Proportions and Biometry in The Maxillary Anterior Dentition – A Review

Abstract

Despite a widespread variability in nature, practitioners have long been guided by the desire for predictable and reproducible means to interpret anterior teeth proportions for successful anterior dental aesthetics. Tooth biometry is an essential aspect of anterior arch restorations, where identification and correction of tooth size variations is critical to smile analysis and design.

Achieving a beautiful smile requires harmonious application of art and science.

Recent advances in electronics have made it possible to create virtual smile designs for patients with the click of a button. However, set formulas for intra-arch anterior tooth relationships, as numerous studies have shown, cannot be used as guidelines, they can only be applied and preferred by confined sets of patient populations.

Through this article the authors aim to:

Give a synopsis of the psychological and scientific basis of ideal beauty and proportions in nature and the validity of contemporary guidelines.

Review the literature to investigate the suitability and limitations of various proportions proposed for the anterior dentition, like the golden proportion, the recurring aesthetic dental proportion and the golden percentage.

Draw conclusions on the more predictable and reproducible tools that clinicians can apply, for satisfying results, including in patients with missing anterior teeth, abnormal values or tooth size variations and discrepancies.

This review will assist the restorative dentist in the everyday practice with the necessary tools and knowledge in order to achieve an aesthetic result with ease and predictability in every aesthetic reconstruction case, regardless of its complexity.

Keywords:

facial aesthetics, golden proportion, dental proportions, teeth dimensions, tooth biometry, anterior restorations

References

Stakhov, A. The golden section, secrets of the Egyptian civilization and harmony mathematics Chaos, Solitons, Fractals 2006 30(2) 490-505

Akhtaruzzaman Md., Shafie, A. Geometrical Substantiation of Phi, the Golden Ratio and the Baroque of Nature, Architecture, Design and Engineering International Journal of Arts 2011 1(1):1-22 doi:10.5923/j.arts.20110101.01

Gary Meisner Golden Ratio- The divine beauty of mathematics Published 2012

Luca Pacioli Divina Proporzione 1509 Milan

Adolf Zeising Der goldene schnitt 1884 Leipzig

Edler R.J. Background considerations to facial esthetics Journal of Orthodontics 2001 28(2):159-168

Langlois et al. Infant preferences for attractive faces: rudiments of a stereotype? Developmental psychology 1987 23: 363–369

Samuels C., Ewy R. Aesthetic perception of faces during infancy British Journal of Developmental Psychology 1985 3:221-228

Langlois J., Roggman I.A. Attractive faces are only average Psychological Science 1990 1:115-121

Alley T.R., Cunningham M.R. Average faces are attractive but very attractive faces are not average Psychological science 1991 2:123-125

Ricketts,R.M The biologic significance of the divine proportion Am J Orthod 1982 81:351-370

Ferring. V., Pancherz. H. Divine proportions in the growing face Am J Orthod & Dentofacial Orthop 2008 134:472-9

Lombardi R. The principles of visual perception and their clinical application to dental esthetics. J Pros Dent; 1973 29:358-381

Levin. E. Dental esthetics and the golden proportion. J Pros Dent; 1978 Sept 40:3 244- 252

Preston J.D. The golden proportion revisited. J of esthetic dentistry; 1993 5(6):247-251

Ward DH. Proportional smile design using the RED proportion. Dent Clin North Am 2001, 45:143–54.

Sreenivasan M., Niketa R. Evaluation of natural smile: golden proportion, red, or golden percentage. J Conserv Dent, 2008 11:16-21

Kokich, V. Perceptions of dental professionals and laypersons to altered dental esthetics: Asymmetric and symmetric situations Am J Orthod Dentofacial Orthop 2006, 130:141-51

Rosenstiel S. F., Ward D.H., Rashid G., Dentists’ preferences of anterior tooth proportion—a web-based study J Prosthodontics, 2000 9:3, 123-136

S.J., Range and mean distribution frequency of individual tooth width of the maxillary anterior dentition Pract. Proced. Aesthet. Dent 2007 19(4) 209-215

Chu S.J., Hochman M., A biometric approach to esthetic crown lengthening. Pract Proced Aesthet Dent 2007 19(10)

Magne P., Gallucci O., Belser C. Anatomic crown width/length ratios of unworn and worn maxillary teeth J Prosthet Dent 2003 89:453-61.

Rufenacht C., Principles of esthetic integration Fundamentals of Esthetics 1990 Quintessence Berlin

Jefferson Y. Facial beauty- establishing a universal standard Int J of Orthodontics 2004 15(1):9-22

Kazem D., Mohammad B. Maxillary anterior teeth width proportion a literature review EC Dental Science 2017 406159637/ECDE-16-00566

Shilpa S., et al To evaluate the validity of Recurring Esthetic Dental proportion in natural dentition J Conserv Dent. 2011 14(3):314–317

Davis, N. Smile design Dent Clin N Am 2007 51:299–318

Cinelli F., et al Maxillary Anterior Teeth Dimensions and Relative Width Proportions: A Narrative Literature Review Dent. J. 2024, 12, 3. https://doi.org/ 10.3390/dj12010003

Coachman, C., Calamita M. Digital Smile Design: A tool for treatment planning and communication in esthetic dentistry Quintessence Dent Technol. 2012, 35:103–11

Yeşim Ö. Digital smile design as a communication tool for predictable clinical results: An update and review J Exp Clin Med 2021; 38(S2): 123-128 doi: 10.52142/omujecm.38.si.dent.8

Marquardt S. JCO Interviews J Clin Orthod 2002 36:6 339-347

Swati S., et al Esthetic Considerations in Orthodontics: An Overview Dent J Adv Stud. 2021 DOI https://doi.org/ 10.1055/s-0041-1726473 ISSN 2321-1482

Sterrett J.D., Oliver T., Robinson F., Fortson W., Knaak B., Russell C.M. Width/length ratios of normal clinical crowns of the maxillary anterior dentition in man J Clin Periodontol 1999 26:153-157