Esthetic Considerations in Orthodontics: An Overview

Abstract

Esthetics has been an ever-evolving concept and has gained considerable importance in the field of orthodontics in the last few decades. The re-emergence of the soft tissue paradigm has further catapulted the interest of the orthodontist. So much so that achieving a harmonious profile and an esthetically pleasing smile has become the ideal goal of treatment and is no longer secondary to achieving a functional dental occlusion and/or a rigid adherence to skeletal and dental norms. Esthetics in the orthodontic sense can be divided into three categories: macroesthetics, miniesthetics, and microesthetics. Macroesthetics includes the evaluation of the face and involves frontal assessment and profile analysis. The frontal assessment involves assessment of facial proportions, while the profile analysis involves evaluation of anterior–posterior position of jaws, mandibular plane, and incisor prominence and lip posture. Miniesthetics involves study of the smile framework involving the vertical tooth–lip relationship, smile type, transverse dimensions of smile, smile arc, and midline. Microesthetics involves the assessment of tooth proportions, height-width relationships, connectors and embrasures, gingival contours and heights, and tooth shade and color. The harmony between these factors enables an orthodontist to achieve the idealized esthetic result and hence these parameters deserve due consideration. The importance placed on a pleasing profile cannot be undermined and the orthodontist should aim for a harmonious facial profile over rigid adherence to standard average cephalometric norms. This article aims to give an overview of the macro, mini, and microesthetic considerations in relation to orthodontic diagnosis and treatment planning.

Aesthetic Management of Tooth Size Discrepancies

“…The gingival margins of the lateral incisors should be below an imaginary line connecting gingival margins of central incisor and canine. 27 Clinicians should be aware of altered passive eruption, 28 a condition where the relation between teeth, alveolar bone and gingiva is altered and often emphasise tooth size discrepancies affecting the length of the tooth.…”

Is Orthodontic Treatment an Etiologic Factor for Altered Passive Eruption? A Clinical Study and Systematic Review

“…The realm of esthetics has undergone a constant transformation and recently garnered monumental weight in orthodontics [1]. The pursuit of a visually pleasing smile and a balanced facial profile has become a primary objective of OT, surpassing the traditional focus on achieving functional occlusion and conforming to skeletal and dental norms [1,2]. Although all orthodontists strive to create beautiful smiles, there is currently no standardized method for objectively analyzing frontal smiles.…”

Machine Learning-Based Evaluation on Craniodentofacial Morphological Harmony of Patients After Orthodontic Treatment

“…It was claimed that the facial features, especially oral aesthetics, had the potential to influence self-perceived appearance, especially during the phase of life with intense social and affective interaction ( Burden, 2007 ). Patients seeking orthodontic treatment aim to improve their dental aesthetics and facial balance ( Turley, 2015 ; Singh et al, 2021 ). As a standardized method, cephalometric analysis is routinely used to investigate the interrelationship among craniofacial bony and soft tissue landmarks and is employed as a treatment planning and evaluation tool by orthodontists, based on cephalometric radiographs before and after orthodontic treatment.…”