Smile analysis and photoshop smile design

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Fig. 1:Three altered views of the same patient enable analysis of what can be accomplished to enhance facial and smile aesthetics.

Fig. 2: Sagittal views best demonstrate which specialists should be involved in treatment, whether orthodontists or maxillo - facial surgeons, to best aesthetically alter the facial aesthetics.

Fig. 3: Drawing a line along the glabella, subnasale, and pogonion enables a quick evaluation of aesthetics without the need for radiographs to determine alignment of ideal facial elements.

Fig. 4: Evaluating the maxillary incisal edge position is the starting point for establishing oral aesthetics.

Fig. 5: According to the 4.2.2 rule, this patient’s smile is deficient in aesthetic elements, having only 1mm of tooth display (left), minus 3mm of gingival display, and 4mm of space between the incisal edge and the lower lip.

Fig. 6: Gingival symmetry in relation to the central incisors, lateral incisors and canines. Optimal aesthetics is achieved when the gingival line is relatively horizontal and symmetrical on both sides of the midline.

Fig. 7: The aesthetic ideal from the gingival scallop to the tip of the papilla is 4–5mm.

Fig. 8: Acceptable width-tolength ratios fall between 70% and 85%, with the ideal range between 80% and 85%.

Fig. 9: Acceptable width-tolength ratios fall between 70% and 85%, with the ideal range between 80% and 85%.

Fig. 10: Acceptable width-tolength ratios fall between 70% and 85%, with the ideal range between 80% and 85%.

Fig. 11: An acceptable starting point for central incisors is 11mm in length, with lateral incisors 1–2mm shorter than the central incisors, and canines 0.5–1mm shorter than the central incisors for an aesthetic smile display.

Fig. 12: The canines and other teeth distally located are visually perceived as occupying less space in an aesthetically pleasing smile.

Fig. 13: A general rule for achieving proportionate smile design is that lateral incisors should measure two-thirds of the central incisors and canines four-fifths of the lateral incisors.

Fig. 14: If feasible, the contact areas can be restoratively moved up to the root of the adjacent tooth.

Fig. 15:Photoshop provides an effective and inexpensive way to design a digital smile with proper patient input. To start creating custom tooth grids, open an image of an attractive smile in Photoshop and create a separate transpa

Fig. 16: The polygonal lasso tool is an effective way to select the teeth.

Fig. 17: Click “edit > stroke,” then use a two-pixel stroke line (with colour set to black) to trace your selection. Make sure the transparent layer is the active working layer.

Fig. 18: Image of the central incisor with a two-pixel black stroke (tracing).

Fig. 19: Image of the teeth traced up to the second premolar to create a tooth grid.

Fig. 20: Size the image in Photoshop.

Fig. 21: Save the grid as a .png or .psd file type and name it appropriately. Create other dimension grids using the same technique.

Fig. 22: To determine the digital tooth size, a conversion factor is created by dividing the proposed length by the existing length of the tooth.

Fig. 23: Select the ruler tool in Photoshop.

Fig. 24: Measure the digital length of the central incisor using the ruler tool.

Fig. 25: Measure the new digital length using the conversion factor created earlier.

Fig. 26: Create a new transparent layer and mark the new proposed length with the pencil tool.

Fig. 27: Open the image of the chosen tooth grid in Photoshop and drag the grid on to the image of teeth to be smile designed. This will create a new layer in the image to be smile designed.

Fig. 28: Adjust the grid as required while maintaining proper proportions by using the free transform tool from the edit menu.

Fig. 29: Modify the grid shape as necessary using the liquify tool.

Fig. 30: Select all of the teeth in the grid by activating the magic wand selection tool and then clicking on each tooth with the grid layer activated (highlighted) in the layers palette.

Fig. 31: Use the selection modify tool to expand the selection to better fit the grid shape.

Fig. 32: Activate the layer of the teeth by clicking on it. Blue-coloured layers are active.

Fig. 33: With the layer of the teeth highlighted, choose “liquify”; a new window will appear with a red background called a “mask”.