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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 negative space, incisal angles, and contact areas into your approach to cosmetic dentistry in the practice.

Boundaries and Balance

While giving considerations to the design of a smile, multiple aspects must be taken into account so that the effort you put into the composition can translate well in the work of the lab ceramist.

One of the key tips to remember is this: Take into account the importance of not only the object, but the space around that object.

There are 2 direct benefits to this concept:

  1. It helps to give boundaries to the tooth.
  2. It gives balance to the composition.

Manipulating Incisal Angles

So how does this translate directly to smile design? Apply these concepts by ensuring that adequate room is given for incisal embrasures or interincisal angles between the teeth at the incisal edge of the anterior teeth. Interdental contact areas determine width and depth in this scenario.

What you don’t want to happen is an aged appearance to the smile because of a flat smile line. This can occur when the edges of teeth wear and the presence of interincisal angles is reduced or altogether disappears.

Here’s what you need to know about central incisors in a typical dental composition:

The contact area typically extends all the way up to the incisal edges of the teeth. This leads to a reduced size of the incisal angle. In addition, the contact point of the teeth moves in an apical direction from central incisors to canines. This then increases the size of the interincisal angles.

Smile DesignAged vs. Youthful Traits of Smiles

Ultimately, restoring a smile to a youthful appearance hinges upon the ability of the clinician to consider these factors:

  • Recreation of the natural progression of the interincisal angles
  • Renewal of morphology and appropriate tooth lengths
  • Creation of a convex incisal curve

Properly address the incisal angles by allowing room for the negative space in preparation design to be recreated by the ceramist. Once this is done, then proper instrumentation can be utilized to further accentuate these areas post-cementation.

Look for the final “Violations of Smile Design” on the blog in our series by CMS educator Dr. Jason Olitsky, where he’ll discuss concepts such as gingival symmetry, smile lines, and papilla heights.

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