A beautiful smile is the window that opens out to a person. A relaxed smile has a very important role in self-expression. In recent years, the concept of smile design has gained great popularity.
What is Smile Design?
Smile design; Considering factors such as face, lips, smile, speech, compatibility of teeth and gums with each other, functionality and aesthetics, in order to eliminate existing problems in the mouth and to gain an aesthetic appearance, a functional and aesthetic dental treatment suitable for the patient's personal needs should be planned and this should be done in advance. is visualization. Although the term 'smile design' is known as dental treatments for aesthetic purposes, smile design is actually the design and simulation process before starting the treatment.
Smile Design Concepts
We can divide smile design processes into 2;
They are designs made with wax up and mock up studies and applied on the patient's own teeth.
They are designs made with simulations made with digital smile design programs that can be used as a special program as well as with power point and keynote on the computer.
How to design a smile with wax-up and mock-up?
First of all, a plaster working model is obtained by taking measurements from the inside of the mouth. The tooth (eg lamina) planned to be made with special waxes on this model is prepared in the desired form in communication with the patient. The measurement is taken on the model with a silicone measure or with a transparent silicone.
Temporary crown material, from which we can obtain artificial teeth, is added into the obtained silicone key (if transparent silicone is used, the process is continued with flowable composite because it is more aesthetic) and applied on the teeth, after waiting for it to harden, it is removed and the restoration planned to be made on the teeth is transferred. The patient will be able to see the restoration planned to be done one-on-one, and after the approval is obtained, the actual preparation procedures are started.
How to make a digital smile design?
Digital smile design processes start with photo shoots. Basically, the process starts by taking 2 photos with retractor, 1 photo showing the occlusal surfaces of the teeth, and 1 photo at 12 o'clock to show the anterior-posterior curvature of the anterior teeth.
The necessary designs are made by transferring the photos to a power point, keynote or a special smile design program, and the patient is immediately shown what kind of teeth they can have. The appropriate tooth form is determined together with the patient and the design is made.
What are digital smile design programs?
I can give two-dimensional Smile Designer Pro and Dsd App as examples of digital smile design programs. While Smile Designer Pro works on every platform (Windows, Mac), Dsd App only works on ipad. In 3D, I can give examples of nemo, exocad, 3shape programs.
Here's how to design a smile with Smile Designer Pro.
When the program is opened, the patient information is recorded on the screen that appears, and the necessary photographs for the design are uploaded to the system. Then, the midline occlusal plane and the planes passing through the pupils and the lip contour are determined. Depending on the gender, age and desire of the patient, one of the dental forms installed in the system is selected, a simulation is created by making the necessary size adjustments, and the necessary arrangements are made by presenting it to the patient's taste and the design is completed.
The Role of Periodontal Treatments in Smile Design
The basis of smile design is undoubtedly healthy and aesthetic gums. For an aesthetic design, the process is started by evaluating the gingival health first.
If the individual has pigmented gums, the gums are treated with laser or traditional methods to turn them into a dry rose pink color.
If there is gingivitis, i.e. gum disease, tooth surface cleaning and polishing is performed, and more importantly, effective oral care techniques are taught.
If the gingival disease has progressed to the bone and periodontitis has occurred, it is aimed to regain gingival and bone health by performing various surgical procedures.
Another factor to consider in smile design is gingival level. An ideal gingiva appears 0.5 -1 mm during laughing. If the gums appear more than the specified amount during laughing, this is called a gingival smile (gummy smile). Depending on the severity of the case, if gingival leveling is required in the treatment, bone leveling and sometimes advanced surgeries are required.
If this gingival smile is caused by the lack of volume of the lips, lip filling is performed. If the reason is excessive mobility of the lips, excessive movements of the lips can be prevented by botox application. If the upper lip is positioned above, this also causes a gingival smile. The treatment is done by positioning the lips down (lip reposition).