1. PRESENTED BY - DR. JICKY RAJAN
I ST YESR PG
DEPT. OF ORTHODONTICS

3. • Smile is one of the most important expression contributing
to facial attractiveness.
• With patients becoming increasingly conscious of a
beautiful smile, smile esthetics has become the primary
objective of orthodontic treatment.
• The most important esthetic goal in orthodontics is to
achieve a balanced smile, which can be best described as
an appropriate positioning of teeth and gingival scaffold
within the dynamic display zone*
*Ackerman MB, Ackerman JL. Smile analysis and design in the digital era. J Clin
Orthod 2002;36:221-36.

4. • Smile analysis should involve evaluation of
certain elements in specific sequence * :-
 Dento-facial analysis
 Dento-labial analysis
 Dento-gingival analysis
 Dental analysis.
*Mc Laren EA, Cao PT. Smile analysis and esthetic
design: “In the zone”. Esthet Dent 2009;5:44-8.

5. A. DENTO FACIAL
i. Midline
B. DENTO LABIAL
i. Incisor display
ii. Smile arc
iii. Smile symmetry
iv. Buccal corridor
C. DENTO GINGIVAL
i. Gingival health
ii. Height and contour of gingiva
D. DENTAL
i. Contacts and connectors
ii. Embrasures
iii. Crown height and width
iv. Mesiodistal width

6. A.DENTO-FACIAL ANALYSIS
i. MIDLINE
• The starting point of the esthetic treatment
plan is the facial midline.
• One of the goals of the orthodontic treatment is
to achieve maxillary and mandibular midlines
that are coincident-both with each other and
with the facial midline.

7. • The most practical guide to locate the facial
midline is to use two anatomical landmarks as
references* :-
Nasion
the base of the philtrum, also referred to as the
cupid’s bow in the center of the upper lip.
• A line drawn between these landmarks not only
locates the position of the facial midline but also
determines the direction of the midline.
• * Morley J, Eubank J. Macroesthetic elements of smile
design. J Am Dent Assoc 2001;132:39-45.

9. • Ideally the maxillary central incisor midline
should coincide with the facial midline.
• However if it is not possible, then the midline
between maxillary central incisors should be
strictly vertical and parallel to the facial midline.

12. B. DENTO-LABIAL ANALYSIS
i. MAXILLARY INCISOR DISPLAY AT REST
• The average maxillary incisor display at rest is 1.91
mm in men and 3.40 mm in women.
• The amount of incisor show at rest is the most
important esthetic parameter because decreased
incisor display is characteristic of ageing.
•
• This steady decline in maxillary tooth exposure at
rest with aging, is accompanied by an increase in
mandibular incisor display

13. Maxillary incisor display on smile / Lip line
• The lip line is the amount of vertical tooth
exposure on smiling i.e the height of the upper
lip relative to the maxillary central incisors.

14. • The lip line is optimal when the upper lip
reaches the gingival margin, displaying the total
cervico-incisal length of the maxillary central
incisors, along with the interproximal gingivae
while smiling

15. • A high lip line exposes all of the clinical crowns
plus a contiguous band of gingival tissue

16. • A low lip line displays <75% of the maxillary
anterior teeth

17. • Because female lip lines are an average 1.5 mm
higher than male lip lines, 1-2 mm of gingival
display at maximum smile could be considered
normal for females.

18. ii. SMILE ARC
• The smile arc is defined as the relationship of
the contour of the incisal edges of the maxillary
anterior teeth relative to the curvature of lower
lip during a social smile.
*Dong JK, Jin TH, Cho HW, Oh SC. Th e esthetics of the smile: A
reviewof some recent studies. Int J Prosthodont 1999;12:9-19.

19. Smile arcs are of three types:-
Straight
Consonant
Non consonant

20. Consonant smile arc has the curvature of incisal
edges of the maxillary anterior teeth parallel to
the upper border of the lower lip.
For consonant smile arc, the centrals should
appear slightly longer or, at least, not any
shorter than the canines along the incisal plane

21. • Straight smile arc is that in which the incisal
edges of the maxillary anterior teeth are in a
straight line to the upper border of the lower lip.

22. • Reverse or non-consonant smile arc is the one in
which the incisal edges of the maxillary anterior
teeth are curved in reverse to the upper border
of the lower lip.

23. • Reverse smile arc occurs when the centrals are
shorter than the canines along the incisal plane
which can be due to occlusal malfunction or loss
of vertical dimension.
• Parallel and straight smiles provide better
esthetic than reverse smile.

24. iii. SMILE SYMMETRY
• An asymmetry in the smile can be due to:-
 Asymmetric smile curtain
 Transverse cant of the maxillary occlusal plane.

25. • Transverse cant can be due to different amounts
of tooth eruption on the right and left sides or
skeletal asymmetry of mandible resulting in
compensatory cant of maxilla.

26. • In an asymmetric smile curtain, there is a
difference in the relative positioning of the
corners of the mouth in the vertical plane .It can
be assessed by the parallelism of the
commissural and pupillary lines

27. iv. BUCCAL CORRIDOR
• Buccal corridor refers to dark space (negative
space) visible during smile formation between
the corners of the mouth and the buccal surfaces
of the maxillary teeth.
• It is measured from the mesial line angle of the
maxillary first premolar to the interior portion of
the commissure of lips.

28. • It is represented by a ratio of th intercommissure
width divided by the distance from the first
premolar to first premolar

29. • Buccal corridor is directly influenced by arch
form.
• The ideal arch is broad and conforms to a U
shape and is more likely to fill the buccal
corridors than narrow and constricted arch.

30. • Buccal corridor should be kept to a minimum as
it is unattractive, but at the same the buccal
corridor should not be completely eliminated.

31. C. DENTO-GINGIVAL ANALYSIS
i. GINGIVAL HEALTH
• It is of utmost importance that the gingival
tissues are in a complete state of health prior to
the initiation of any treatment

32. ii. HEIGHT, SHAPE AND CONTOUR OF THE
GINGIVA
• Establishing the correct gingival levels for each
individual tooth is the key in the creation of
pleasing and harmonious smile.
The gingival margins of the central incisors should
be at the same level or slightly incisal to that of the
canines
the gingival margins of the lateral incisors should
be towards incisal when compared to central
incisors and canines.

33. • The discrepancies in the levels of gingival
margin may be caused by
attrition of the incisal edges
ankylosis due to trauma in a growing patient
severe crowding
• The gingival margins can be leveled by
orthodontic intrusion or extrusion or by
periodontal surgery, depending on the lip line,
the crown heights, and the gingival levels of the
adjacent teeth.

34. • Gingival shape implies the curvature of the
gingiva at the margin of the tooth.
• In an esthetic smile, the volume of the gingiva
from the apical aspect of the free gingival margin
to the tip of the papilla is about 40-50% of the
length of the maxillary anterior tooth and fully
fills the gingival embrasure.

35. D. DENTAL ANALYSIS
i. CONTACTS AND CONNECTORS
• There is distinction between a connector space and a
contact point.
• The contact points between the anterior teeth are
generally smaller areas that can be marked by
passing articulating ribbon between the teeth.
• The connector is a large, broad area that can be
defined as the zone in which two adjacent teeth
appear to touch.

36. • The contact points of maxillary teeth move
progressively gingivally from the central incisors
to the premolars, so that there is a progressively
larger incisal embrasure, whereas connectors
decreases in size from the centrals posteriorly.

37. • An esthetic relationship exists between the
interproximal connectors of anterior teeth that is
referred to as the 50-40-30 rule

38. ii. EMBRASURES
• The incisal embrasures are the triangular spaces
incisal to the contact point. Ideally these should
display a natural, progressive increase in size or
depth from the central to the canine.

39. • Ideally the embrasures show progressive
increase in size or depth from the central to the
canine.
• The contact point moves apically as we proceed
from central to canine

40. • The individuality of the incisors will be los t if
their incisal embrasures are not properly
developed.
• Also, if the incisal embrasures are too deep, it
will tend to make the teeth look unnaturally
pointed.
• As a rule, a tooth distal to incisal corner is more
rounded than its mesio incisal corner.

41. iii. CROWN HEIGHT AND WIDTH
• Crown height combined with percentage of
incisor display is the deciding factor in the
amount of tooth movement required to improve
the smile index.
• The vertical height of the maxillary central
incisors in the adult is normally between 9 and
12 mm.

42. • Most references specify the central incisors to
have about an 8:10 width/height ratio.
• In one of a recent study the optimal width-to-
length ratio for the maxillary central zone was
found to be between 75% and 85% of the length.
• Smiles with these values were most often
considered “esthetic to highly esthetic.”

43. iv. MESIO-DISTAL WIDTH
• The centrals must be the dominant teeth in the
smile and they must display pleasing
proportions.
• They are the key to the smile.
• The shape and location of the centrals influences
or determines the appearance and placement of
the laterals and canine

44. • The apparent width of the lateral incisor should
be 62% of the width of the central incisor.
• The apparent width of the canine should be 62%
of that of the lateral incisor.

45. • The apparent width of the first premolar should
be 62% of that of canine.
• This ratio of recurring 62% proportions appears
in a number of other relationships in human
anatomy is referred to as the “Golden
proportion.”

46. CONCLUSION
• Although the concept of smile analysis is not
new but is often not incorporated in orthodontic
treatment planning.
• It is therefore emphasized that all the above
discussed elements of smile analysis should be
considered as guidelines and reference points for
beginning esthetic evaluation, treatment
planning and subsequent treatment .

47. “ANYBODY THAT
SMILES
AUTOMATICALLY
LOOKS BETTER