Dr. LuBovich - The Art of Dentistry

Facial Aesthetics Tutorial

The picture of Aaclepios, the Greek God of Medicine with the vertical and horizontal lines, relate the reasons why patterns tried in the mouth are essential for maximum cosmetic results.

The black vertical line is the middle of the face. This is a guideline for both the position and direction of the midline of the teeth. Perhaps you have seen someone’s front teeth that are crowned, and the lines of the crowns do not match the imaginary lines of the face? We make the midline of the teeth a very important part of the smile design process.

The red horizontal line is a line drawn between the pupils of the eyes. We use this line to guide us to lining up the bottom edges (incisal edges) of the upper front teeth.This is also a very important landmark in the smile design process.

The blue horizontal line is drawn through the cheek bones (the widest part). When this measurement is taken and divided by 16, the golden proportion of esthetics provides us the width of the upper central incisors.

The green horizontal line is drawn from one corner of the lip to the other. This relates to the plane of the incisal edges. Usually, the best smile design requires the horizontal plane of the front teeth to follow this line. However, there are some exceptions to this rule when the lip moves higher on one side than the other in smiling. When lip movement is not symmetrical , and one side moves higher than the other, usually, the plane of the incisal edges are modified to follow the smile, a little.

Most times, crowns and veneers for front teeth are made in dental laboratories without any try in of the patterns on prepared teeth. This is always a compromise, and the result is never as cosmetic as when a pattern is made to try on prepared teeth. How can one hold a model of a patient’s teeth, and create a smile to follow these guidelines without trying the pattern in the mouth? Think about it.

In order to match up front tooth crowns to the patient’s face, patterns tried in the mouth are essential for a superior smile design result. Dental patterns are like house plans. No one would build a house without plans. “Without a plan, one plans to fail.” Wax patterns tried on prepared teeth, in the mouth, enable the smile designer to match the crown shapes, length, midline, to the sex and shape of the face. This is a design pattern making process that DRL has developed, and very few dentists incorporate this pattern making into their development of a smile. Patterns make the ultimate smile design better; however, making patterns take more time and skill. This is truly an example of “A little harder right way.”