Smile Designing

When it comes to re-creating a patient’s smile, it is not as simple as placing veneers or crowns on teeth that are whiter and brighter than the patient’s existing dentition (Figs. 1 & 2). The smile is an important reflection of one’s self along with communicating a variety of emotions to those around us and it is unique to each individual person. In fact, there are many factors that must be carefully considered and evaluated in creating a smile that is esthetically pleasing to the doctor and the patient. And even with digital technology having a widespread effect on so many things, including restorative dentistry, as well as allowing for digital simulations of a patient’s final smile, there are many factors1 and principles2 that must be evaluated by the treating doctor. Creating an ideal smile may require orthodontics, orthognathic surgery, periodontal surgery, cosmetic dentistry, oral surgery, and plastic surgery. Likewise, it cannot be stressed enough that if indirect restorations will be a part of the final treatment plan, involving the dental technician that will be doing the final restorations, should be consulted early in the process as they can bring an invaluable component to helping the clinician and patient achieve the desired final result.

Patients Desires & Expectations

One of the most important parts that must be considered before any treatment is begun is the clinician must take the time to discuss and discover the patient’s chief complaint and concerns and whether he or she can achieve or succeed the patient’s desired final result. After a thorough review of the patient’s medical and dental history, a comprehensive dental examination is completed, including proper radiographs, evaluation of the muscles and temporomandibular joint (TMJ). When it comes to restorative dentistry that involves significant dental treatment, including the patients smile, it is essential to have proper documentation to a achieve proper diagnosis. This will include proper photos that are taken with a digital SLR camera with a macro lens (Fig. 3) that include: full face photos (Fig. 4); 1:2 lip at rest or repose photos (Fig. 5); anterior and lateral photos (Figs. 6-8) and/or video of the patient smiling naturally, dynamically as well as an exaggerated smile; 1:2 retracted anterior and lateral views (Figs. 9-11); retracted views occlusally (Figs. 12-13); 1:1 retracted views of the anterior dentition (Figs. 14-16).

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