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Orthodontic S: A Century of Smiles OR A Century of Profiles

This document discusses the importance of analyzing smiles from multiple dimensions and over time for orthodontic treatment planning. Static smile records should include photos from frontal, profile, and oblique views at rest and during smiling. Dynamic records use videos to capture smiling and speech. Smiles are assessed based on characteristics like incisor display, buccal corridors, smile arc, and changes over time from growth, maturation and aging. Analysis considers the frontal, sagittal, oblique and temporal dimensions to develop a comprehensive understanding of the smile.

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61 views54 pages

Orthodontic S: A Century of Smiles OR A Century of Profiles

This document discusses the importance of analyzing smiles from multiple dimensions and over time for orthodontic treatment planning. Static smile records should include photos from frontal, profile, and oblique views at rest and during smiling. Dynamic records use videos to capture smiling and speech. Smiles are assessed based on characteristics like incisor display, buccal corridors, smile arc, and changes over time from growth, maturation and aging. Analysis considers the frontal, sagittal, oblique and temporal dimensions to develop a comprehensive understanding of the smile.

Uploaded by

minal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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ORTHODONTIC

S
A CENTURY OF SMILES
OR
A CENTURY OF PROFILES

1
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

2
RECORDS NEEDED

1. STATIC
2. DYNAMIC

3
STATIC RECORDS

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

4
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
5
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.

6
FRAME THAT BEST REPRESENTS THE
PATIENTS NATURAL UNSTRAINED SOCIAL
SMILE IS TAKEN 7
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.

8
9
The inner commisure is formed by the mucosa
overlying the buccinator muscle where it
inserts with the orbicularis oris muscle
fibers at the modiolus. 10
11
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 )

12
EFFECT OF LIGHTING DURING 13
PHOTOGRAPHY
SMILE CLASSIFICATION-

SOCIAL SMILE – voluntary

ENJOYMENT SMILE - involuntary

14
SOCIAL SMILE

15
ENJOYMENT SMILE

16
RUBINS CLASIIFICATION
OF SMILE STYLE:
1. COMMISURE (MONALISA) SMILE
2. CUSPID SMILE
3. COMPEX SMILE

17
CUSPID SMILE

18
COMPLEX SMILE

19
MONALISA SMILE

20
A. CUSPID SMILE
B. COMPLEX SMILE
C. MONALISA SMILE

21
TRADITIONALLY SMILE ANALYSIS WAS
PERFORMED IN 1 VIEW – FRONTAL VIEW.

SMILE ANALYSIS NOW INCLUDES


4 DIMENSIONS –

1. FRONTAL
2.SAGITAL
3.OBLIQUE
4.TIME

22
23
FRONTAL DIMENSION

INTERCOMMISURE WIDTH
SMILE INDEX = ------------------------------------
INTERLABIAL GAP
24
SMILE INDEX IS USED FOR
QUANTIFYING SMILE.
HELPFUL FOR COMPARING SMILE
AMONG DIFFERENT PATIENTS OR
ACROSS TIME IN SAME PATIENT

25
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.
26
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

27
TRANSVERSE CHARACTERSTIC OF SMILE IN
FRONTAL DIMENSION :

1. ARCH FORM
2. BUCCAL CORRIDOR
3. TRANSVERSE CANT OF MAXILLARY
OCCLUSAL PLANE

28
ARCH FORM

29
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.

30
31
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.

32
PRESENCE OF EXCESSIVE
NEGATIVE SPACE 33
ADEQUATE BUCCAL CORRIDOR
34
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

35
OBLIQUE DIMENSION

36
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.
37
CONSONANT SMILE ARC
38
NONCONSONANT SMILE ARC
39
40
41
42
FLATTENING OF THE SMILE ARC
43
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.

44
SMILE ARC FLATTENING DURING
INTRUSION OF UPPER INCISORS
45
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.

46
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.
 

47
Habits

Habits may also be an etiologic factor. The reduction


in anterior vertical dentoalveolar development
secondary to thumb sucking is the most obvious
example.

48
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
49
INCISOR PROCLINATION & VERTCAL
INCISOR DISPLAY

50
TRANSVERSE EFFECT

SAGITTAL POSITION OF MAXILLA GREATLY


INFLUENCES THE SMILE IN FRONTAL VIEW
EVEN IN THE TERMS OF TRANSVERSE SMILE
DIMENSION

51
52
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
53
BRACKET POSITIONING

1. TO PRESERVE THE POSITIVE SMILE


CHARACTERSTICS.

2. TO IMPROVE THE SMILE

54

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