SECTlOh’ tUI?
‘OR‘i
REMOVABLEPROSTHODONTICS
Dental esthetics and the golden proportion
Edwin I. Levin, B.Ch.D.
London, England
lh e goId en proportion has been used since time
immemorial and was formulated as one of Euclid’s
elements; it was used extensively in Greek architec-
ture, e.g., the Parthenon on the Acropolis of Athens,
and has been employed in art through the ages.‘, ’ It
has been described and studied by many famous
artists,3 scientists,’ mathematicians,J-g and philoso-
phers. La Corbusier5 developed a scale, the modular,
based on the golden sections of the human body.
Dentists have also written about the golden
proportion. In a comprehensive article on esthetics
written in 1973, Lombardi“’ mentioned the golden
proportion and anticipated more detailed observa-
tions regarding its application to dental esthetics.
Leonardo da Vinci illustrated a dissertation by
Luca Pacioli on the golden proportion in 1509. It
was reprinted in 1956 in Milan, and he made
drawings of his independent studies.R
Euclid II showed how to divide a straight line by
means of the golden proportion; Kepler called it the
“Divine Proportion.”
The American mathematician Mark Barr called
the ratio PHI. It is the first Greek letter of Phidias,
who used the proportion extensively.fi
Coxeter” quotes Kepler as follows: “Geometry has
two great treasures: one is the theorem of Pythago-
ras, the other the division of a line into extreme and
mean ratio. (The Euclidian description of the golden
proportion.) The first we may compare to a measure
of gold, and the second we may name a precious
jewel.”
Hambridge”, I2 extended the linear forms of the
golden proportion to the surface in extensive studies
and publications on dynamic symmetry.
This artick is condensed from material read before The Alpha
Omega Society, London; The Anglo Continental Study Group,
London, Nov., 1975; and The British Institute of Surgical
Technicians, April, 1973. From Table Demonstrations at; The
British Dental Association Annual Conference, June, 1969, and
The London Dental Hospital Annual Conference, March,
1969.
2.44 SEPl’EMBER 1978 VOLUME 40 NUMBER 3 002%3913/78/0240-0244$00.90/00 1978 The C. V. !&sbv Co.
LOUIS BLATTERFEIN
5. HOWARD PAYNE
GEORGE A. %ARB
A B
Fig. 1. The line is divided into the golden proportion.
The Pythagoreams’ secret symbol was the five-
pointed star, the geometric representation of the
golden proportion.
This article will consider just a few of the many
manifestations of the proportion in the beauty of
nature and art as it applies to dental esthetics. They
include only the straight-line relationships and omit
all curves, spirals, gnomons, and triangles, which are
well documented in the literature.
PROPORTION BETWEEN TEETH
There are many subtle manifestations of this
proportion in nature. In its simplest form it is the
proportion between a larger part and a smaller part
(Fig. 1). When the ratio between B and A is in the
golden proportion, then B is 1.618 times larger than
A.
A simple example of the golden proportion in
nature is demonstrated in Figs. 2, 3, and 6 by using
golden proportion calipers* described in 1954.“’
These calipers always open to a constant golden
proportion between the larger and smaller parts.
The width of the central incisor is in the golden
proportion to the width of the lateral incisor (Fig. 3).
The width of the lateral incisor to the width of the
canine is also in the golden proportion (Fig. 4) as is
the width of the canine to the first premolar. The
widths of the incisors are in the golden proportion to each
other as seenfrom the front. The size of the fingers (Fig.
3) will give a sense of the enlargement of the incisors.
This enlargement was used to demonstrate that the
incisors really are in the golden proportion and that
it is not merely a way of manipulating lines on teeth.
The reader may test the validity of this statement by
placing casts of esthetically pleasing natural teeth on
*Clausen and Weiting, Gremen, Germany.
DENTAL ESTHETICS AND GOLDEN PROPORTION

Fig. 2. Examples of the golden proportion in nature, demonstrated by calipers that always
give the golden proportion at any opening. A, The dominant band on the moth wing. B, The
veins on a leaf. C, Other veins on a leaf.

Fig. 3. The central incisor is in the golden proportion to the lateral incisor.
Fig. 4. The lateral incisor is in the golden proportion to the canine.

the grids of Fig. 5 or by trying them in the mouth difference between the golden proportion and any
(Figs. 6 and 16). It will be found that all the teeth of other pleasing proportion? A brief study of Figs. 7
the anterior esthetic segment from premolar to and 8 will answer this question.
premolar fit these grids with remarkable precision. A-C is a straight line divided by L3 into two
The solid circled number refers to the width of the unequal parts-in any proportion.
space occupied by the central incisor, which can be 1. The smaller AB
different on both sides. = any proportion
The larger %?
THE LARGER TO THE WHOLE 2. The larger BC
= any proportion
The question must arise as to why the golden The whole AC
proportion is different from any other pleasing The above statements (1) and (2) can apply to any
proportion-and, more importantly, is there any line divided by any point.

THE JOURNAL OF PROSTHETIC DENTISTRY 245

 t- 1

09 3
I 1 t

E. Levin. 42 Harley Street, W.1.

246 SEPTEMBER 1978 VOLUME 40 NUMBER 3

DENTAL ESTHETICS AND GOLDEN PROPORTION

Fig. 7. Lines divided into any proportion.

, 618 , 1
I (i)
A 6 C

1 La_rger : 1 L o.(j,*
t I (ii)
B C Whole I.618

1618
I i
A C
618 , 1 1.618
i (iii)
A B C D
Fig. 6. The anterior teeth are in the golden proportion
to each other. Fig. 8. Lines divided into the golden proportion.

If AB = 2 and BC = 5, then: width, so it is an example of an arithmetic progres-

1. The smaller AB 2 sion.
The larger BC = 5 = 0.4 The sequence, 1,2,4,8,16,32,64, is an example of
a geometric progression where each term is multi-
2. The larger BC 5 plied by 2 to get the next term.
S-E 0.71
The whole AC 7 The progression using the golden proportion
Equations 1 and 2 are different. Now use the numbers is unique and extraordinary because:
golden proportion numbers as in Fig. 8. I
AB 0.618 - = 1.618
I. BC = - 1 = 0.618 0.618
We have thus one progression of numbers, arrived
BC 1 at by three different methods-two geometric and
-=- = 0.618
2. AC 1.618 one arithmetic. The two geometric progressions are
Thus the proportion of the smaller to the greater is arrived at either by multiplying each term by 1.618
the same as the proportion of the greater to the whole. or dividing by 0.168 as follows:
The division of the line by point C thus represents a 1.000x 1.618= 1.618 1.000+0.618= 1.618
point of equilibrium between these two proportions. 1.618X 1.618= 2.618 1.618+0.618= 2.618
If you move the point a fraction one way or the 2.618~ 1.618= 4.236 2.618 -+ 0.618~ 4.236
other, then you have two proportions which are 4.236~ 1.618= 6.854 4.236 + 0.618= 6.854
neither the same nor are they in equilibrium. The 6.854 x 1.618 = 11.090 6.854+0.618- 11.090
only time that these two proportions are the same is Thus in Fig. 8 the three examples of the linear
when they are golden. forms of the golden proportion are illustrated.
This point of division is a mathemetical confirma- Equation l-The Simple Form
tion of (1) how the eye senses proportion, (2) how Equation 2-The Larger to the Whole
proportion appears in nature, and (3) how artists Equation 3-The Geometric Form
have used proportion.
THE ARITHMETIC PROGRESSION
GEOMETRIC PROGRESSIONS The width of the spaces of the grids (Fig. 5), whose
Geometric progressions are common in nature, values are 0.618, 1, 1.618, and 2.618, are also in an
e.g., the snail shell.’ The equiangular or logarithmic arithmetic progression as follows:
spiral is a beautiful symbolic representation of a 0.618 + 1.000 = 1.618
geometric progression.” In music, the octave progres- 1.000 + 1.618 = 2.618
sion of doubling is also a geometric progression, 1.618 + 2.618 = 4.236
whereas the harmonic progression is an arithmetic 2.618 + 4.236 = 6.854
progression. The coiling of the ship’s rope is not a Each term is the sum of the preceding two terms.
geometric progression because each coil is of equal This is a demonstration of the famous Fibonacci

THE JOURNAL OF PROSTHETIC DENTISTRY 247


Fig. 9. Peacock feather showing two of the twelve golden proportions that are ail interdepen-
dent.
Fig. 10. The two interdependent golden proportions
use of the golden proportion calipers.
series of numbers,’ in which each term is the sum of
the previous two terms as follows: 0, 1, 1, 2, 3, 5, 8,
13, 21, 34, 55, 89, etc. This is called the Fibonacci
series after Leonardo of Pisa (or Filius Bonacci), alias
Leonardo Fibonacci, born in 1175, whose great book
The Liber At& (1202) was a standard work for 200
years and the principal means of demonstrating and
introducing the enormous advantages of the Hindu-
Arabic system of numeration over the Roman
system.”
The connections between the Fibonacci Series, the
golden proportion, the polygons, the Vedic Hindu
Square, the Cabbala number system, and Islamic art
are beautifully illustrated in the Language of
Pattern. ”
A great deal has been written about the occur-
rence of these numbers in the beautiful things of
nature, especially in relation to intersecting spirals as
in the sunflower, or in pine cones.* In 1850 Zeising
divided the entire body into the proportions of the
Fibonacci Series. Lee,‘j in his book Dental Aesthetics,
has a photograph which he uses to demonstrate that
“the width of the central incisor is equal to the width
of the lateral incisor and l/2 the width of the canine.”
This half width of the canine is of course the
anterior half.
1.618 = 1 + 0.168, whether we use the golden
proportion, the geometric progression, or the Fibon-
acci Series.
Lee’s bookI also contains an excellent bibliogra-
phy of papers on dental esthetics.
Figure 9 shows an example of the interrelationship
between parts that make the beauty of nature so
fascinating and so difficult to copy in our manmade
248
I EVIK
of the pentagon, demonstrated by the
designs. The peacock feather shows 12 discreet gold-
en proportions which are all interrelated in such a
way that it is difficult to sort out all the relationships;
two of these relationships are shown.
The symbol of the golden proportion is the penta-
gon, which was the symbol of the Pythagorea.n
School, whose followers were deeply involved in the
study of the golden proportion (Fig. 10).
The grids (Fig. 5) have proved very useful in
prosthodontics in detecting what is wrong esthetical-
ly when the eye cannot. The grids cannot, of course.
replace the eye, nor can they be used instead of the
eye; but when we are having difficulty the grids can
be helpful.
Numerous studies demonstrate that most people
sensethe golden proportion quite naturally. (Zeising.
Lone, Ghyka, and Fechner, whose opinions are
summarized by Gardener”) in the same way as one
divides a fruit in half or erects a perpendicular. It
must be emphasized that these are the widths as
seen, not as measured. Attempts to find the relation-
ship between the measured widths of the incisors have
all been futile, but nevertheless these attempts have
been an indication of an intuitive sense that there 1sa
relationship which could be formulated. Credit is
due to those students for these attempts.
Two further examples of the “simple” golden
proportion are included separately because of their
controversial nature and difficulty of determination.
Fig. 11 shows the way the lower one third of the face
is divided in the golden proportion by the incisal
edge of the teeth, with the face at rest, i.e., with the
teeth separated by the freeway space (interocclusal
distance). This is not always so precise, and the
SEII-EMBER 1978 VOLUME 40 NUMBER 3
DENTAL ESTHETICS AND GOLDEN PROPORTION

Fig. 11. A, 6, and C shows how the incisal edge of the upper incisors divide the lower third of
the face into the golden proportion. D, The lips at rest.

variation is related to the curvature of the chin, or teeth between the darker spaces is in the golden
double chin, and the curvature of the tip of the nose proportion, the result is a most natural and pleasing
and its curved connection to the upper lip. Figure 12 appearance.
shows the way the contact point divides the length of
the interdental space, not the tooth, into the golden THE BILATERAL FORM
proportion. This is the most common of the subtle variations
One must consider viewing distance when discuss- seen in nature and in natural dentitions. We have
ing esthetics. A Michaelangelo painting loses its already seen that A:B = B:C = 1.000 : 0.618. If we
magic when looked at under magnification. The now align the midpoints of B and C as in Fig. 13 and
beautiful cracks and dots and lines that are a place them alongside each other, we then find that
manifestation of the ceramists’ art are clearly neces- not only is there now a “larger-to-whole” relation-
sary at intimate distances but disappear at social ship, but that on either side of the midline we again
distances, where the dark interdental spaces domi- have, of course, the larger-part-to-smaller-part “sim-
nate the visual effect. When the size of the lighter ple” relationship.

THE JOURNAL OF PROSTHETIC DENTlSTRY 249

I
I.618 c ’

1
I I
I I
I.618

Fig. 14. Automobile design showing the dominant visual

mid 1 ( 0.618 features in the golden proportion and its subtle varia-
I tion
line
Fig. 13. Variation on the golden proportion by aligning apparently casual lines, which in fact are beautifully
midlines of the parts. The bilateral form. interrelated.
The dash representing the eye is terminated later-
Patterns of this bilateral form are especially found ally by the outer canthus of the eye-a point difficult
in works of art, whether it is car design as in Fig. 14 to determine because it finishes on the curve of the
or in the proportions of beautiful antiques. eyeball. Mesially is the lateral aspect of the inner
canthus, or the end of the visible white eyeball. Thus
PROPORTIONS BETWEEN THE SMILE AND
the distance between the two eyes is the distance
FACE
between the “eye whites” (Figs. 15 and 16).
The most primitive ancient drawing of the face is The width of the smiling lips from one corner of
also representative of the earliest drawings of chil- the mouth to the other is equal to the distance
dren: two dashes for eyes and a curve for the smiling between the bridge of the nose and the width of the
mouth, surrounded by a circle for the face (Fig. 15). eye (Fig. 15, C).
The psychiatrists have confirmed the importance of
the mother’s smile and its effect upon a very young PROPORTIONS BETWEEN TEETH AND
child. SMILE
This drawing has some fascinating features, the In the drawings of older children the eye-dashes
principles of which are of relevance to prosthodon- become circles and the lips are apart. We are thus
tics. It indicates the important esthetic landmarks. presented with a new group of fascinating golden
These are represented by the termination of these proportions that are helpful in prosthodontics.

250 SEPTEMBER 1976 VOLUME 40 NUMBER 3

DENTAL ESTHETICS AND GOLDEN PROPORTION
I ii
Fig. 15. The golden proportion of the eyes and smile.
Note that the lips apart drawn in Fig. 15, iii do not
extend right to the corner of the mouth; they
actually stop some distance from them. Thus there is
an area of darkness or neutrality between the teeth
and the corner of the smiling mouth which is one of
the most important factors in giving a prosthesis a
natural appearance. All too often this area of
neutrality is filled up with overcontoured buccal
surfaces of posterior teeth or the arch is too wide in
the premolar and molar region, Between these two
dark or neutral spaces in the smile lies the anterior
esthetic segment. The neutral space lies between the
arch and the corner of the smiling mouth. It is a
dynamic space which appears in a broad smile and
can be described as a bilateral space, bounded
laterally by the corner of the smiling mouth and
medially by a dominant feature at the corner of the
arch. This dominant feature lies between the
bulbous labial surface of the canine or premolar or
between their incisal tips, as observed from the
jkont.
The anterior esthetic segment is bounded laterally
by the bulbous canine or premolar and it is the part
of the dental arch that gives the impression of smile
and teeth.
In the esthetically pleasing smile, the spaces
between the corners of the mouth and the dental
arch form a “backdrop” in which the anterior
esthetic segment is featured. Moreover, this segment
(FG, Fig. 15, ;ZJ)is in the golden proportion to the
width of the smile (DE, Fig. 15, iv; Figs. 6 and 16).
Use the grid (Fig. 5) appropriate to the teeth and
then see how closely the corner of the smiling mouth
approximates the line on the far edge of the grid
(Figs. 6 and 14). The choice of grid can be predeter-
mined by measuring the width of the smile and
dividing it in half. If the midline of the central
incisors does not coincide with the midline of the
face, then adjust for this discrepancy. No one is
symmetrical. The number in the dotted circle repre-
THE JOURNAL OF PROSTHETIC DENTISTRY
111 iv
sents half the total width of the smile (Fig. 5).
A common error made in the construction of
complete upper dentures is that this neutral space
appears evenly full of teeth when the patient smiles,
even to the extent of showing all the molars. The
effect is like that of a room full of furniture-the
space is too full, and there is no tooth especially
dominant at the corner of the arch. The teeth appear
to fade evenly from central incisors to molars.
FORh4 OF THE CORNER OF THE AN”FER1OR
ESTHETIC SEGMENT
Our final problem is deciding what form the
corner of the anterior esthetic segment should take.
Here one has to resort to music to find the correct
analogy.
In any smile the central incisors dominate and
may be compared to the fundamental note of a
music chord. Using the same analogy, the next
dominant harmonic must be in the region of the
canine or premolar. One of these teeth should be
dominant to mark the corner of the mouth clearly
and to stress the visual strength contained in the
arch. Without dominance at the corner, the arch
looks neutral and lacks vigor and individuality. The
most difficult aspect of prosthodontics is to establish
the exact shape of the corner of the arch so as to be in
complete harmony with the visual personality
projected by the patient.
It is equally difficult to establish the precise point
on the arch which should dominate the corner of the
arch. It always seems to be somewhere between the
maximum contour of the canine (as seen from the
front) and the first premolar. Although it may never
appear to be identical on both sides, nevertheless the
whole of the anterior esthetic segment is always in
the golden proportion to the width of the smile (Figs.
6 and 16). Sometimes the canine should occupy this
point, having three teeth in the golden proportion to
the width of the smile, and on other occasions the
251
 LEVIK

complications, it can also happen that on one side

three teeth in the golden proportion appear visually
correct and on the other side four teeth look more
pleasing! As music is the study of the harmony of
souna!in space, so proportion is the study of harmony of
structures in space.

SUMMARY
A system of esthetic predictions is described that
has been used since antiquity. The naturalness of the
system is emphasized by showing examples from
nature and how artists and designers use it. The
application of this system to dental esthetics is
facilitated by the description and inclusion of a
dental grid for the anterior esthetic segment.

My thanks to the London Dental Hospital, Whitechapel, for

their assistanceand encouragement in demonstrating this materi-
al.

REFERENCES
1. Ghyka, M.: Geometrical Composition and Design. London,
1964, Alec Tiianti.
2. Borissavlievitch, M.: The Golden Number. London, 1958,
Alec Tiranti.
3. Pucioli, L.: Divina Proportione. Wien Graser. 1896, C.
Winterberg.
4. D’Arch, W. T.: Growth and Form. Oxford, 1952, Cambridge
University Press.
5. Huntley, H. E.: The Divine Proportion. New York, 1970,
Dover Publications.
6. Gradner, M.: More Mathematical Puzzles. London. 1966,
Penguin Books.
7. Gardner, M.: Mathematical Games. Scientific American
236:134, 1977.
8. Coxeter, H. S. M.: The golden section and phyllotaxis.
Scripta Mathematics 19:135, 1953.
9. Coxeter, H. S. M.: Introduction to Geometry. London, 1961.
John Wiley & Sons Ltd.
10. Lombardi, R. E.: The principles of visual perception and
their clinical application to denture esthetics. J PRO~THET
DENT 29:358, 1973.
11. Hambridge, J.: The Elements of Dynamic Symmetry. New
York-Brentano’s, 1926, Yale University Press, 1948, p 133.
12. Hambridge, J.: Dynamic symmetry. Scientific American
4~23, 1921.
13. Joseph, M.: Golden section compasses. The Mathematics
Fig. 16. The three aspects of the golden proportion Teacher 47:338, 1954.
pertinent to dental esthetics and the numerical values. The 14. Album, K., Smith, J. M., Steel, S., and Walker, D.: The
vertical lines are spaced in the golden proportion. Language of Pattern. London, 1973, Thames and Hudson.
15. Lee, J. H.: Dental Aesthetics. Bristol, 1962, John Wright &
premolar should dominate the corner of the arch. Sons, Ltd.
Thus four teeth would be in the golden proportion to
Rcjmint rcqwts to:
the width of the smile. The grids thus represent the
DR. EDWIN 1. LEVIN
spaces for three teeth or four teeth, and testing for 42 HARLEY ST.
both in complete dentures is the only way in which a LONDON WIN 1AB
final decision can be made. Just to add to the ENGLAND

252 SE-ER lW8 voLuME 40 NUMBER 3