PERIODONTAL

CONSIDERATIONS
ESTHETIC
SMILE
IN

K. PRUDHVI, I

ST

MDS

DEPARTMENT OF PERIODONTICS
GITAM

DENTAL COLLEGE
1

Introduction
A beautiful smile is an added asset to a
beautiful face.
Esthetic demands of patients are increasing and
esthetics has become an inevitable part of
dentistry.
Key to successful results in esthetic dentistry
lies in a saying by Dawson (1995) if you know
where you are and you know where you want to
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Facial Aspects

Dentofacial
Aspects

Dental
Aspects

Dentogingival components
noted a number of dentogingival
elements for consideration into general patient
esthetic evaluation.
Goldstein (2000 )

Dental midline
Occlusal plane
Incisal edge
curvature
Contact points
Incisal embrasures
Axial inclination

Gingival line
Gingival height of
contour
Gingival
embrasures

DENTAL

GINGIVAL

Periodontal Parameters For Esthetic

Smile
Gingival health
Gingival health is the basic pre-requisite for
an

esthetic

gingival

morphology.

Inflammation produce changes in color and

surface texture of the gingiva. Therefore
proper assessment of gingival esthetics can
only be performed under inflammation free
periodontal conditions.
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Gingival Contours
The contour of the gingival margins of the six
maxillary anterior teeth plays an important role
in smile esthetics and is determined by the
following features

The contour of the gingival margins must

coincide with the CEJs of the teeth.
The maxillary gingival margin should run
parallel to the incisal edges of the teeth and
parallel to the lower lip line when the
individual is smiling.
The gingival esthetic line:- Ahmad 1998 is
the line connecting zeniths of the central
incisors and canines which intersects the
dental midline This line will be harmonious
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Sylvain and Charruel et al

Chinche and Pinault

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The gingival level

of the maxillary
left
and
right
lateral
incisors
are
situated
below the level of
the
central
incisors and the
canines.

The gingival level

of the maxillary
left and right
lateral incisors
are at the same
level as the
central incisors
and the canines.

The gingival
level of the
maxillary left
lateral incisors
is at a lower
level compared
to the right
lateral incisors.
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The gingival
levels of the
maxillary
lateral incisors
are above the
level of the
central incisors
and canines.

The gingival
levels of the
maxillary
canines are at a
higher level than
the central
incisors.
However, the
lateral incisors
are at a much

Unequal
gingival
levels of
the
maxillary
central
incisors.

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Gingival Zenith
Defined as the apex of gingival height of
contour.
It influence the emergence profile and axial
inclination of the teeth by modifying the line
angle position of the long axis of the
emergence of the crown from the gingiva

12

Carolina et al
Stephen et al

1
mm

0.4mm COINCIDED

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Gingiva papilla And Gingival Embrasures

The contact point between the central
incisors is in the most incisal position
compared with the contact point between
other teeth.
The interdental spaces appear narrower on
the right than on the left causing a
difference in the papillary height between
the two sides.

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Gingival Display
The degree of gingival exposure ideally
should be only 1-3 mm above the cervical
area of the tooth (Kokich,1999).
An expanse of soft tissue should not be
considered to be unaesthetic per se, but
the way this soft tissue is arranged relative
to the teeth and lips is of an esthetic
concern.
During an extensive smile, the upper lip
T
should rest at the level of the mid facial
Z
gingival margins of the maxillary anterior
A
teeth.
N
A
H
A
15
et

Gingival Color
The color of the gingiva plays an important
role in overall esthetics.
As seen clinically, it varies from person to
person, in different areas of the mouth and
appears to be correlated with the color of the
skin.

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According to Dummett (1959), color of the

healthy gingiva is variable, ranging from pale
pink to deep bluish purple. Between these
limits of normalcy are a large number of colors,
which depend primarily upon

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Degree of pigmentation of the gingiva

and skin is reciprocally related .

The
highest
rate
of
gingival
pigmentation has been observed in the
area of the incisors with a decrease in
the posterior areas.

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CONCLUSION
Appearance
of
the
gingival
tissues
surrounding the teeth and their relation ship
with lips plays an important role in the
esthetics of the maxillary anterior region of
the mouth.

Knowledge of normal is essential

pre
requisite
for
diagnosis
of
abnormal.
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Therefore, an understanding of the ideal

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