electrosurgery Laser troughing

20. C - THE TEMPORARY RESTORATION
1-Properly contoured
2-Well adapted to the preparation margin
3-Should possess a very smooth surface
4-Establish cervical embrasures to provide access for oral hygiene
aids
5-Left not more than two to three weeks

21. 10-An over contoured embrasure will reduce the space intended
for the gingival papilla and causing pressure and irritation on the
papilla, also inhibits effective oral hygiene
9-Open embrasures to allow easy access to the interproximal area
for plaque control.
8-Crown contours should be such that it should not provide any
niche for plaque retention and should promote self-cleaning.
7-Interdental papilla is often neglected due to improper design of
interdental space.
6-Overcontouring leads to food trap and hence complicating the
periodontal status.

22. laceration of the gingiva with rotary instruments + poor temporary
restoration.
Final restoration …………… fails to vertically reach the finish line of
the prepared tooth
Overextended or under extended restoration
plaque accumulation at the margin of the restoration.

23. A uniform duplication of the form and contours of the natural dentition.
2- TOOTH REDUCTION
Insufficient tooth reduction poor esthetics
Development of adequate color requires a certain thickness of porcelain
The facial reduction should be 1 to 1.5 mm.

24. The areas to be considered during preparation :
1- labioincisal aspects.
2- Cervical portion of the facial surface.
A) The facial surface should be reduced in two planes; one nearly
parallel with the path of insertion, and one parallel with the incisal
two-thirds of the facial surface of the tooth

25. C) One plane reduction which creates adequate space for the
restoration both in the shoulder and the incisal areas, will
endanger the pulp entity and produce overtapered restoration.
B) One plane reduction parallel with the path of insertion may result
in insufficient space for porcelain in the incisal 1/3 of the tooth

26. inadequate facial reduction, the laboratory fabrication can
be handled in one of two ways
1- develop proper contour in the restoration, results in a lack of
color vitality due to insufficient porcelain thickness: External and
internal color modification to enhance the esthetics of the
restoration.
2- over-contoured restoration to develop proper color leading to
plaque accumulation which affects the gingival health.

28. 3- SHADE SELECTION
Shade interpretation
Difficulty in color matching …precise matching of a desired shade
can be difficult.
The original color of a tooth is the color one sees as a result of
the reflection, refraction, deflection, and absorption of light by
the enamel, the dentin, and possibly the pulp.
The color seen in a tooth is the result of combined optical
effects of the layers of tooth structure, the translucency and
thickness of the enamel and color of the underlying dentin.

29. The esthetic dentistry, using a combination of science and art,
involves the use of colors to create a natural tooth like restoration,
color and shade are very important because teeth are multi-
chromatic with color variations from cervical to incisal, every tooth
in the mouth from the central incisors to molars, both upper and
lower, varies in color.

30. Color:
Dimensions of color:
Color cannot be perceived without light, which is a form of
electro-magnetic energy visible to the human eye. The visible
spectrum of light lies in a narrow band of 380nm to 760nm. It has
the ability to stimulate the cells in the retina which is interpreted
by the brain, discerning the sense of color.

31. Color that is perceived is the result of a light source, the object that
absorbs, transmits, reflects or scatters the light from the source, and
the interpretation of the result by the human visual system
Light form of visible energy that is part of the radiant energy
spectrum. Radiant energy possesses specific wavelengths, which
may be used to identify the type of energy

32. In 1666 Isaac Newton discovered that white light can be broken
down into a rainbow of color
In nineteenth century that German physiologist Ewald Hering first
described the now familiar color circle.

33. In 1905, Albert Henry Munsell, an American artist and art teacher,
further modified the color circle, devising a system of color
organization that centered around three unique aspects of color:
hue, chroma, and value. Using these three aspects, was able to
construct a three-dimensional color wheel

34. Color Mixing
Light mixture- primary colors:
red, green, blue.
Additive mixture system- mixing
of two of the light mixture primary
colors
red + blue = magenta
red + green = yellow
green + blue = cyan
Pigment mixture system: yellow, cyan, magenta
Color of the Human Teeth
Clark was the first to accurately describe the color of the human
teeth in 1931

35. Dr. E. B. Clark, a dentist, produced the first data in 1931.
He indicated the Hue ranged from 6 YR (yellow-red) to 9.3 Y (yellow).
The Value ranged from 4 to 8, and the Chroma ranged from 0 to 7.
Clark stated that “Color, like form, has three dimensions”.

36. Lemire and Burk found:
The Hue range from 8.9 Y to 3.3 Y, a Value range of 5.8 to 8, and a
Chroma range from 0.8 to 3.4
Goodkind and Schwabacher:
Identified the Hue range as 4.5 YR to 2.6 Y, the Value range as 5.7 to
8.5, and the Chroma range from 1.1 to 5.

37. Guidelines for Clinical Shade Selection
1.light
2.amount lighting
3.location of lighting
4.restricting light
5.surrounding colors
6.tone of selection
7.patient position
8.tooth condition
9.comparison prcds.
10.selectiodistance
11.verification
12.diagram
13.photograph

41. Vita 3D stapes 1 (Value)
VALUE :
Value or brilliance is the relative blackness or whiteness of color. On a
scale of black to white, white has “high value”, black has “Low value” and
Midway between black and white is the medium grey. Value is the only
dimension of color that can exist by itself.
Munsell color system extends from zero to ten, black is zero and white is ten

42. Vita 3D stapes 1 (Value)
1-Determine the lightness level
(value)
2-Hold shade guide to patient’s mouth
3-Start with darkest group moving right
to left
4-Select Value group 1, 2, 3, 4, or 5

43. Vita 3D stapes 2 (Chroma)
CHROMA :
In Munsell’s words, “it is the quality which we distinguish a strong
color from a weak one “ Human teeth fall into the yellow to yellow
red area of the Munsell color order system. Pale colors have a low
chroma whereas intense colors have high chroma.

44. Vita 3D stapes 2 (Chroma)
Select the chroma
1-From your selected Value group, remove the middle tab (M) and
spread the samples out like a fan.
2-Select one of the three shade samples to determine chroma.

45. Vita 3D stapes 3 (Hue)
HUE :
In Munsell’s words, “It is that quality by which we distinguish one color family
from another”.
Generally there are six hue families. Violet, blue, green, yellow, orange and red.
For example, in the Vita shade guide there are four hues A, B, C and denoting
reddish brown, reddish yellow, grayish and reddish grey respectively.

46. Vita 3D stapes 3 (Hue)
Determine the hue
Check whether the natural tooth is more yellowish or more
reddish than the shade ample selected

47. Shade matching using the VITA Easyshade Compact:
1-“Tooth areas” mode selected. Note the active dot appearing in
the cervical third of the tooth on the screen.
2-Wand tip on the buccal surface at the cervical third of the tooth.
3-“OK” signal in the cervical third and active dot in the middle
third on the screen.
4-Wand tip on the buccal surface at the middle third of the tooth.

48. 5- OK signal in the cervical and middle thirds and active dot in the
incisal third on the screen.
6-Wand tip on the buccal surface at the incisal third of the tooth.
7- OK signal in the cervical, middle, and incisal thirds on the
screen.
8-VITAPAN Classical and VITAPAN 3D-Master shades that are
closest to the natural tooth structure color shown on screen.
Note: The nonslip infection-control shield has been omitted from
this series of photos for demonstration clarity.

49. Color research continued to evolve based on the Munsell color model.
In 1976, The Commission Internationale de l’Eclairage (CIE), an
international color research group founded in 1931, published the
CIELAB color system.
CIELAB COLOR SYSTEM

50. In this 3-dimensional color system, L* refers to brightness (0 to 100),
a* represents red (+a*) vs. green (-a*) and b* indicates yellow (+b*)
vs. blue (-b*). When a* and b* are zero, the L value represents the
continuum of black to white.
The CIELAB model offers some advantages over other color models.
The L*a*b* color space was designed to correlate with perceptions of
color.

51. Color Differences CIELAB
Is often used to measure changes in color, including changes in tooth
color from use of whitening products. Color difference equations are
used to quantify the color change. ΔL*, the change in brightness,

52. Factors can be responsible for poor color matching
1-A poor selection may have been made from available shades, or it
may not be possible to match the natural teeth with the available
porcelain colors.
2. The dental laboratory may have failed to reproduce the selected
shade from the available materials or there may have been
insufficient information to effect a satisfactory color modification.

53. 4. Also, the porcelain may not have been handled in such a manner
as to reveal its inherent coloration.
3. The tooth reduction is insufficient in certain areas, or the metal
framework or opaque porcelain, or both, may be too thick, leaving
insufficient space for dentin porcelain.

54. COLOR VARIATIONS AMONG TEETH
Cervically : dentin is more than enamel.
Incisally the enamel is thicker than the dentin, which increases the
translucency.

55. 1- Maxillary anterior teeth
canines pigments related to the dentine thickness.
.
lateral incisor slightly less pigmentation than the central
incisor, related to the facio-lingual dentine thickness, which is often
slightly less on a maxillary lateral incisor.

56. The canines exhibit the greatest color intensity, with the incisors
usually appearing the same.
If a variation in the incisors exists, it is the opposite of that found in
the maxillary incisors.
The lateral incisor pigmentation owing to the larger
crown dimension.
Mandibular anterior teeth :

57. Staining
Not only used to duplicate the natural variation of the tooth
color, but also to create and enhance illusion through
manipulation of shape.
Darker stains optical illusion of smaller size
Increasing the value ( increase whiteness) closer area
Decreasing the value(increase grayness) less prominent area