Sara Atiyah

Oper 2nd session 25-2-2021

Dr. Hala Ragheb

Smile Design

Smile design is a concept that revolves around facial-driven esthetics that tells us where we are
and where we want to be to have a prettier smile.

Smile design is a discipline as endo and prostho (it is not a division by itself; it is used in any
kind of restorative dentistry.

Concept means it is based on principles and we convert these principles into drawings.

Analyze what the patient have and propose what is suitable for the patient.

Benefits:

Communication with team: in case the patient’s case needs multiple intervention .

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb
Surgical guide: to know where the implants should be inserted (if no proper guide: unpleasing
surgically)

If a I have a pre-hand design, the dentist will put an implant suitable for pleasant prosthesis
(crown)

Functional analysis: recently through 3D photos

A comprehensive case: misalignment/ missing teeth

Ex: if the patient is edentulous, best design based on his facial references (it facilitates
complex cases)

Simple case as diastema can be fixed using flowable composite (direct mock-up)

If the case includes more than 1 problem, go

to design simply on power point
presentation.

Use photos to analyze smile and propose

smile design.

Use software special for smile design (as

CAD CAM design software)

Lab technician importance is in scanning, 3D

and use software in case of intraoral
scanner, then make the design 3D on the
software.

There are 2D software on laptop as keynotes, photoshop.

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb
4 parameters to analyze in order to make design:

Smile design theory:

1. Facial esthetics (named macro-level: examining face and try to correlate to mini-level
with lips, teeth..)
2. Macro-esthetics (lips, teeth, and gum when smiling)
3. Dento-gingival esthetics (look into details of each tooth/ the micro-level)
4. Micro-esthetics. (material helping in face design)

Frontal view of face: evaluate the balance

between the 3 horizontal thirds and the 2
vertical halves.

A: esthetically pleasing (equal 1/3s)

balanced

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Oper 2nd session 25-2-2021
Dr. Hala Ragheb
B: not balanced (high VD to improve face esthetics)

C: needs orthognathic surgery in order to have harmony in face.

Observing frontal view and equal thirds: make us know what type of intervention that should
be approached (single or multi-disciplinary approach)

Observe midline of face: how it coordinates

with the midline of teeth.

Inter-papillary line: determines incisal

plane.

incisal plane can be parallel to the line or

canting.

(sometimes not visible live, and canting

accurately seen on photos).

Shape of the face: indicate for the best

teeth suiting the patient.

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

Everything related to photographic analysis is done on laptop (not live on patient)

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

I can see tooth inclination as well (sagittal view)

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

Gingival esthetic line horizontal:

line drawn by zinitte of each
tooth.

If < 4-5 mm: esthetically

unpleasant.

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

not comfortable dot in center (relaxation)

in case of 2 dots

(no visual tension)

Ex: 1 spot on central incisor is seen; we need to make equilibrium (balance)

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

Bulgy unpleasant restorations natural with line angles and halo effects

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

Reverse (vampire look; canine taller than centrals)

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

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 Sara Atiyah
Oper 2nd session 25-2-2021
Dr. Hala Ragheb

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