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Esthetic Handout 2024 PDC

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27 views5 pages

Esthetic Handout 2024 PDC

Uploaded by

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

“SIMPLIFIED”

William “Bo” Bruce, DMD, AAACD


[email protected]

For info on study club


lectures email

[email protected]

© 2024 Upstate Smiles. All rights reserved.


This material may not be reproduced, displayed, modi ed or distributed without the express prior written
permission of the copyright holder.
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Treatment Planning- William ‘Bo’ Bruce, DMD, AAACD

Facial Analysis:
Treatment Alternatives
Orthognathic surgery

Diagnosis
Retrognathic
Prognathic
Mid-face deficient
Long lower 1/3 face

Start Outside
What’s the skeletal profile?
What is the lip dynamic?
Treatment Planning- William ‘Bo’ Bruce, DMD, AAACD

Analysis of the Gummy Smile


6 basic reasons for the gummy smile:
Anterior over eruption
Wear with compensatory eruption
Altered passive eruption
Short upper lip
Vertical maxillary excess
Hyper-mobile lip

Required photos:
Full face lips at rest
Full face pro le lips at rest
Exaggerated “E” position

These reasons can be better organized in two categories:


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Treatment Planning- William ‘Bo’ Bruce, DMD, AAACD

Rule out dentally related reasons rst. Ask three questions:


Is there excess wear?
Does the anterior gingival plane consistent with the posterior gingival plane?
Is the width to length ratio of anterior teeth normal?

Short upper lip


Commissure and philtrom heights will differ 3 mm or greater
Interlabial space greater than 5 mm

Vertical maxillary excess


Interlabial space greater than 5 mm
Long lower 1/3 of face in comparison to middle and upper independently

Hyper-mobile lip
Commissure and philtrum heights will have less than 3 mm difference
Interlabial space less than 5 mm

Anterior Smile:
Are the upper incisors edges in the right position?
Are the upper incisors the correct proportion?

Treatment Alternatives:
Restore
Reposition (ortho)
Reshape
Surgery

Diagnosis:
Upper incisor inclination
Upper incisor edge position
Width to Length ratio/Gingival levels

Are the incisor edges in the right position?


Check Horizontally
Check Vertically

Neutral zone determines tooth position


Supported by upper lip
Determined by lower lip
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Treatment Planning- William ‘Bo’ Bruce, DMD, AAACD

Too far forward


Too far back
Too long
Too short

Vertical Position (see image below)

Right proportions:
• Check width to length ratio

Width / Length = 82%


100 / 82 x width = The length of the tooth
1.22 x width = The length of the tooth
1 ½ Mandibular central incisor = Maxillary central incisor

Posterior Smile:
Is the buccal corridor deficient?
Is there a gingival step?

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