Miles of smile (2)

A CENTURY OF SMILES
OR
A CENTURY OF PROFILES
ORTHODONTIC
S
www.indiandentalacademy.com

ORTHODONTIST MUST WORK WITH 2 DYNAMICS
1. SOFT TISSUE REPOSE & ANIMATION ASSESED
AT THE PATIENTS EXAMINATION
2. FACIAL CHANGES OCCUR THROUGHOUT THE
LIFETIME: -
MATURATION
AGING

RECORDS NEEDED
1. STATIC
2.DYNAMIC

STATIC RECORDS
1.FRONTAL AT - REST
SMILE
SMILE CLOSEUP
2. PROFILE AT – REST
SMILE
3. OBLIQUE SMILE
4.OBLIQUE SMILE CLOSEUP

VIDEO CLIPS ARE TAKEN IN
STANDARDIZED FASHION AT A
FIXED DISTANCE FROM OBJECT IN
FRONTAL AND OBLIQUE VIEW.
PATIENT’S HEAD IS POSITIONED
IN NHP.
VIDEO CLIPS ARE TAKEN BEFORE
AND AFTER TREATMENT.
PATIENT IS ASKED TO SAY –
“ CHELSEA EATS CHEESECAKE ON
THE CHESAPEAKE

DYNAMIC RECORDING
DIGITAL VIDEOGRAPHY TO
RECORD SPEECH AND SMILE.
DIGITAL VIDEO YIELDS 30
FRAMES PER SECOND.
5 SECOND VIDEO CLIP IS TAKEN,
YIELDING 150 FRAMES.

FRAME THAT BEST REPRESENTS THE
PATIENTS NATURAL UNSTRAINED SOCIAL
SMILE IS TAKENwww.indiandentalacademy.com

ANATOMY OF THE SMILE
The upper and lower lips frame the display
zone of the smile. Within this framework, the
components of the smile are the teeth and the
gingival scaffold.

The inner commisure is formed by the mucosa
overlying the buccinator muscle where it
inserts with the orbicularis oris muscle
fibers at the modiolus.www.indiandentalacademy.com

When a video is taken with ambient
light only, the buccal corridor often appears
much more pronounced than when supplemental
light is added. Thus, what has been
called “negative space” is often not space at all,
but just an illusion.
(JCO 2000 ACKERMAN &ACKERMAN )

EFFECT OF LIGHTING DURING
PHOTOGRAPHY

SMILE CLASSIFICATION-
SOCIAL SMILE – voluntary
ENJOYMENT SMILE - involuntary

SOCIAL SMILE

ENJOYMENT SMILE

RUBINS CLASIIFICATION
OF SMILE STYLE:
1. COMMISURE (MONALISA) SMILE
2. CUSPID SMILE
3. COMPEX SMILE

CUSPID SMILE

COMPLEX SMILE

MONALISA SMILE

A. CUSPID SMILE
B. COMPLEX SMILE
C. MONALISA SMILE

TRADITIONALLY SMILE ANALYSIS WAS
PERFORMED IN 1 VIEW – FRONTAL VIEW.
SMILE ANALYSIS NOW INCLUDES
4 DIMENSIONS –
1. FRONTAL
2.SAGITAL
3.OBLIQUE
4.TIME

INTERCOMMISURE WIDTH
SMILE INDEX = ------------------------------------
INTERLABIAL GAP
FRONTAL DIMENSION

SMILE INDEX IS USED FOR
QUANTIFYING SMILE.
HELPFUL FOR COMPARING SMILE
AMONG DIFFERENT PATIENTS OR
ACROSS TIME IN SAME PATIENT

FRONTALLY SMILE CAN BE VISUALIZED IN 2
DIMENSION – VERTICAL & TRANSVERSE
1. VERTICAL CHARACTERSTICS-
A) INCISOR DISPLAY
B) GINGIVAL DISPLAY
C) SMILE ARC
D) RELATION BETWEEN GINGIVAL MARGINS OF
MAXILLARY INCISORS AND UPPER LIP.
2. TRANSVERSE CHARACTERSTICS –
A) ARCH FORM
B) BUCCAL CORRIDOR
C) TRANSVERSE CANT OF MAXILLARY O.P.

LESS THAN 75% OF CENTRAL INCISOR
CROWN DISPLAY DURING SMILE IS
CONSIDERED INADEQUATE.
CAUSES :
1. VERTCAL MAX DEFICIENCY
2. A LARGE SMILE INDEX
3. SHORT CLINICAL CROWN HEIGHT
A) INADEQUATE ERUPTION
B) GINGIVAL ENCROACHMENT
C) DUE TO ATTRITION

TRANSVERSE CHARACTERSTIC OF SMILE IN
FRONTAL DIMENSION :
1. ARCH FORM
2. BUCCAL CORRIDOR
3. TRANSVERSE CANT OF MAXILLARY
OCCLUSAL PLANE

ARCH FORM

ARCH EXPANSION FILLS OUT THE
TRANSVERSE DIMENSION OF SMILE IN
COLLAPSED ARCH FORM.
RESULTING UNDESIREABLE SIDE EFFECTS :
1. BUCCAL CORRIDOR CAN BE OBLITERATED
2. THE SMILE ARC MAY BE FLATTENED, WHEN
ANTERIOR SWEEP OF THE MAXILLARY ARCH
IS BROADENED.

BUCCAL CORRIDOR : FRUSH AND FISHER ,
PROSTHODONTISTS, COINED THIS TERM.
TRANSVERSE SMILE IS FUNCTION OF
BOTH ARCH WIDTH AND A-P POSITION
OF MAXILLARY ARCH.
MEASURED FROM THE MESIAL LINE
ANGLE OF THE MAXILLARY 1ST
PREMOLARS TO INTERIOR COMMISURE
OF THE LIPS.

PRESENCE OF EXCESSIVE
NEGATIVE SPACEwww.indiandentalacademy.com

ADEQUATE BUCCAL CORRIDOR

TRANSVERSE CANT OF MAXILLARY OCCLUSAL
PLANE
ETIOLOGY :
1. DIFFERENTIAL ERUPTION &PLACEMENT OF
ANTERIOR ANTERIOR TEETH.
2. SKELETAL ASYMMETRY OF MANDIBLE
SMILE ASYMMETRY CAN ALSO OCCUR DUE
TO ASYMMETRIC SMILE CURTAIN

OBLIQUE DIMENSION

SMILE ARC
CANT OF THE OCCLUSAL PLANE
SMILE ARC IS DEFINED ASTHE
RELATIONSHIP OF THE CURVE FORMED BY
THE INCISAL EDGES OF THE MAXILLARY
ANTERIOR TEETH, PREMOLARS AND
MOLARS TO THE CURVATURE OF LOWER
LIP. (NEW DEFN)
Factors that contribute to the appearance
of the smile arc are the sagittal cant of the
maxillary occlusal plane and the archform.

CONSONANT SMILE ARC

NONCONSONANT SMILE ARC

FLATTENING OF THE SMILE ARC

1.Normal orthodontic alignment of the maxillary
and mandibular arches may result in a loss of
the curvature of the maxillary incisors relative to
the lower lip curvature.
2.. Maxillary intrusion arches or maxillary
archwires with accentuated curve could
result in a flattening of the smile arc.

SMILE ARC FLATTENING DURING
INTRUSION OF UPPER INCISORS

The subject’s inherent growth pattern may also be
at fault. The studies of smile arc flattening have
shown that, while treated patients did have a
higher rate of smile arc flattening, 5% of the
untreated population also experienced smile arc
flattening.

More vertical growth in the posterior maxilla than in the
anterior maxilla could result in a changed relationship
Between the occlusal plane and the curvature of the
lower lip upon smile. In this type of patient, high-pull
headgear keeps the maxillary posterior teeth superior
to the incisors and is therefore an aid in maintaining
or improving the smile arc.

Habits
Habits may also be an etiologic factor. The reduction
in anterior vertical dentoalveolar development
secondary to thumb sucking is the most obvious
example.

SAGITTAL DIMENSION
1. OVERJET
2. INCISOR ANGULATION
EXCESSIVE POSITIVE OVERJET IS
READILY PERCEIVED IN SAGITTAL
DIMENSION
UPRIGHT MAXILLARY INCISORS
TEND TO INCREASE THE INCISOR
DISPLAY

INCISOR PROCLINATION & VERTCAL
INCISOR DISPLAY

TRANSVERSE EFFECT
SAGITTAL POSITION OF MAXILLA GREATLY
INFLUENCES THE SMILE IN FRONTAL VIEW
EVEN IN THE TERMS OF TRANSVERSE SMILE
DIMENSION

TIME
GROWTH
MATURATION
AGING
EFECTS :
1.LENGTHNING OF PHILTRUM AND COMMISURE
HEIGHT.
2. DECREASE IN TURGOR
3. DECREASE IN INCISOR DISPLAY AT REST
4.DECREASE IN INCISAL AND GINGIVAL
DISPLAY DURING SMILE

BRACKET POSITIONING
1. TO PRESERVE THE POSITIVE SMILE
CHARACTERSTICS.
2. TO IMPROVE THE SMILE

Miles of smile (2)

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