Professional Documents
Culture Documents
70 Case Studies
Anteriores:
Natural & Beautiful Teeth
Dr Jan Hajt, Munich/Germany
Our implant patients are ever more demanding. Whereas dental implantology used to concentrate almost exclusively on complication-free implant healing, implantological practitioners now increasingly find themselves confronted with the special
requirements of the aesthetic zone. Sophisticated patients expect near-perfect copies of their red and white aesthetics.
All restorations, including implant-supported restorations, should conform to natures rules. This is not an easy endeavour, as
even experienced implantologists will often have to admit. The success of a restoration will depend on the treatment provider
mastering not only the implantological discipline per se, but also the rules of facial harmony and anterior aesthetics.
These have been summarized in an ingenious way by Dr Jan Hajt from Munich in his new book entitled Anteriores: Natural &
Beautiful Teeth (German title: Anteriores natrliche schne Frontzhne). We are reprinting for you a short excerpt from this work.
Incisal-edge lines
Relationship between the incisal-edge
line and the lower-lip line (smile arc)
D. M. Sarver proposed to define the relationship
between the curvature of the upper incisal-edge line
and the curvature of the lower lip in a smile as the
smile arc. According to Sarver, these two lines are in
agreement in an ideal smile, or, to borrow Sarvers
term,consonant. A flattened incisal-edge line, due to
age or abrasion, is non-consonant. These terms are
important and describe the situation very well in that
consonance is quite distinct from strict parallelism.
The incisal images do not have to form a harmonious arc with the lower lip, but are supposed to harmonize with it (Fig. 1). Depending on the length and
position of the canines, the resulting shape will be
either a smoothly curved arc or the typical seagullwing shape (Fig. 2). The incisal edges may touch the
lower lip completely or intermittently, but they may
also keep their distance from the lower lip. An
inverse, i.e. downward, curvature of the incisal-edge
line appears conspicuously unsightly (Fig. 3).
According to Tjan, the upper teeth will touch the
lower lip in approximately one-half of all cases. In onethird, there will be a gap between the two; in onesixth, the lower lip will slightly overlap the teeth.
Lower-lip position is a relatively reliable indicator of
EDI
71
Case Studies
Fig. 5
The further the occlusal plane is
tilted anteriorly, the more
pronounced will be the curvature
of the incisal-edge line.
Courtesy of Ackerman.
Fig. 6
Correlation between the width of
the dental arch and the curvature
of the incisal-edge line.
Courtesy of Ackerman.
EDI
72 Case Studies
plane and the shape of the dental arch (Fig. 5 and 6).
Other influential factors are the individual characteristics of tooth positions and functional patterns.
The curvature of the incisal-edge line is particularly important in connection with orthodontic therapy.
It has been reported that orthodontic tooth movements may often flatten this line.
The study by Hulsey gives us more detailed information about the aesthetic effects of different
degrees of agreement. Based on his observations
EDI
73
Case Studies
Fig. 14 The extraoral view shows that the canine tips are slightly higher,
the lateral incisors rise higher toward the distal aspect, and the curvature
of the entire arc is more pronounced.
Positions of the edges of the central incisors relative to the upper-lip line at rest
Fig. 15 Geometry of the incisal-edge line.
ered much more beautiful than higher ratios indicating flatter curvatures of the incisal edges. Inverse curvatures of the lower lip are encountered only in very
rare cases. These will also result in non-consonance
of the two contour lines (Fig. 12).
The relationship of the lower lip to the incisal-edge line
is one of those criteria that may vary greatly in relevance
depending on the particular patient type. While some
faces tolerate considerable variation, the appearance of
some patients strongly reflects even minor alterations.
EDI
74 Case Studies
Fig. 17
Baseline situation. Tooth 11:
Endodontically
pre-treated.
Teeth 12, 21, 22:
Labially eroded
enamel, malpositioning, insufficient composite restorations.
CONTACT ADDRESS:
Dr Jan Hajt
Weinstr. 4 . 80333 Mnchen
GERMANY
EDI
75
Case Studies
Anteriores:
Natural & Beautiful Teeth
Picture Gallery
So much for our short excerpt from Anteriores: Natural & Beautiful Teeth. In addition, this book offers an
impressive picture gallery with a great variety of
images of natural teeth. While it is that dentists see
healthy natural teeth every day, the subtle differences and the sheer infinite variety of shapes will
only unfold when a large number of examples are
shown together and compared directly. This is why
this book presents a selection of naturally beautiful
01
20
EDI
76 Case Studies