Masters of Fixed

Prosthodontics
Esthetic Dentistry II

FACULTY OF DENTISTRY AIN SHAMS UNIVERSITY

(2023-2024)
Name:
Clinical workflow of esthetic rehabilitation cases
A. Complete smile analysis diagnostic file.
B. Complete photography portfolio
C. Preoperative records
D. Control phase (scaling , post& cores, direct restorations, gingival
corrections etc…)
E. Digital smile design
F. Mockup.
G. Preparation.
H. Try in.
I. Delivery.
1- The clinical requirements of esthetic rehabilitation are to be delivered by the
end of semester 4 for exam entry.
2- Requirements :
 Easch candidate is required to deliver ONE esthetic rehabilitation case
(involving a minimum of 6 teeth in the anterior zone) using indirect ceramic
restorations (veneers, crowns bridges, resin bonded restorations)
fulfilling all the steps with complete documentation.
 Each 2 candidates are required to share in ONE minimally invasive
esthetic rehabilitation case ( bleaching or resin infiltration)

• Eligibility criteria for exams entry

Proper photography, documentation of all steps is obligatory.

 For the entry of semester 4 clinical exam, the following is required:

1- One fully documented delivered esthetic rehabilitation case.
2- Complete esthetic portfolio for the esthetic rehabilitation case (
hard & soft copies).
3- One documented minimally invasive esthetic rehabilitation case.
 Preoperative photos Guidelines
• Use DSLR camera (photos must be of good resolution )
• The photos must be taken with the exact same position of the patient
• Make sure that the patient’s head isn’t tilted
• Teeth must be in occlusion
• The patient ’s eyes look straight to the camera lens

Extraoral photos Intraoral photos

Frontal smile Upper occlusal

Frontal retracted Lower occlusal

Lateral smile Retracted Frontal view

Lateral at rest Retracted Right lateral

12 O clock Retracted Left lateral

Close up view (smile)

Close up (at rest)

 Diagnostic Chart
Case 1
Patient History:
1. Social History:

Name:
Age:
Sex:
Occupation:

2. Medical History:

Kidney Disease Anemia Tuberculosis

Rheumatic fever Hepatitis Diabetes
Liver Disease Asthma Hypertension
Thyroid Disease Epilepsy Heart Disease

-Did the patient ever have surgery or have been hospitalized? Yes No
If yes, please specify the cause:
-Is the patient allergic to any substances? Yes No
If yes, please specify:
-Is the patient a smoker? Yes No
-Is the patient currently on any medication? Yes No
If yes, please specify the medication and the frequency of intake:
-Has the patient ever been diagnosed with COVID-19? Yes No
If yes, please specify approximately how long ago:
-For Females, is the patient Pregnant or lactating?

3. Dental History:

-Oral Hygiene Condition: Good Fair Poor

-When was the patient’s last visit to a dentist? ………………………………………………………
-What kind of procedure did the patient undergo then? …………………………………………
-Mention the patient’s previous dental procedures:
………………………………………………………………………………………………

Chief complaint:
………………………………………………………………………………………………
………………………………………………………………………………………………
 Smile Analysis Chart
A- Macro-Esthetics: (Extra-oral Facial Analysis)

1- Facial Thirds: (Lower Facial Third Height Analysis)

Normal Excessive Deficient

2- Facial Midline:
Centralized Non-centralized

3- Facial Symmetry:

Symmetric Asymmetric

4- Inter-pupillary Line:

Parallel To the Horizon Slanted

5- Lip Length:

Normal Short Lip Long Lip

6- Facial Profile:

Straight Convex Concave

B- Mini-Esthetics:

1- Vertical Overlap: (Overbite)

Normal Deep Bite Open Bite

2- Horizontal Overlap: (Overjet)

Normal Excessive Cross Bite

3- Anterior Incisal Plane in Relation to the Interpupillary Line:

Parallel Canted to Canted to The

the Right Left

4- Maxillary Teeth Base Shade:

Shade Guide Used: Shade Selected ( )

……………………
 C- Micro-Esthetics:

Teeth dimensions
1- Maxillary Central Incisor Width: ……..mm

2- Maxillary Central Incisor Height: ……..mm

Central Incisor Proportions: (Central Dominance –W/L x

100) ……..%

3- Maxillary Teeth
Alignment:
Normal Crowded Spac

Zenith Points:
Normal Irregular

Gingival Biotype:
Thick Thin

4- Mandibular Teeth
Alignment:
Normal Crowded Spaced

Zenith Points:
Normal Irregular

Gingival Biotype:
Thick Thin
 Teeth dimension worksheet
Initial Width of central incisor=
Initial Length of the central incisor =
Inter-canine width=

Suggested RED Proportion=

Frontal view inter- canine width ICW

The width of maxillary
central incisor
2
2 ( 1+ RED + RED )

Suggested dimensions Suggested dimensions Suggested dimensions

of the central incisor of the lateral incisor of the canine

Width = Width = Width =

Length = Length = Length =
 1- Macro Esthetics Analysis

Facial Midline
o Centralized
o Non-
Centralized

Interpupillary Line
Lower Facial
Third Height o Parallel to
Horizon
o Normal
o Slanted
o Decreased
o Increased

Frontal view
 Facial Profile
o Convex
o Straight
o Concave
Nasolabial Angle
Close up view (at rest )
Lip Length
Lip Length
o Normal
o Normal
o Long
o Long
o Short
o Short

Lateral view
 2-Mini Esthetics Analysis

o Lip Line
o Normal
o High
o Low

Buccal Corridor
o Narrow
Close up view ( at rest) o Intermediate
o Wide
o Incisal Display at
Smile Arc
Rest Close up view (smile) o Straight
o Normal
o Deficient o Convex
o Excessive o Reverse

Maxillary Teeth Amount of Teeth &

Alignment Gingival Display
o Normal During Smiling
o Crowded o Normal
o Spaced o excessive
o deficient
 2- Micro Esthetics Analysis

Gum Line & Zenith

Points
Axial
o Correct Position
Inclination
o Needs
o Vertical
Modifications
o Mesial
Di t l

Facial Midline Dental Midline

Labial view
Central Incisor Dental Midline in Relation to
Facial Midline
Proportions
o Coinciding / Parallel
o Normal o Shifted / Parallel
o Canted
 Patient’s Esthetic portfolio
Preoperative photos

Frontal retracted Frontal smile

Lateral smile Lateral at rest Lateral retracted
Close up view (at rest) Close up view (smile ) 12 o clock
 Intra-oral photos

Upper occlusal Lower occlusal

right lateral Labial view Left lateral
 Mock up step

right lateral Labial view Left lateral

 Preparation step

Right lateral(intraoral) Labial view(intraoral) Left lateral(intraoral)

Upper occlusal Lower occlusal
 Delivery step

Frontal smile Frontal retracted Close up view

Upper occlusal Lower occlusal Labial view
-Treatment Plan:

-Planned Restoration:
Design
Type of Retainers
Pontic
Material of Choice
Shade
Type of Cement
Case: ………………………………..

Date Step Signature

 Minimally invasive esthetic rehabilitation

preoperative postoperative
Assignment evaluation sheet

Supervisor’s name :

Date : Topic :

Inadequate Average Good

Evaluation rubrics
0 1 mark 2 marks

1- Knowledge about the subject

2- Scientific content fulfillment

3- Organization of material

4- Presentation skills

5- Teamwork skills

Supervisor’s comments

Final Grade /10