This document discusses smile design in direct tooth-colored restorations. It outlines key components that must be considered when designing an aesthetic smile, including dental midline alignment, tooth dimensions and proportions, gingival health, and soft tissue harmony. The smile design process involves detailed facial and dental analysis to evaluate these elements and plan restorative treatments if needed. Techniques for smile enhancement mentioned include whitening, bonding, veneers, crowns, dental implants, and gum contouring. An ideal smile design harmoniously integrates all smile components to complement the patient's overall facial appearance.

1. 2020
SUPERVISOR :DR.AHMED SATEA
WIN 7

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Al-Rafidain University College
Dentistry Department
Operative
Smile design in direct tooth
colored restoration
Ghadeer abdulbasit fat'hi
Grade: five
Group:A3

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INTRODUCTION
Esthetic dentistry is combination of scientific principles and artistic abilities
to create or enhance beauty of individual within functional limits these
principles act as guideline for clinical restoration. Dentist must consider the
subjective concern of the patient when designing a natural smile. Esthetic
dentistry characterized primarily by smile its goal for creation esthetic dental
restoration to stimulate or improve the appearance of natural dentition. the
successful esthetic restorations must integrate harmoniously with the whole
face not just with the surrounding teeth. SMILE DESIGN is the process that
soft and hard tissue are studied, evaluated and the certain changes are
brought about which will have positive influences on the overall esthetic of
the face. the smile design is not only related to restorative dentistry its also
involve orthodontic, prosthodontics, and periodontal approach. Our subject
today in restorative dentistry for gaining ideal smile require analyses and
evaluation of the face, lips, gingival tissue and teeth.
:smilecomponent of attractiveIn general the
frame that set off the image of smile.its the:lip*
Enhancing its correct shape, fullness, symmetry make the
smile appear ideal.
drawn betweenis imaginary vertical line:facial midline*
the front of two upper teeth and continue along the face
vertically. for optimum esthetic value facial midline
should be in the middle of the face. The most accurate approach to
determining facial midline: point between eyebrows and the cupids bow in
the center of the upper lip .
In Ideal smile line the the edgesline created by top of lower lip.:smile line*
of upper teeth should be parallel to the lower lip when smile.
unstained,attractive smiles have things in common (whiteness,teeth:*
straight, no spaces, no crowded or overlapping).
Vital elements of smile design:
Tooth component
Incisal length Interdental contact
Axial inclinationDental midline
Tooth dimension Embrasure
Zenith point Symmetry and
balance
Sex,Age
Soft tissue component
Gingival health
gingival harmony
Interdental embrasure
Smile line

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1.Dental midline :should be collinear with facial midline.
The vertical contact interfere between 2centrals. It should
be parallel with facial midline (parallel with long axis of
face) midline discrepancies up to 4mm not consider
unesthetic. Slanted midline that placed obliquely in
relation to the facial midline will always distort the symmetry even it placed
exactly in correct position.
2.Incisal length: most important determinant in smile
creation as once set it serve us a reference point for
establishing the proper tooth contour and gingival levels .
3.Tooth dimension :correct dental proportion is related to facial morphology
and is essential in creating esthetically pleasant smile. The width to length
determination theis 4:5. We have guidelines forratio of central incisor
its numerical form andA)GOLDEN PROPORTION :correct proportions :
applied by mathematicians. If the ratio applied to the smile made up of
central,lateral and mesial half of canine it show the central incisor is 62%
wider than lateral which is wider 62% than the visible portion of
all these measurement from the front view.(mesial half)canine
the successiveB)RECURRING ESTHETIC DENTAL PROPORTION:
width proportion when viewed from the facial aspect should
remain constant as we move posteriorly from midline .(i.e each
tooth become smaller by fixed percentage as you move back in
its a:PROPORTIONCHU'S ESTHETIC GAUGEthe mouth).
computer software proportion.
4.zenith point :it’s imaginary point highest gingival point in the marginal
gingiva. while the marginal gingiva is not rounded arch
form so it has parabolic shape with zenith slightly distal to
the midline of the tooth except lateral incisor that have the
highest point in the midline.
5.interdental contact point :the point where the interdental contact area ends.
longest contact between centrals, shortest contact between lateral and canine.
The contact point of maxillary teeth are relevant for ensuring optimal pink
aesthetic for patient with high smile line (visible cervical margin ).

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6.Incisal embrasure : Reduced incisal embrasures result in
straight smile line that’s associated with aging.
7.sex ,age :in female maxillary incisors round, delicate. In
males they are cuboidal and vigorous. aged teeth appear shorter ,minimal
embrasure and low value in contrast to young teeth
appear with high value, defined embrasure and unworn
incisal edge.
Soft tissue component : the lips is the frame of teeth
and gingiva .the gingiva frame of teeth the ratio of tooth structure to the
amount of gingival and labial tissue should be harmonized to prevent over
dominance of any one element.
Treatment plan and sequences :
The crafting of ideal smile analyzes and evaluation of face ,lips, gingival
tissues achieved by :
1.facial analysis , profile analysis , dental analyzes by using chart
and drawing manually .
2.analyzes by computer using software like DSD.
Smile design sequences :
stablish the lips which are the frame of the smile to be designed .
Artistic element
thatShape and form
include :masculine smile
that mean more closed
and prominent incisal
angle .
Feminine smile
:rounded incisal
angles incisal
embrasure ,sof
facial line angle.
Position and
aligment that
include surface
texture and color
.the cervical color
area appear darker
than incisal area
.young patient
teeth appear lighter
compared with old
aged .

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By using the data exactly where its required this will achieve a beautiful
smile .all of feature of smile coming together to complement the patient
face.
for smile design :sTechnique
Whitening — a chemical application with a peroxide base is applied directly
to the teeth to remove minor staining and discoloration.
Bonding — An acrylic material is applied to a tooth that can be shaped and
colored to match the natural look of the patient's other teeth. Primarily used
for chipped, broken or decayed teeth, as well as to alter tooth shape with
minimum tooth removal.
Enamel Shaping — the removal of minute amounts of enamel, the tooth's
outer layer, to improve the look of the shape of a tooth.
Establish the incisal
edge position by using
the interpupillary line
and the lip line as guide.
Develop midline symmetry and
align dental midline to the
facial midline.
Establish the gingival margin
based on the space available
calculate the length of teeth
using width : length ratio of
78%
Establish the gingival margin
Create imaginary form of
central incisor. Create the imaginary form of
the opposite central incisor.
Develop relative proportions of
lateral incisors and canines
Extend the smile into the
corners
Extend the smile into the
corner eliminate the dark
corridors of the smile ,pay
attention to parallelism and
inclination

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Veneers — a thin shell of tooth-colored material, usually porcelain, custom-
designed to be affixed to the front surface of the teeth..
Crowns and Bridgework — a technique that covers heavily damaged teeth or
replaces missing teeth. They usually have an inner core for strength and an
outer porcelain shell for the feel and appearance of real teeth.
Dental Implants — as an alternative solution for replacing missing teeth,
titanium posts are surgically implanted in the patient's jaw. Artificial tooth
replacements are connected to the posts to restore missing tooth above the
gum.
Gum Contouring — a minor surgical procedure altering the position of the
gum tissue and sometimes the underlining bone, to improve the look and
regularity of the gingival line around the teeth.
Changing the patient
smile

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References
*ward H Daniel. Proportional smile design using recurring esthetic dental
proportion (RED) DCNA.2001:45(1);143-53.
*van Zyl I, Geissberger M. stimulated shape design. Helping patient decide
their esthetic ideal . Jam Dent Assoc 2001 Aug; 132(8):1105-9.
*fundamental of esthetics; Claude R.Refenacth.
*Johnston CD, Burden DJ, Stevenson MR. The influence of dental to facial
midline discrepancies on dental attractiveness ratings. Eur J Orthod 1999;
21:517-22.