A nice smile is the window that is opened to the world. A relaxed smile has a very important role to play in expressing oneself. The concept of smile design has gained great popularity in recent years.
What is smile design?
Smile design is a dental treatment plan prepared in line with functionality and aesthetics commensurate with the needs of the patient to eliminate existing problems in the mouth and to achieve an aesthetic look by considering factors such as the harmony of the face, lips, smile, speech, teeth and gums with each other, and visualizing it beforehand. Although the term ‘smile design’ is known as an aesthetic dental treatment, smile design is actually the design and simulation process before the start of treatment.
Smile Design Concepts
Smile design can be divided into 2 processes;
- Designs applied on the patient’s teeth with wax up and mock up work.
- Designs that can be simulated with Power point and keynote on the computer as well as a digital smile design program that can be used as a special program.
How to make a smile design with wax-up and mock up?
Initially a gypsum working model is made by measuring the inside of the mouth. The tooth (eg lamina) that is planned to be made is prepared with special wax on this model in the desired form that is communicated by the patient. It is measured with silicone impression or transparent silicone on the model. Temporary crown material that will be used to manufacture an artificial tooth is inserted into the acquired silicone key (if transparent silicone is used, the process is continued with liquid composite because it is more aesthetic) and applied on the teeth, after it has hardened it is removed and the planned restoration on the teeth is transferred. The patient is able to see the restoration planned one-on-one immediately and after the approval of the patient, the real preparation procedures are initiated.
How to design a digital smile?
Digital smile design starts with a photo shoot. Basically the process is started by taking 2 fullface retractor photographs, 1 photo showing the occlusal surfaces of the teeth and 1 photograph is taken in the 12 o’clock position to display the anteroposteriar curvature of the front teeth.
The photos are transferred to a power point, keynote or a special smile design program and the necessary designs are made and the patient is immediately shown the teeth that he/she can have. The appropriate tooth form is determined with the patient and the design is made.
What are the digital smile design programs?
Examples of digital smile design programs I can mention are the 2-dimensional Smile Designer Pro and Dsd App.. Dsd App only works on ipad, while Smile Designer Pro runs on every platform (Windows, Mac). I can also mention nemo, egzocad, 3shape programs in 3D.
Smile design with Smile Designer Pro is done as follows.
The program is opened and the patient information is saved on the screen that is displayed and the photos required for the design are uploaded onto the system. Subsequently the midline occlusal plane and the planes passing through the pupils and the lip contour are determined. Depending on the patient’s gender, age and desire, one of the tooth forms loaded in the system is selected, the necessary size adjustments are made, a simulation is made and presented to the approval of the patient, the necessary corrections are made and the design is completed.
The Place of Periodontal Treatments in Smile Design
Healthy and aesthetic gums are undoubtedly the basis of smile design. The process is started by evaluating gum health for an aesthetic design.
If the patient has pigmented gums, the gums can be treated with a laser or traditional methods to make them a rosy pink.
In case of gingivitis, in other words gum disease, dental surface cleaning and polishing is done and more importantly effective oral care techniques are demonstrated.
If gingival disease has developed into periodontitis up to the bone, the aim is to regain gum and bone health by performing various surgical procedures.
Another factor to consider in smile design is the gingival level. An ideal gingiva is revealed about 0.5-1 mm during laughter. If the gums appear more than the specified amount during laughing, this is called a gummy smile. Depending on the severity of the case, if gingival leveling is necessary, bone leveling is sometimes called for which means advanced surgery is required.
If gummy smile is caused by insufficient volume of the lips, lip filling is carried out. Excessive motility of the lips can be prevented by botox application. If the upper lip is positioned above, this causes gummy smile and it is corrected by lowering the lip (lip repositioning).