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Smile Designby Dr. Jason Olitsky

When evaluating the esthetic principles inherent to successful smile design, there are 7 violations that are common and undermine the success of the finished cosmetic case. Here’s one of my top clinical tips for maximizing the outcome of your esthetic cases by instituting a knowledge of reflective and deflective zones into your approach to cosmetic dentistry in the practice.

Making Porcelain Veneers Look Like Teeth

The basics of tooth form are dependent on three fundamental types that can be observed in patients:

  1. Basically Tapering
  2. Basically Square
  3. Basically Ovoid

The ultimate goal in understanding these concepts is to avoid overcontouring teeth, a problem which can affect how the ceramist builds out the porcelain for veneers.

To approach this issue, consider the reflective and deflective zones that make up teeth and how you can manipulate the transition line angles that separate these zones.

This manipulation can affect many different perceived qualities of a tooth, from appearing short and fatter or longer or skinner to seeming more rectangular or having more curves.

Overcontoured teeth are usually a result of there being no distinction between the reflective and deflective zones. Consider the facial aspects of the tooth in close proximity to the mesiofacial and distofacial line angles, which when moved outward or toward the center can make the tooth look alternately wider or narrower.

How to Help Your Ceramist

Overcontoured teeth in your preparation design can lead to under reduced transitional line angles. The primary focus should be on overlaying a properly designed mock-up of the final restoration on top of the teeth. It also crucial to maintain depth cuts of appropriate thickness.

Bonus Tip 

To prevent making the entire tooth thicker in porcelain, ensure that the depth cuts on the mock-up extend across the facial of the tooth and through the mesiofacial and distofacial line angles in all three planes.

The Benefit of Direct Veneers

Building direct veneers from scratch is a skill that can be mastered with time spent studying the shapes of teeth. The benefit of this for you personally and in the practice is that you are in complete control of the line angles in a patient’s veneers.

Smile design Look for the next 2 “Violations of Smile Design” on the blog in our series by CMS educator Dr. Jason Olitsky, where he’ll discuss concepts such incisal angles, negative space, and gum symmetry.

Check out the first four violations of smile design in the series, including “A Crooked Smile,” “The Reverse Smile,” “The Social Six,” and “Four Central Incisors” to elevate your learning.