Dental Analysis Dr.

Ehsan Hossam El Din

B.D.S.; M.D.Sc. (Operative Dentistry)
D.D.S (Conservative Dentistry)
Lecturer, Faculty of Oral and Dental Medicine,
Ahram Canadian University
Dental Analysis
1. Dental midline 8. Interproximal contact point
2. Incisal edge position 9. Incisal embrasure
3. Smile arc 10. Sex, age, personality
4. Central dominance 11. Teeth shade
5. Proportion 12. Surface texture and luster
6. Tooth shape 13. Buccal corridor
7. Axial inclination 14. Display zone
1. Dental midline
▪ Should be:
1. Coincide (or at least Parallel) to facial
midline
2. Coincide with mandibular midline
3. Perpendicular to incisal plane
4. Perpendicular to interpupillary line
5. Over the papilla (drop straight down
from the papilla)
The philtrum of the lip is one of the
most accurate anatomical guidelines to
assess the midline.
1. Dental midline
1. Coincide (or at least Parallel) to facial
midline (only in 70 % of population)
➢ Minor discrepancies between facial
and dental midlines are acceptable
and in many instances not noticeable
➢ The maximum allowed discrepancy 2
mm (up to 4 mm) as long as the long
axes of the teeth are parallel with the
long axis of the face.
1. Dental midline
➢If the incisors are inclined by 2
mm right or left (canted
midline), this is considered as
unaesthetic and should be
corrected.
1. Dental midline
2. Coincide with
mandibular
midline (fail to
coincide in
almost 75% of
the population)
2. Incisal edge position
• Maxillary incisal edge
position is the most
important
determinant in smile
creation because
once set, it serves as
a reference point to
decide the proper
tooth proportion and
gingival levels.
2. Incisal edge position
• The parameters used to help
establish the maxillary incisal
edge position are:
➢ Parallel to interpupillary line
➢ Phonetics (in repose & full
smile):
▪ Degree of tooth display
at rest (M sound)
▪ Degree of tooth display
during smiling (E sound)
2. Incisal edge position
• M sound:
✓ After pronunciation, the lips
return to their normal rest
position, allowing evaluation of
the amount of the tooth display
in rest position.
✓ Younger patients show between
2-4 mm of maxillary incisal edge
in this position. As age
increases, the decline in the
muscle tonus results in less
tooth display.
2. Incisal edge position
• E sound:
✓The maxillary incisal edge
position should be
positioned 50 -80 %
from the space between
upper and lower lip.
3. Smile arc
• An imaginary line along the
incisal edges of the
maxillary anterior teeth that
mimic the curvature of the
superior border of the
lower lip while smiling.
3. Smile arc
• When the centrals
appear shorter than the
canines along the
incisal plane (Reverse
smile line).
 4. Central dominance

• The centrals are the key to the smile

• They must be the dominant teeth in the smile
and they must display pleasing proportions
4. Central dominance

• Width/length ratio of
centrals should be
approximately 75-85
 4. Central dominance

• A higher W/L ratio means a shorter & squarer tooth,

and a lower ratio indicates a longer appearance.
 4. Central dominance

• Maxillary central incisors average between 10 mm

and 11mm in length and 8.3-9.3 mm in width
4. Central dominance

Is this incisor too short or

too wide?
• Crown width is 8.0 mm,
within normal range, but
height is 8.5 mm,
significantly shorter than
acceptable range.
5. Dental proportion guidelines
1. Golden proportion by Lombardi:
5. Dental proportion guidelines
1. Golden proportion by Lombardi:

• This principle states that:

when viewed from the facial,
the width of each anterior
tooth is 62 % of the width of
the adjacent tooth (the
mathematical ratio being
1.6:1:0.6).
5. Dental proportion guidelines
1. Golden proportion by Lombardi:
• Disadvantages: Its applicability in
clinical practice is limited due to:

– Differing arch forms, lip and

facial proportions.
– Strict adherence to golden
proportion calculations limits
creativity and this may lead to
cosmetic failure
5. Dental proportion guidelines
2. Recurring aesthetic dental proportions
(RED) by Ward:

• when viewed from the facial

aspect, as we move
posteriorly from the
midline, the width
proportion should remain
constant from the facial
aspect.
5. Dental proportion guidelines
2. Recurring aesthetic dental proportions
(RED) by Ward:

• Unlike the Golden

Proportion, the values of
RED proportion should lie
in the range of 60% to
80%.
5. Dental proportion guidelines
2. Recurring aesthetic dental proportions
(RED) by Ward:

• Advantage: offers great

flexibility to match tooth
properties with facial
proportions.
 Average teeth
dimension
• Maxillary central incisors between 10-11mm in length & 8.3-9.3 mm in
width.
• Lateral incisors are between 1-2mm shorter & narrower by 2-3 mm
than the central incisors .
• Canines slightly shorter by between 0.5-1mm & narrower by 1-1.5 mm
than the central incisors.
6. Tooth shape

1. The shape of upper

central incisors should be
in harmony with the
shape of the face.
6. Tooth shape

2. Morphopsychology is a
branch of science which
accept as truth, that a
person’s facial features
have some relation with
his personality.
 6. Tooth shape

2. Morphopsychology is a
branch of science which
accept as truth, that a
person’s facial features
have some relation with
his personality.
Sensible Love of art
 6. Tooth shape

2. Morphopsychology is a
branch of science which
accept as truth, that a
person’s facial features
have some relation with
his personality.

Dynamic
 6. Tooth shape

2. Morphopsychology is a
branch of science which
accept as truth, that a
person’s facial features
have some relation with
his personality.

Strong
 6. Tooth shape

2. Morphopsychology is a
branch of science which
accept as truth, that a
person’s facial features
have some relation with
his personality.

Calm
 7. Axial inclination

Blue: central vertical midline

Red: Axial inclination

• Axial inclination compares the vertical alignment of

maxillary teeth, visible in the smile line, to central
vertical midline.
7. Axial inclination
• From the central to the
canine, there should be
natural, progressive
increase in the mesial
inclination of each
subsequent anterior tooth.
• It should be least
noticeable with the centrals
and more pronounced with
the laterals and slightly
more so with the canines.
7. Axial inclination
 8. Interproximal contact point

• ICA is the broad zone where two adjacent teeth touch.

• The zone coronal to ICA is called the spillway spaces or
embrasures, the area apical to ICA forms the interproximal
spaces. The most incisal aspect of ICA is the interproximal
contact point (ICP).
• As a general rule, as we go posteriorly, the ICP moves apically.
 8. Interproximal contact point

• The contact area between:

centrals → 50% of the length of the crown of the central incisor
central and lateral incisors → 40% of the length of the crown of the
central incisor
lateral incisor and canine → 30% of the length of the crown of the
central incisor
'50-40-30' rule
 8. Interproximal contact point

• Interdental contact area can be moved

apically to close the gap.
• Long contacts with no papilla are regarded
as unesthetic and should be avoided.
8. Interproximal contact point
 9. Incisal embrasure

• The incisal embrasure is a space existing on

the incisal aspect of the inter-proximal
contact area between adjacent anterior
teeth.
9. Incisal embrasure
• The interdental embrasures
form interdental angles
shaped as an inverted “V”
shape.
• The incisal embrasure should
display a natural, progressive
increase in size or depth
from the central to the
canine.
9. Incisal embrasure
• Role:
– Esthetics: Incisal
embrasures play an
important role in smile
esthetics and influence the
perception of
attractiveness.
– Function: allow the lower
teeth to clear in excursive
movements without being
trapped.
 9. Incisal embrasure

• Men have shallower incisal embrasures than women,

by age the embrasures get smaller and shallower due
to wear of incisal edge.
9. Incisal embrasure

• Before and after

comparison
showing how the
incisal embrasure
can affect a
patient’s smile.
 10. Sex, age, personality (SPA factor)
• Anterior esthetics were described
depending on the personality, age, and
gender of the person as it is reflected in
the shape and form of that individual's
teeth.
• Minor differences in the length, shape
and positioning of the maxillary teeth
allow for dramatic characterization.
10. Sex, age, personality (SPA factor)

Female

Male
 10. Sex, age, personality (SPA factor)

Female Male
Maxillary incisors: Maxillary incisors:
• round, smooth, delicate
• Cuboidal, vigorous
• the incisal edges of the
maxillary incisors, and • square incisal edges
especially the lateral, that appear to be
appear more rounded blunt.
• The incisal edges and
transitional line angles
of feminine teeth are
rounded, while the
edges tend to be
translucent.
 10. Sex, age, personality (SPA factor)
Young Old
 10. Sex, age, personality (SPA factor)
Young Old
• Unworn incisal • Shorter due to wear, so less
smile display
edge • Minimal incisal embrasure
• Defined incisal • High chroma, low value
embrasure • The enamel layer becomes
• Low chroma, thinner from simple daily
functions, so dentin begins to
high value dominate the shade.
(lighter, and • Daily oral habits allow the
brighter, with pigments and ions to be
absorbed into the teeth.
low color • Changes in the underlying
saturation) dentine, owing to aging or
pathologically related color
changes.
10. Sex, age, personality (SPA factor)
• When we think of canine
teeth, aggressive cartoon
characters come to mind. The
design of canines may take the
passive-aggressive factor into
consideration when the tone
of the appearance is selected.
10. Sex, age, personality (SPA factor)
Before:
• Aggressive, hostile,
angry
• Maxillary canine:
pointed long
“fangy” cusp form

After:
• Passive, soft
• Maxillary canine:
blunt, rounded,
short cusp form
Sex, personality, age
(SPA factor)
11. Teeth shade
• Hue distinguishes one color
from another and is
described using common
color names such as green,
blue, red, yellow, etc.
• Chroma (Saturation) may be
defined as the strength or
dominance of the hue.
• Value refers to the lightness
or darkness of a color. It
defines a color in terms of
how close it is to white or
black.
 11. Teeth shade
• Factors affecting optical quality of an
object as seen by an observer’s eye:
1. Spectral characteristics of the light
source
2. Spectral characteristics of the object
3. Sensitivity of observer eye
 11. Teeth shade
• Factors affecting optical quality of an
object as seen by an observer’s eye:
1. Spectral characteristics of the light
source
➢ Type, intensity, angle between
eye and object
 11. Teeth shade
• Factors affecting optical quality of an
object as seen by an observer’s eye:
1. Spectral characteristics of the light
source ➢ Metamerism: color,
translucency & surface texture
of the same object appear
different under different light
sources. Therefor, color
determination of teeth should
be done under neutral
illumination.
11. Teeth shade
• Factors affecting optical quality of
an object as seen by an observer’s
eye:
2. Spectral characteristics of the
object

➢ Surface reflectivity, light

scattering, light absorption
 11. Teeth shade
• Factors affecting optical quality of an
object as seen by an observer’s eye:
3. Sensitivity of observer eye

➢ Chromatic assessment period

should be < 5 seconds
 11. Teeth shade
✓ Requirements for correct color determination:
1. The illuminant should be neutral.
2. The background should be neutral or gray to
eliminate dominance of particular colors.
3. The background involves wetness of the tooth,
office curtains,walls, and we should remove any
lipstick and make-up before color
determination.
4. Patient position: color selection is preferably
made with patient seated at the same level
relative to the observer’s eye.
 11. Teeth shade
✓ Color determination in dentistry can be divided
into two categories:
• Subjective technique (Visual technique)
- Shade guide
• Objective technique (Instrumental technique)
A. Spectrophotometer
B. Colorimeter
C. Digital cameras and imaging systems
11. Teeth shade
• Shade selection must be customized
for each individual.
• It should be natural and
polychromatic.
• The body of the tooth can be uniform
in color but the gingival third should
be noticeably richer in chroma.
• The chroma should also increase
from central to the canine, canine
having a higher chroma.
12. Surface Texture and Luster

It refers to the degree of

smoothness vs. roughness that
occurs on the tooth’s surface.
 13. Buccal Corridor
• A dark space (negative space) that is visible between
the corners of the mouth and the buccal surfaces of
the maxillary teeth during smiling.
• Its appearance is influenced by:
1. The width of the smile and the maxillary arch
2. The tone of the facial muscles
3. The positioning of the labial surface of the upper
premolars.
• The buccal corridor is directly influenced by the arch
form.
• A narrow arch is generally unattractive. The
unattractive, negative space should be kept to a
minimum. To solve or minimize this problem, the
premolars can be restored.
14. Display Zone and Teeth Visibility

➢ In a young individual (when the

mouth is relaxed and slightly
open): 3.5mm of the incisal
third of the maxillary central
incisor should be visible.
➢ As age increases: Less tooth
display due to the decline in the
muscle tonus
Thank you