ORTHODONTICS: 10 commandments of smile esthetics

The search for improved dentofacial esthetics persists in modern society. Thus, inspired by pretty faces and beautiful smiles, patients have sought treatment modalities to improve dentofacial esthetics and yield positive changes in their smile. 

smile-esthetics


With a view to achieving ideal esthetic outcomes, some reference parameters must be followed. During many years, these guidelines were based on experts' opinions, in which case special attention should be given to studies conducted by Camara, as they provide essential information on smile esthetics.

On the other hand, these clinical guidelines are questionable, since esthetics is a subjective notion and tends to vary among different individuals and cultures. This fact is a drawback for clinicians who seek a treatment protocol that involves changes in smile esthetics because many articles on this theme were based on author's opinions rather than scientific evidence.


Based on the pioneer research conducted by Kokich et al, some authors sought digital imaging technology to search for more scientific and consistent references. Since then, several smile variables have been researched as follows: Smile arc; buccal corridor; amount of gingival exposure at smiling; presence of gingival and incisal asymmetry; presence of anterosuperior diastema; presence of midline shift and changes in axial proclination; maxillary incisors ratio, size and symmetry; among others.

While the wide variety of articles studying those characteristics is of paramount importance to dental literature, it hinders the work of clinicians seeking simple and practical treatment protocols. Professionals usually have a few questions: Where should smile esthetic planning begin? What are the most relevant aspects considered in esthetic treatment? Which scientific references should be considered in a given therapeutic approach?




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