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cosmetic section

Fig 9a Fig 9b

Fig 9c Fig 9a-d: Increased vertical dimension of occlusion, restored
dental tissues, aesthetics and occlusal balance

integrated into facial harmony (Baratieri and Guimarães, 2008; Frese ethnicity and height were recorded for all participants. The Caucasian
et al, 2012; Medeiros, 2013; 2018; Mondelli, 2003), and the correctness group prevailed, while the largest measurements were in males. These
of dental measurements is a big challenge at this point. measures help plan the periodontal recontour.
The 4D protocol presents a step by- step guide that allows important Magne et al (2003) performed mesio/distal and cervico/incisal
aspects to be evaluated in the first appointment. The didactic division measurements on images of 146 maxillary anterior extracted teeth.
between macro-aesthetics, micro-aesthetics and nano-aesthetics Measurements were evaluated on erupted and non-erupted teeth in
guides the analysis of the anatomical components that creates dental Caucasian individuals. Yamaguto and Vasconcelos (2005) measured
and facial harmony. the distal width from molar to molar by the upper and lower teeth in
The ‘golden ratio’ is an aesthetic reference that has been used for 60 models of orthodontic accessories. As measures presented in the
more than 2,000 years (Preston, 1993) and was introduced to the dental Brazilian sample, the results in Sterret (2003) and Magne et al (2003)
industry by Lombardi (1973). The Levin grid was created to simplify its were close.
use (Levin, 1978) and for a long time was the largest standard reference After reviewing the literature, and during the creation of the ‘rule of
for rehabilitation. 20’, it was observed that dental measurements began to coincide with
There is, however, some controversy as to whether this is actually harmonic smiles, as observed in Magne et al (2003), Sterrett (2003),
in the dental ratio (Preston, 1993; Soares, 2006). Perhaps this and Yamaguto and Vasconcelos (2005).
inconsistency is the reason for the increasing search for aesthetic According to the Chu method, teeth with appropriate harmonic
treatments for smile transformation (Coachman and Calamita, 2012; proportions have a width/height ratio of 75% to 80%. This simple
Frese et al, 2012; Fradeani and Corrado, 2006; Medeiros, 2013; 2018). calculation makes quick planning possible based on previous dental
Digital smile design (Coachman and Calamita, 2012) is used measurements.
for smile planning. With the correct photographs, digital planning The ‘rule of 20’ and the Chu method are ways of planning teeth
presents simple steps for assessing the size, shape and position of teeth, based on real measurements, and both find similar values (German et
as well as gingival contour. al, 2016). The ‘rule of 20’ (Medeiros, 2013; 2018), as well as the Chu rule
However, with some limitations, planning is performed through a (German et al, 2016), allows us to work with real dental measurements,
frontal view, not using actual widths for the lateral and canine incisors, different from the digital smile design, the ‘golden ratio’ (Lobbezoo
as in the ‘golden ratio’ (Levin, 1978; Lombardi, 1973; Mondelli, 2003; et al, 2013; Snow, 1999; Soares, 2006) and the Levin grid (Lombardi,
Preston, 1993). 1973), which works with apparent measurements.
Sterret (2003) evaluated dental measurements in three groups: True dimensions lead us to greater precision in planning – this is
canines, lateral incisors and maxillary central incisors; gender, the great advantage when performing diagnosis and planning with

18 Dental Practice i November-December 2023 i Vol 19 No 6