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31 Cards in this Set
- Front
- Back
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Esthetic Dentistry vs Cosmetic dentistry
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Esthetic - Needed dentistry done esthetically
Cosmetic dentistry - Elective dentistry used to enhance cosmetics |
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Smile analysis areas of concern
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Facial esthetics
Macroesthetics of smile zone aka Display zone Microesthetics of dental tissues |
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Facial Esthetics
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Study of Parameters of facial beauty
- Replace missing teeth and alveolar tissues - Restoring vertical dimension - Orthognathic surgery - Standard orthodontics - |
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Golden Proportion
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1.618/10
Phi = 1.618 |
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Macroesthetics
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Relationships and ratios of teeth to each other, to soft tissues, and to facial characteristics
- Midline: Starting point, Nasion to base of philtrum, view 4-6 weeks. Atleast parallel to prevent Canted midline. - Symmetry - Incisal Embrasures - Tooth reveal - Vestibular space - Shade progression |
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Contacts/Connectors
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Contact - Area of actual contact between teeth
Connector - Area where teeth appear to touch; ideally from embrasure to papilla |
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Minimum Reveal
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Lips at rest but parted
2-4mm in young & decreases with age |
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Incisal edge position
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Length and Buccal-lingual position
- Probably the most important factor in how esthetic the smile is |
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Maximum Reveal
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Have patient smile as big as they can or trying to have them say E in an exaggerated way
- Tells you how critical esthetic aspects of gingival area of restorations will be. Perio? Subgingiva? PFM? |
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Intercommissure line
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Maxillary anterior should fill 75% to 100% of space below the line for a youthful smile
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Smile Line
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Should follow lower lip in smile pose
- Should be flatter in men and be esthetic |
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Microesthetics
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Shape, Size, Color, Surface anatomy and texture, Translucency, and periodontal considerations
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Length/Width
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1/0.8
Width should be 75-80% Length |
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Size determination
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- Surrounding teeth
- Space available - Smile analysis and design - Gingival Margin Position - Golden proportion |
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Surface Anatomy
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- Light reflection Highlights it
- Older teeth are smoother |
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Translucency
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- Not too little or too much
- Should be subtle - Difficult to mask color and make it translucent |
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Bonding vs Veneers
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Bonding
- More conservative - Cheaper - Totally under your control - Can chip and discolor and can't make significant color change - Can't add too much length because composite not strong enough Veneers - More durable - More esthetic of done well - Can make more significant color and shape change - Little to no maintenance - Not as conservative - More expensive - Can't alter like crowns to stain or add porcelain |
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Crowns vs Veneers
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Crowns
- Easier to do and modify - Indicated for extensive restorations or wears and bruxers - Indicated when endo involved Veneers - More conservative - More esthetic and natural - Occlusion unchanged Much easier to match crown to veneer because there's more porcelain |
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How to prevent a dark triangle
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Distance from contact point to bone
5mm or less - Papilla fills 100% 6mm - 56% 7mm or more - 27% |
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Bleaching for Cosmetics
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Always offer to patients needing cosmetic dentistry
- Must wait atleast 2 weeks before shade selection for rebound |
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Veneer preps
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Initial depth cuts
- 0.3mm Gingival - 0.5mm middle and incisal Proximal margins about 0.5mm Prepare 75% through contact Incisal reduction 1.5mm of not changing length |
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Shewing the cusp
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C is done for bicuspids and fat cuspids
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Proximal margin types
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At contact
- Ideal when teeth are in good alightment - Margin not visible - Easy bonding and finishing Lingual proximal margins - Indicated for previously restored or carious teeth - Can close diastema or when teeth have been stripped |
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Indications & Disadvantages of slice prep
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- Diastema closure
- Large interproximal lesions - Dark triangles - Crowding - Need more retention - Less conservative - Less definite seating - Risk of undercut |
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Staining and Glazing
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Strength
Smooth Shade or color alteration |
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3 Ways to finish porcelain
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Natural glaze - Used when adding contact
Polish Separate glaze cycle |
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Types of coloring
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Additive color - Start with black and end with white
Subtractive color - Start with white and end with black Staining is a subtractive color system |
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Vita Shade Guide
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Hue
A - Orange Grey B - Yellow C - Grey D - Grey Brown A & D are translucent Chroma is 1-4 |
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Change incisal edge translucency
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- Add grey or violet to increase translucency
- Add white to lingual to decrease translucency. |
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Before and After glazing
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Crown comes out lighter than it looks going in
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Porcelain Veneer Provisionalization Techniques
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Luxatemp
- Self cure, used with clear stent or impression Standard Composite - Traditionally used Acrylic - Least desirable |
