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cosmetic dentistry_beauty & science No. 1, 2017

| technique naturomimetic layering Material category Objective Example Opaque group To mask discoloration Beautifil Opaquer Dentine group Opacious dentine To replace deeper dentine Beautifil II A20 (Opacious dentine) Normal dentine To replace outer dentine Beautifil II A2 (Universal dentine) Enamel group Translucent To replace enamel Beautifil II Enamel HVT Effect group (stain) To create special effect Beautifil II Gum shade Table 1: Materials category.59 enamel, whereas more opaque resins should be used to reproduce artificial dentine. D-Smile Style I-Smile Style S-Smile Style C-Smile Style There are varieties of composite resin materials available in the global market, and dental manu­ facturers are now developing resin with different shades and opacities to mimic colour, translucen­ cies and visual appearance of the natural tooth structure and have come up with different grouping systems. Regardless of the method of restorative materials grouping that is employed by manufacturers, all the direct aesthetic restorative materials can be catego­ rised into four groups59 based on its optical proper­ ties (Table 1). Smile Style and surface texture design Table 2: DISCover Smile Style— tooth characteristics. The naturomimetic restoration technique follows the patient’s psychology, as described in the Smile Design Wheel concept.60 Smile Style and tooth sur­ face texture should be selected based on patient’s perception, personality and desire. However, select­ ing the correct smile style requires knowledge about the personality component of the Smile Design Wheel in depth. While discovering a patient’s personality (tempera­ ment), the author used the concept of ‘DISC’, which was introduced by the psychologist Dr William Moulton Marston in his publication Emotion of Normal People in 1928.61 Marston theorised that people are motivated by four intrinsic drives that direct his/her personality patterns. He used four descriptive behavioural tendencies, which are represented by four letters of the alphabet: D (dominance), I (influence), S (steadiness) and C (compliance). Based on the DISC personality traits, the author has categorised smiles into four cate­ gories (Tables 2 & 3). To achieve a naturomimetic enamel restora­ tion, the clinician should understand age­related natural tooth surface texture characteristics. Generally, there is a decrease of surface texture as patients increase in age.62 However, surface texture should be designed on a case­by­case basis to satisfy the patient’s need and desire. The surface texture of a tooth is confirmed by three factors. 1. Surface texture or degree of surface smooth­ ness or roughness. This can be divided into two categories. 2. Macro­texture (vertical and/or horizontal eleva­ tion and depressions, or ridges and grooves seen on the surface of a tooth). Smile Style Central incisors D—Smile Style I—Smile Style Lack of dominance with square shape Dominant type with rectangular shape Canine tips Flat type Rounded with flat tips S—Smile Style Dominant type with oval shape Rounded type Lateral incisors IAL IAL angle Tooth axis Flat and may touch incisal aesthetic line (IAL) Rounded and flat incisal edges and do not touch incisal aesthetic line (IAL) Delicate, rounded mesial and distal incisal edges, and do not touch incisal aesthetic line (IAL) Straight or R = reverse 90°–above Straight or slight divergent Slightly descending to straight type 85–90° Straight Descending type 75–85° Slightly conversing C—Smile Style Dominant type with triangular shape Pointed type Rounded distal and flat mesial incisal edges, and touch IAL Descending type 70–80° Conversing 18 cosmetic dentistry 1 2017

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