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ePaper created 2015-08-28, 13:01:48 | version 1.38.0
14 I I special _ Digital Smile Design of vertical and horizontal dimensions and the golden ratio analysis. _Mapping of the mini-aesthetics (mouth and smile): from the macro-aesthetic focal length, we can come closer to select the perioral and intra- oral zone where it is necessary to carry out the virtual simulation after a careful dento-labial analysis (Fig. 18c). Thephotographstakenstaticallywithclosedlips in relaxation, the lips spontaneously half-closed or the lips in a smile while pronouncing the phonemes “/m/” and “/i/” can be compared to video frames: from the recording of this data, we can evaluate movement, the dynamic curvature of the lower lip in relation to the maxillary anterior teeth, the position of the central incisors, their exposure and the breadth of the smile well delimited by the width of the labial corridors. All of these factors are relevant to the smile design. It is also fundamental to verify the re- lationship with closed lips between the labial vermilion (analysed both frontally and in profile) and the labial dimensions useful for defining and comparing the vertical dimensions of the face, eventual losses or excesses of substance, brux- ism, atrophic jaws, dental alignment, micro- or macrodontia, malocclusion or even simple loss of lip fullness, which is currently of great aesthetic interest not only clinically, but also and above all in the media. Oftenthemultidisciplinaryapproachtoaclinical case entails a preliminary examination by the plas- tic surgeon to establish the aesthetics of the labial profile. The plastic surgeon, who has to speak in favour of possible plastic surgery to the profile or the like, sends the patient to the dentist for a clini- cal evaluation of the dental–skeletal ratios, which is comparable with the aesthetic analysis of the entireprofileoftheface(Powell’saesthetictriangle, Ricketts’ aesthetic plane, etc.). A dento-facial aes- thetic analysis thus becomes a fundamental pillar for the co-operation between the specialists in the facial aesthetics medical team (Fig. 1 in Part I) to allow a predictable diagnosis and a treatment plan based on a multidisciplinary vision, considering the factthatthesofttissueofthelowerthirdoftheface is supported by and moves by sliding on the hard structures (bones and teeth). Inthisregard,ADSDcanbeofhelpforanalysing the lateral thickness of the hard tissue, partic- ularly the position of the anterior teeth, their inclination and their emergence profile. Indeed, it is possible to perform digital image editing analytically on a millimetre grid based on the reference points from the mapping of the facial profile. The simple superimposition of the images and the implementation of protocols or comple- mentary examinations (virtual 3-D orthodontic simulations; vto; cephalometric analysis; dental design related to the thickness of veneers, over- lays, prosthetic crowns, recontouring, etc.) can process virtual plans, in which it is possible to pre- Fig. 19_Dento-facial profile with multidisciplinary ADSD and Powell analysis. Figs. 20a–c_DDPD Dental Shapes importation from personal database and DDID, digital dental modeling. cosmeticdentistry 2_2015 Fig. 20b Fig. 20c Fig. 19 Fig. 20a