FUNDAMENTALS OF AESTHETIC DENTISTRY

Two main objectives in esthetic dentistry:

1. To create teeth of pleasing proportions

2. To create a pleasing tooth arrangement in harmony with the gingiva lips and face

FUNDAMENTALS OF AESTHETHICS

1. Light and shadow

2. Principles of color
3. Principles of form
4. Principles of perception to control illusion
5. Principles of line – midline, smile lines, horizontal and vertical lines

Esthetic dentistry is about color and perception. Manipulation of light, color, illusion, shape and form in
order to create more esthetic situations

LIGHT AND SHADOW

Objects cannot be distinguished without light. When lit, they exhibit two dimensions- length and width.
True natural light is multidirectional and reveals texture and throws shadows adding a third dimension-
depth

The communication of form is by shadow. Dental restorations can mimic shadows of adjacent teeth to
create a shape that blends with the surrounding tooth forms. Shadow manipulation can make poorly
shaped teeth esthetic.

PRINCIPLES OF COLOR

Isaac Newton observed that when white light [asses through a prism it divides into an orderly pattern of
colors termed a spectrum. He also observed that when these colors pass back through the prism they
produce white light proving all colors were in the original beam.

Color is the result of absorption and reflection. In absorption, white light is passed through a filter. The
eye perceives the color of the filter. In reflection the color seen is the portion of color reflected back to
the eye

Light enters the eye and stimulates photoreceptor rod and cones in the retina. The energy is converted
into nerve impulses, carries through the optic nerve into the occipital lope of the cerebral cortex. Rods
interpret brightness differences and value. Cone cells function in hue and chroma interpretation.

COLOR is the quality of an object or substance with respect to light reflected by it usually determined
visually by measurements of 3 color parameters

In 1915 albert henry Munsell created an orderly numeric system of color description that is still standard
to DATE. It divides color into three parameters – hue, chroma and value.
HUE

Hue is the name of the color. Red orange yellow green blue indigo violet. In younger dentition, hue
tends to be similar throughout the mouth. With age, variation in hue occurs due to intrinsic and extrinsic
staining from restorative materials, foods, beverages, smoking and other influences.

CHROMA

Saturation or intensity of hue. It can only be present with a hue. Example: to increase chroma of porcelain
more of that hue is added. Chroma is the quality of hue decreased by bleaching. Chroma of teeth increases
with age

VALUE

Relative lightness or darkness of a color. A light tooth has a high value while a dark tooth has a low value.
It is not the quantity of the color gray but the quality of brightness on a gray scale. In dentistry changing
value does not involve adding gray but rather manipulating colors t increase or decrease amount of
grayness. Gray produces a dull color – lowers value. White brightens color – higher value

COLOR RELATIONSHIP

The color wheel:

Hues have a relationship to one another that can be demonstrated in a color wheel. Primary secondary
and complementary hues are graphically depicted by the color wheel.

1. Primary hues
Red, yellow and blue form the basis of the dental color system. Primary hues and their relationship
to one another form the basis of the color wheel

2. Secondary hues
Mixture of any two primary hues form a secondary hue.
Red and blue – violet
Blue and yellow – green
Yellow and red – orange
Altering chroma of primary hues in a mixture can change the hue of the secondary hue produced
On the color wheel, secondary hues are positioned between primary hues

3. Complementary hues
Colors directly opposite each other on the color wheels are complementary hues
A primary hue is always opposite a secondary hue. When a primary hue is mixed with a
complementary secondary hue the effect is to cancel out both colors and produce gray.
 Tip: to change hue, lessen chroma or lower value place the complementary color over the color
to be modified.
If a portion of crown is yellow, lightly washing with violet will produce an area that is no longer
yellow as the yellow is cancelled out and there is increased grayness (low value).
If the tooth needs to be brown but it is yellow. Violet is added to cancel out the yellow then the
desired color added
Complementary hues also exhibit the phenomenon of intensification. When placed next to one
another they intensify each other and increase chroma. A light orange line on the incisal edge can
intensify the blue nature of an incisal color.

HUE SENSITIVITY

After 5 seconds of staring at a tooth or shade guide the eye accommodates and becomes biased.

If you stare at a color for longer than 5 seconds then the person stares away at a white surface or closes
on of his eyes the image appears in a complementary hue- mismatch

METAMERISM

Basic theory: a phenomenon that can cause two colors to appear the same hue under one light source
but are an obvious mismatch under a different light source. This complicates color matching of
restorations. A shade button may match under incandescent lighting from the unit but not under
fluorescent lighting in patients work place. Always match in natural light or fluorescent light.

OPCACITY

An opaque material does not permit light to pass through. It reflects all light shined on it.

Eg: a PFM crown needs opaque porcelain to prevent the color of the metal appearing through the
translucent body of incisal porcelain.
TRANSLUCENCY

Allows some light to pass through. Only some light is absorbed. Provides realism to a restoration

DEPTH

Depth is a spatial concept of color blending combining the concepts of opacity and translucency. In
normal teeth light passes through translucent enamel but reflected from depths by relatively opaque
dentin.

PRINCIPLES OF FORM

Perception- a tooth in the environment of others we perceive many qualities of the tooth including color
size shape age and gender.

The golden proportion: for objects to be proportional to one another the ratio of 1:1.618 is esthetically
pleasing. As a rule, in the apparent size of each tooth is 60% the size of the tooth anterior to it the
relationship is aesthetically pleasing.

PRINCIPLES OF PERCEPTION

Change apparent size and shape of tooth through illusion. This bias is the key to the law of the face

Law of the face:

- Area in the facial surface bounded by the transitional line angles as viewed from the facial
aspect. They mark the transitions from facial to mesial cervical distal and incisal
- The tooth surfaces slope lingually to the mesial and distal and towards to the cervical. Often no
transitional line appears on the incisal portion.
- Shadows created due to light begin at the transitional line angles. These shadows delineate the
boundaries of the face
- The apparent face of the tooth is the portion visible from any single view
- The law of face states: in order to make dissimilar teeth appear similar the dentist should make
the apparent faces equal. creating similar faces produces dissimilar areas outside the
transitional line angles but these are esthetically acceptable as they are essentially invisible

PRINCIPLE OF LINE

Can be used to crate the illusion of a longer or shorter tooth. A tooth has horizontal and vertical lines.

Horizontal lines such as cervical staining lines, white hypoplastic lines or long straight incisal edges
create the illusion of width

Vertical lines such as an accentuated developmental groove, hypoplastic lines and vertical texturing
accentuate height.
AGE:

Older teeth

1. Smoother
2. Darker (lower value)
3. Higher saturation (Higher chroma)
4. Shorter incisally
5. Longer gingivally
6. Exhibit more wear
7. Have wider and more open gingival embrasures
8. More characterized

Younger teeth:

1. More textured
2. Lighter (lower value)
3. Lower saturation (lower chroma)
4. Gingival margin is approx. at CEJ
5. Have incisal edges that make laterals appear shorter than incisors or canines
6. Significant gingival embrasures
7. Have light characterization, often with white hypoplastic lines or spots